The global increase in the incidence of metabolic dysfunction-associated steatotic liver disease (MASLD), which affects more than one-third of the general population and up to 70% of individuals with type 2 diabetes or obesity, is a critical public health challenge. Given that liver steatosis is often asymptomatic until the advanced stages of disease, early detection is essential to prevent its progression to fibrosis, cirrhosis and, ultimately, hepatocellular carcinoma. However, liver biopsy, the gold-standard diagnostic method, is invasive, costly, and unsuitable for large-scale screening. As a result, noninvasive tests have emerged as practical alternatives, particularly in primary care settings, where early identification is most feasible. The present study explored current perspectives of noninvasive liver disease screening tools and their implementation in primary care. Serum-based indices, along with imaging techniques, have demonstrated promise in identifying patients with advanced fibrosis. Novel biomarkers, including the enhanced liver fibrosis test and Pro-C3, as well as emerging artificial intelligence-assisted diagnostic platforms, yield improved accuracy and risk stratification potential. Despite accumulating evidence supporting the clinical utility and cost-effectiveness of noninvasive tests, several barriers hinder their routine use in primary care settings, which include limited funding, lack of standardized guidelines, insufficient clinician training, and disparities in access to diagnostic tools. The implementation of structured stepwise screening models has demonstrated improved diagnostic efficiency and reduced unnecessary referrals. Future research should emphasize the integration of artificial intelligence, portable diagnostic devices, and personalized risk models to enhance early detection. Ensuring widespread adoption requires coordinated efforts in policy development, provider education, and health-system investment. Noninvasive screening tools offer a feasible and cost-effective pathway for the early detection of MASLD in primary care; however, their successful implementation depends on addressing logistical, educational, and systemic barriers.
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Methods This study analyzed Data from the Korea National Health and Nutrition Examination Survey 2010–2011. We investigated 3,045 premenopausal women aged 19–59 years. Liver function markers including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase, and fatty liver index were analyzed. Multivariable logistic regression analysis was performed to investigate the association between liver function markers and menstrual cycle irregularity while adjusting for confounding factors. Values were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analysis was also performed.
Results Baseline characteristic analysis showed that approximately 14.4% of the study population experienced menstrual cycle irregularity. The mean age was 34.5±0.7 years. The highest quartile of serum ALT and AST levels showed significantly higher ORs for menstrual cycle irregularity (adjusted OR, 1.83; 95% CI, 1.26–2.64 and adjusted OR, 1.67; 95% CI, 1.17–2.39, respectively). A similar result was observed in the subgroup analysis.
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Background Many studies have assessed the risk factors for adverse drug reactions (ADRs) in elderly patients. However, most of these studies have focused on risk factors for ADRs, not serious ADRs (s-ADRs). s-ADRs are commonly found in hospitalized patients. s-ADRs warrant imminent but thorough investigations, given their critical impact on patient health. Therefore, this retrospective study aimed to assess the associated risk factors for s-ADRs in elderly hospitalized patients.
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Results There were 353 cases of ADRs, 67 of which were s-ADRs. Patients taking more than eight concomitant drugs showed the highest odds ratio (OR, 11.99; 95% confidence interval [CI], 3.42–42.03). The ratio of aspartate aminotransferase (AST)/alanine aminotransferase (ALT) was also significantly related to s-ADRs (OR, 2.78; 95% CI, 1.33–5.81). The use of antibiotics (OR, 2.39; 95% CI, 1.13–5.02) and antineoplastics (OR, 4.17; 95% CI, 1.09–15.94) were significant risk factors.
Conclusion Our findings highlight the importance of polypharmacy. Liver function tests (AST/ALT ratio) must be monitored carefully within high-risk groups for ADRs.
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Background : Fatty liver, the most possible cause for an elevated hepatic aminotransferase level once hepaitis B, hepatitis C, and the drug induced hepatitis were excluded, is supposed to have association with obesity as well as ingestion of alcohol. This study was performed to find an epidemiologic evidence for the association between obesity and fatty liver.
Methods : A case-control study was carried out on 160 cases matched for age and sex with 160 controls in a tertiary care hospital family practice clinic. Patients who had either an elevated aminotransferase level (> 45 IU/L) at two separate times of at one time with ultrasonic evidence compatible to fatty liver without any evidence of other causes that might affect the liver were included into case group. Information on the height, weight, cholesterol level, alcohol consumption, smoking, physical exericise, and past medical history were obtained through a review of medical records and self administered questionnaire. Multiple logistic regression analysis were used to evaluate the independent association.
Results : With the increase of body mass index (BMI), the association between BMI and an elevated aminotransferase level suspected of fatty liver increased. Significantly increased associations were observed in BMI levels 25-29 kg/m² (Odds ratio[OR], 5.02; 95% confdence interval[CI], 1,49-16.93) and more than 30 kg/m² (OR, 14.87; 95% CI, 2.58-85.62). Consuming large amount of alcohol (> 60g/day) and increasing cholesterol level were also significantly associated with eleveted aminotransferase level suspected of fatty liver.
Conclusion : Factors associated with elevated aminotransferase level suspected of fatty liver were heavy drinking, cholesterol level, and BMI. Large OR observed in high BMI levels(over 25 kg/m²) and dose-response relationship with BMI seem to suggest a causal relationship between obesity and fatty liver.
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