Ann Hepatol. 2026 Jan 9:102180. doi: 10.1016/j.aohep.2026.102180. Online ahead of print.
ABSTRACT
Over the past few decades, the profile of liver diseases in Africa and the Middle East has undergone significant changes. The incidence of metabolic dysfunction-associated fatty liver disease (MAFLD) has risen to alarming levels. Despite the seriousness of the situation, there is a scarcity of local or regional guidelines established to address it. This document presents the clinical practice guidelines from the African Middle East Association of Gastroenterology (AMAGE) related to the screening, diagnosis, and management of MAFLD. It addresses multiple aspects of managing this condition while taking into account local circumstances and the healthcare system's management requirements. These guidelines are intended for routine clinical use, with a specific focus on particular groups when needed. Abbreviations: ALD, Alcoholic liver disease; ALT, Alanine aminotransferase; AMAGE, African Middle East Association of Gastroenterology; AST, Aspartate transaminase; AUC, Area under the curve; BMI, Body mass index; CAP, Controlled attenuation parameter; CKD, Chronic kidney disease; CRN, Clinical Research Network; CSPH, Clinically significant portal hypertension; CT, Computed tomography; CVD, Cardiovascular diseases; DALY, Disability-adjusted life years; EGD, Esophagogastroduodenoscopy; EUS-PPG, Endoscopic ultrasound-derived portal pressure gradient; FIB-4, Fibrosis-4 Index; FLI, Fatty liver index; FLIP, Fatty Liver Inhibition of Progression; GCKR, Glucokinase regulator gene; GRADE, Grading of Recommendation, Assessment, Development, and Evaluation; HCC, Hepatocellular carcinoma; HDL, High-density lipoprotein; HOMA-IR, Homeostasis model assessment of insulin resistance; hsCRP, High-sensitivity C-reactive protein; HSD17B13, Hydroxysteroid 17-beta dehydrogenase 13; HSI, Hepatic steatosis index; HVPG, Hepatic venous pressure gradient; LSM, Liver stiffness measurement; MAFLD, Metabolic dysfunction-associated fatty liver disease; MASH, Metabolic dysfunction-associated steatohepatitis; MBOAT7, Membrane-bound O-acyltransferase domain-containing 7; MENA, Middle East and North Africa; MRE, Magnetic resonance elastography; MRI, Magnetic resonance imaging; MRI-PDFF, Magnetic resonance imaging-proton density fat fraction; MRS, Magnetic resonance spectroscopy; NAFLD, Non-alcoholic fatty liver disease; NAS, NAFLD activity score; NITs, Non-invasive tests; PH, Portal hypertension; PNPLA3, Patatin-like phospholipase domain-containing 3; SAF, Steatosis, activity, fibrosis (score); SSM, Spleen stiffness measurement; T2DM, Type 2 diabetes mellitus; TM6SF2, Transmembrane 6 superfamily member 2; VCTE, Vibration-controlled transient elastography.
PMID:41520698 | DOI:10.1016/j.aohep.2026.102180