Objective:

To assess the application of non-invasive tests, specifically the enhanced liver fibrosis (ELF) test and liver stiffness measurement (LSM), in at-risk populations, including those with type II diabetes mellitus and hazardous alcohol use, to identify clinically important disease related to steatotic liver disease.

Approach:

• Study Design: Service evaluation report conducted in Leeds, UK, assessing patients from a community diabetes clinic and alcohol treatment services.
• Testing Methodology: Patients were offered enhanced liver fibrosis (ELF) testing alongside routine assessments, with those scoring ≥9.5 referred for liver stiffness measurement (LSM).

Key Findings:

• 972 patients were assessed, with 325 undergoing both ELF and LSM.
• 45% of patients from the diabetes service had ELF scores below 9.5; only 7.9% had LSM readings ≥15 kPa.
• 72% of patients from the alcohol service had ELF scores below 9.5; 31% had LSM values ≥15 kPa.

Interpretation:

The study provides data on the application of ELF and LSM in screening at-risk populations, highlighting differences in ELF scores between diabetic patients and those with hazardous alcohol use.

Limitations:

• The study is limited to specific populations in Leeds, UK, which may not be generalizable to other regions or populations.
• The reliance on ELF and LSM may not capture all cases of advanced liver disease, potentially leading to missed diagnoses.

Conclusion:

Identifying at-risk individuals through non-invasive tests may enhance early diagnosis of steatotic liver disease, though further validation in broader populations is needed.