Clinical Practice Guidelines for Adult MASLD in Bosnia and Herzegovina: National Recommendations for Diagnosis, Risk Stratification, and Treatment
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease in Bosnia and Herzegovina and a major contributor to liver- and cardiovascular-related morbidity and mortality. These national guidelines provide the first country-specific, evidence-based recommendations for the diagnosis, risk stratification, and management of MASLD, covering the full disease spectrum from steatosis to cirrhosis and its complications. MASLD management is based on a coordinated, stepwise model across primary, secondary, and tertiary healthcare levels, with primary healthcare serving as the central gatekeeper and coordinator of care. Active case-finding of clinically significant fibrosis is emphasized, particularly in high-risk populations, such as individuals with type 2 diabetes mellitus or obesity. Primary healthcare plays a key role in early risk assessment through systematic evaluation of metabolic risk factors and first-line use of simple non-invasive tools, notably the FIB-4 index. A stepwise non-invasive diagnostic algorithm is recommended, with elastography (preferably vibration-controlled transient elastography or 2D shear wave elastography where available) used for further assessment in patients with indeterminate or high-risk results. Lifestyle modification and optimal management of cardiometabolic comorbidities remain the foundations of MASLD treatment. In eligible patients with type 2 diabetes mellitus and/or overweight or obesity,…
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.