When is NAFLD screening considered in obese youth?

When is NAFLD screening considered in obese youth?

• A. If liver enzymes are elevated or in the presence of metabolic risk factors; screen with ALT as a starting point; imaging if indicated
• B. Only if symptoms of jaundice appear
• C. Routine for all children universally
• D. Only in adults over 40

Answer: (A)

In obese youth, screening for NAFLD is considered when there are metabolic risk factors or when liver tests show elevated enzymes. ALT is the preferred starting test because it can signal hepatocellular injury related to fatty liver. If ALT is elevated or metabolic risk factors cluster, imaging such as liver ultrasound (and sometimes MRI) may be used to assess fatty infiltration and guide management. Universal screening of all children isn’t recommended, and jaundice is not a reliable trigger in this population since NAFLD often presents without symptoms.

In obese youth, screening for NAFLD is considered when there are metabolic risk factors or when liver tests show elevated enzymes. ALT is the preferred starting test because it can signal hepatocellular injury related to fatty liver. If ALT is elevated or metabolic risk factors cluster, imaging such as liver ultrasound (and sometimes MRI) may be used to assess fatty infiltration and guide management. Universal screening of all children isn’t recommended, and jaundice is not a reliable trigger in this population since NAFLD often presents without symptoms.