Observational studyDiabetologia2017
EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease in severely obese people: do they lead to over-referral?
Observational study in Diabetologia, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06132477 (Biometabolic Impact of Continuation of GLP-1 Agonists Following Bariatric), which is not on this map. Cited by 58 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Biometabolic Impact of Continuation of GLP-1 Agonists Following Bariatric
Who cites it
58 citing papers in PubMed, 1 synthesis or guideline pooled it, 123 citations in OpenAlex.
- Gut microbiome-based machine learning for diagnostic prediction of liver fibrosis and cirrhosis: a systematic review and meta-analysis.BMC medical informatics and decision making · 2023Pooled it
- Hepatic Steatosis Severity Prediction in Nonobese Individuals: Machine Learning Model Development and Validation.Journal of medical Internet research · 2026Article
- High Prevalence of Metabolic Dysfunction-Associated Steatotic Liver Disease in Patients with Hidradenitis Suppurativa: A Guide to Easily Assess the Clinical Risk of Comorbid Liver Disease.JID innovations : skin science from molecules to population health · 2026Article
- The Vicious Circle of Metabolic Dysfunction-Associated Steatotic Liver Disease When Micronutrient Deficiency Drives Microbial Imbalance and Liver Injury.Life (Basel, Switzerland) · 2025Review
- Lifestyle Intervention Improves Metabolic Dysfunction-Associated Steatotic Liver Disease in Children with Down Syndrome.Nutrients · 2025Article
- Ramadan Fasting and Complications of Metabolic Dysfunction-Associated Steatotic Liver Disease: Impacts on Liver Cirrhosis and Heart Failure.Journal of clinical medicine · 2025Review
- Elevated LECT2 and PEDF in Pediatric MAFLD: Diagnostic Performance and Metabolic Correlations.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Multi-echo three-dimensional (3D) Dixon sequence combined with disodium gadolinium for risk stratification of advanced fibrosis in metabolic dysfunction-associated steatotic liver disease.Quantitative imaging in medicine and surgery · 2024Article
- Ramadan Fasting in Individuals with Metabolic Dysfunction-Associated Steatotic Liver Disease, Liver Transplant, and Bariatric Surgery: A Narrative Review.Journal of clinical medicine · 2024Review
- Supplementation of Micro- and Macronutrients-A Role of Nutritional Status in Non-Alcoholic Fatty Liver Disease.International journal of molecular sciences · 2024Review
- Glutamine prevents high-fat diet-induced hepatic lipid accumulation in mice by modulating lipolysis and oxidative stress.Nutrition & metabolism · 2024Article
- Effects of nonalcoholic fatty liver disease on sarcopenia: evidence from genetic methods.Scientific reports · 2024Article
- Global Trends of Treatment for NAFLD from 2012 to 2021: A Bibliometric and Mapping Analysis.Endocrine, metabolic & immune disorders drug targets · 2024Article
- Article
- Inter-organ crosstalk during development and progression of type 2 diabetes mellitus.Nature reviews. Endocrinology · 2024Review
- Article
- Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes: Screening, Diagnosis, and Treatment.Journal of clinical medicine · 2023Review
- Non-Invasive Measurement of Hepatic Fibrosis by Transient Elastography: A Narrative Review.Viruses · 2023Review
- Unrecognized liver cirrhosis is common and associated with worse survival in hepatocellular carcinoma: A nationwide cohort study of 3473 patients.Journal of internal medicine · 2023Article
- Multiomics study of nonalcoholic fatty liver disease.Nature genetics · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisWe aimed to assess the application of the recent European Association for the Study of the Liver (EASL)-European Association for the Study of Diabetes (EASD)-European Association for the Study of Obesity (EASO) clinical practice guidelines for the management of non-alcoholic fatty liver disease (NAFLD) in severely obese individuals in routine clinical practice.
methodsWe performed a single-centre retrospective observational study of 385 patients referred for severe obesity (BMI ≥ 35 kg/m
resultsWe identified 313 (81.3%) individuals with NAFLD in the cohort. The application of the EASL-EASD-EASO guidelines using NFS would lead to referral to a specialist for up to 289 individuals (75.1%) in the cohort. The combination of NFS and TE measurement reclassified 28 (25%) individuals from the medium/high risk group to low risk and would lead to the referral of 261 (67.7%) individuals to a specialist. These proportions appear to be excessive given the expected prevalence of advanced fibrosis and non-alcoholic steatohepatitis (NASH) of around 10% and 30%, respectively, in the severely obese population. CONCLUSIONS/
interpretationThis is the first study to assess the strategy proposed by the EASL-EASD-EASO clinical practice guidelines for the management of NAFLD in severely obese individuals. The retrospective application of the guidelines in a cohort representing the routine clinical practice in our department would lead to an excessive number of specialist referrals and would also lead to an unjustified increase in health costs. Biomarkers and specific strategy for the screening of NASH and advanced fibrosis in morbidly obese individuals are thus crucially needed and would help to improve the actual guidelines.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.