4 Out of 10 Fatty Liver Patients Receive No Follow-up; Only 12% of High-Risk Patients Undergo Detailed Examinations

National Institute of Health: 80% of Domestic Cases Discovered Incidentally During Health Checkups
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Urgent Need for a Screening System for Liver Fibrosis

It has been found that 4 out of 10 domestic patients diagnosed with fatty liver take no follow-up measures after their diagnosis. In particular, there are concerns about a serious gap in post-diagnosis management, as even high-risk patients—who require thorough monitoring due to complications such as diabetes or obesity—rarely undergo detailed examinations.

On May 28, the Korea Disease Control and Prevention Agency’s National Institute of Health announced the findings of an analysis on “Treatment Linkage and Guideline Implementation Status Among Domestic Fatty Liver Patients.” The study was conducted by Professor Jeon Daewon’s research team at Hanyang University in collaboration with Professor Oh Joohyun of CHA Hospital, Professor Lee Junhyuk of Nowon Eulji University Hospital, and the research team at Medichek Research Institute of the Korea Association of Health Promotion.

This study analyzed the results of a survey of 12,946 Korean adults, selecting a final sample of 1,000 respondents who stated they had steatotic liver disease (SLD).

According to the findings, 79.9% of all fatty liver patients discovered the disease incidentally through routine health checkups, without any particular symptoms. However, only 57.7% of these patients actually visited a medical institution and began follow-up care (treatment linkage rate), while the remaining 42.3% took no action after the diagnosis.

The most common reason for not visiting a hospital after diagnosis was “I did not think my fatty liver was serious” (41.6%), followed by “I believed I could manage it myself” (23.9%), and “I did not receive recommendations for additional tests or follow-up management from healthcare professionals” (23.9%). This indicates that many people do not recognize fatty liver as a warning sign for metabolic disorders or cardiovascular disease.

Only 14.9% of patients who received follow-up care underwent a liver fibrosis test, which is a core component of fatty liver management. Among high-risk patients—those with type 2 diabetes, obesity, repeated elevations in liver enzymes, or cardiometabolic risk factors—only 12.1% underwent the liver fibrosis test, despite guidelines recommending close monitoring.

The liver fibrosis test is an advanced examination that measures the process of the liver becoming stiff due to damage, helping predict the risk level of the disease. This demonstrates that the liver fibrosis test, which is recommended by guidelines after a fatty liver diagnosis, is not being sufficiently conducted in real-world clinical settings, especially at primary care institutions (where the testing rate was 10.6%).

The research team emphasized, “Because fatty liver rarely presents symptoms, it is often detected incidentally during health checkups, but some of these cases may already be at high risk of liver fibrosis. It is important not to stop at simply detecting fatty liver, but to have a system that identifies patients who need further testing and ensures they actually receive these tests.”

If a patient is diagnosed as being in the pre-cirrhosis stage through a liver fibrosis test, it is essential to achieve a weight reduction of 7–10% through active lifestyle modifications and to continue regular follow-up examinations.

Kim Wonho, Director of the Division of Convergence Research on Chronic Diseases at the National Institute of Health, stated, “Through this study, we confirmed that even high-risk patients are not undergoing liver fibrosis tests in real-world clinical practice, despite guideline recommendations. Going forward, we plan to pursue implementation research that can be applied in healthcare settings, such as improving systematic management pathways, in order to reduce the risk of cardiovascular disease and mortality.”

This content was produced with the assistance of AI translation services.