Recruiting nowNot applicableObservational
What this study is about
GRIPonMASH will assist (primary) health care providers clinicians to implement the latest patient care pathway, as described by the European Association for the Study of the Liver (EASL), to identify patients at risk of severe metabolic dysfunction-associated steatotic liver disease (MASLD) and to raise awareness. The primary objective is to implement a transmural patient care pathway, in order to identify patients with MASLD and its progressive form metabolic dysfunction-associated steatohepatitis (MASH) in primary care centres and clinics in 10 European countries.
A promising-looking record is not the same as confirmed eligibility. The study team must review the full criteria and current recruitment status.
Basic eligibility
Age18 Years to 75 Years
SexAll
Healthy volunteersNot accepted
ConditionMASH, MASLD, MASH With Fibrosis, Fibrosis, Liver, Steatosis of Liver, Type 2 Diabetes, Obesity, Metabolic Syndrome, Arterial Hypertension
Full registry criteria
Inclusion Criteria: * Newly diagnosed subjects should fulfil criteria for diagnosis of type 2 diabetes mellitus or metabolic syndrome or obesity or arterial hypertension, following the study definitions. * Subjects that are currently being treated for type 2 diabetes mellitus or metabolic syndrome or obesity or arterial hypertension, should have had a prior diagnosis based on study definitions. Study definitions: Type 2 diabetes mellitus * At least 2 times a fasting glucose \> 7,0 mmol/L * Or elevated non-fasting glucose \>11,1 mmol/L 2 hrs after OGTT * Or HbA1c ≥48 mmol/mol (≥6.5%) * Or being actively treated for previously diagnosed type 2 diabetes by a health care provider Obesity * Body mass index (BMI) \> 30 * Or waist circumferences Caucasian: male ≥ 94 cm, female ≥ 80 cm South-Asian/Chinese: male ≥90 cm, female ≥80 cm Japanese: male ≥85 cm, female ≥90 cm Arterial hypertension * Systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg * Or being actively treated for previously diagnosed arterial hypertension by a health care provider Metabolic syndrome \- Central obesity defined as waist circumference (see above), if BMI is \>30 kg/m2, central obesity can be assumed and waist circumference does not need to be measured AND any two of the following: * Raised triglycerides: ≥ 150 mg/dL (1.7 mmol/L), or specific treatment for this lipid abnormality * Reduced HDL cholesterol: \< 40 mg/dL (1.03 mmol/L) in males, \< 50 mg/dL (1.29 mmol/L) in females, or specific treatment for this lipid abnormality * Raised blood pressure (BP): systolic BP ≥ 130 or diastolic BP ≥ 85 mm Hg, or treatment of previously diagnosed hypertension * Raised fasting plasma glucose (FPG): FGP ≥ 100 mg/dL (5.6 mmol/L), or previously diagnosed type 2 diabetes (if above \>5.6 mmol/L or 100 mg/dL, an oral glucose tolerance test is strongly recommended, but is not necessary to define presence of the syndrome) Exclusion Criteria: * The patient is known with hepatitis B, C or HIV or any other liver condition (like hemochromatosis, sarcoidosis, Wilson's disease etc); * The patient is known with any other condition that may lead to liver fibrosis or cirrhosis; * The patient engages in (excessive) alcohol use: \> 3 units/day in males \[30 grams/day\] and \> 2 units/day in females \[20 grams/day\]; * The patient has a history or evidence of any other clinically significant condition or planned or expected procedure that in the opinion of the Investigator, may compromise the patient's safety or ability to be included in this study; * The patient is an employee or contractor of the facility that is conducting the study or is a family member of the Investigator, sub-Investigator, or any Sponsor personnel; * The patient is not able to understand the details of the protocol and/or is not able to provide written informed consent; * The patient is pregnant or breastfeeding. * The patient underwent bariatric surgery in the last 12 months.
Primary outcomes
Prevalence of liver steatosis and MASLD estimated by FibroScan CAP in patients at riskBaselineSteatosis grade deduced from controlled attenuation parameter (CAP) measurement with Fibroscan
Prevalence of liver fibrosis estimated by FibroScan LSM in patients at riskBaselineFibrosis stage deduced from liver stiffness measurement (LSM) by vibration controlled transient elastography (VCTE) measurement with Fibroscan
Prevalence of at-risk MASH estimated by FAST score in patients at riskBaselineAt-risk MASH deduced from FAST score
*Subset of patients: prevalence of MASH in patients at risk16 or 30 weeksMASH diagnosis confirmed by histology (NAS/SAF criteria) upon liver biopsy; only in patients with \>12 kPa at 1st FibroScan or \>=8 kPa at 2nd FibroScan
Comparison of the prevalence of MASLD, liver fibrosis and (at-risk) MASH between the participating countriesBaseline (1-3) to 16/30 weeks for biopsy-confirmed MASH (4)Prevalence (see outcome 1-4) stratified per country
Evaluate added value of a 2-step pathway as compared to FibroScan only for detection of high-risk patientsBaselineNumber of patients at risk identified by FIB-4 compared to numbers found using LSM by VCTE with FibroScan measurements, and numbers found in combination