The global increase in the incidence of metabolic dysfunction-associated steatotic liver disease (MASLD), which affects more than one-third of the general population and up to 70% of individuals with type 2 diabetes or obesity, is a critical public health challenge. Given that liver steatosis is often asymptomatic until the advanced stages of disease, early detection is essential to prevent its progression to fibrosis, cirrhosis and, ultimately, hepatocellular carcinoma. However, liver biopsy, the gold-standard diagnostic method, is invasive, costly, and unsuitable for large-scale screening. As a result, noninvasive tests have emerged as practical alternatives, particularly in primary care settings, where early identification is most feasible. The present study explored current perspectives of noninvasive liver disease screening tools and their implementation in primary care. Serum-based indices, along with imaging techniques, have demonstrated promise in identifying patients with advanced fibrosis. Novel biomarkers, including the enhanced liver fibrosis test and Pro-C3, as well as emerging artificial intelligence-assisted diagnostic platforms, yield improved accuracy and risk stratification potential. Despite accumulating evidence supporting the clinical utility and cost-effectiveness of noninvasive tests, several barriers hinder their routine use in primary care settings, which include limited funding, lack of standardized guidelines, insufficient clinician training, and disparities in access to diagnostic tools. The implementation of structured stepwise screening models has demonstrated improved diagnostic efficiency and reduced unnecessary referrals. Future research should emphasize the integration of artificial intelligence, portable diagnostic devices, and personalized risk models to enhance early detection. Ensuring widespread adoption requires coordinated efforts in policy development, provider education, and health-system investment. Noninvasive screening tools offer a feasible and cost-effective pathway for the early detection of MASLD in primary care; however, their successful implementation depends on addressing logistical, educational, and systemic barriers.

Citations

• A transdisciplinary framework for managing metabolic dysfunction associated steatotic liver disease
  Sania Kouser, Sanketh V. Sharma, Arun Bhanu, Subrahmanya Kumar Kukkupuni, Chethala N. Vishnuprasad
  Frontiers in Pharmacology.2026;[Epub]     CrossRef
• Alcohol Abstinence Is Associated with Regression of Non-Invasive Fibrosis Markers in Patients with Metabolic Syndrome: A 12-Month Prospective Study
  Daniela Mihăilă, Horațiu-Paul Domnariu, Doru-Florian-Cornel Moga, Carmen-Daniela Domnariu
  Journal of Clinical Medicine.2026; 15(6): 2257.     CrossRef
• AI/ML-enabled biosensing platforms for MASLD and MASH: Biomarkers, modalities, and translational readiness
  Parkhi Disha, R. Harikrishnan, Sampada Tavse, P. Srideviponmalar
  Biosensors and Bioelectronics: X.2026; 31: 100808.     CrossRef
• Insulin Resistance as a Dynamic Correlate of Fibrosis Status in Chronic Hepatitis B: A Visit-Level Longitudinal Risk Stratification Framework
  Abdalwahab Omar Alshammari, Idris Adewale Ahmed
  Life.2026; 16(6): 939.     CrossRef
• Imaging-based fibrosis assessment and risk stratification in MASLD
  Shunqin Jin, Tao Zhou, Dachuan Jin, Jiahao Xie, Guoping Sheng, Hongzhi Li, Guangming Li, Chuan Qin, Peng Gao
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Artificial intelligence in primary care in Poland: opportunities, challenges, and public health policy implications
  Praveen Malik, Adam Bednarek, Katarzyna Bednarek
  Polish Journal of Public Health.2026; 136: 66.     CrossRef
• Towards early detection and prevention: proactive screening strategies in primary care
  Su Hwan Cho
  Korean Journal of Family Medicine.2025; 46(6): 379.     CrossRef

Background
Skipping breakfast is associated with an increased risk of chronic inflammatory diseases. This study aimed to examine the association between breakfast-eating habits and inflammation, using high-sensitivity C-reactive protein (hs-CRP) as a marker.
Methods
A total of 4,000 Korean adult males with no history of myocardial infarction, angina, stroke, diabetes, rheumatoid arthritis, cancer, or current smoking were included. Data from the 2016–2018 Korea National Health and Nutrition Examination Survey were used for analysis. The frequency of breakfast consumption was assessed through a questionnaire item in the dietary survey section asking participants about their weekly breakfast consumption routines over the past year. Participants were categorized into two groups, namely “0–2 breakfasts per week” and “3–7 breakfasts per week”; hs-CRP concentrations were measured through blood tests.
Results
Comparing between the “infrequent breakfast consumption (0–2 breakfasts per week)” and “frequent breakfast consumption (3–7 breakfasts per week)” groups, the mean hs-CRP was found to be significantly higher in the “infrequent breakfast consumption” group, even after adjusting for age, body mass index, physical activity, alcohol consumption, systolic blood pressure, blood pressure medication, fasting blood glucose, and triglycerides (mean hs-CRP: frequent breakfast consumption, 1.36±0.09 mg/L; infrequent breakfast consumption, 1.17±0.05 mg/L; P-value=0.036).
Conclusion
Less frequent breakfast consumption was associated with elevated hs-CRP levels. Further large-scale studies incorporating adjusted measures of daily eating patterns as well as food quality and quantity are required for a deeper understanding of the role of breakfast in the primary prevention of chronic inflammatory diseases.

Citations

• Cumulative circadian disruption factors and metabolic syndrome
  Jungun Lee
  Korean Journal of Family Medicine.2025; 46(3): 125.     CrossRef

Background
The present study aimed at identifying the difference in the risk of microalbuminuria among individuals with various obesity phenotypes in terms of metabolic health and obesity.
Methods
This cross-sectional study included 15,268 individuals and used data from the National Health and Nutrition Survey conducted from 2011 to 2014. Obesity was defined as body mass index ≥25 kg/m². Metabolically unhealthy was defined as meeting two or more of the following criteria: systolic and diastolic blood pressure ≥130/85 mm Hg or current use of hypertensive drugs; triglyceride level ≥150 mg/dL; high-density lipoprotein level <40/50 mg/dL (in both men and women); and fasting blood glucose level ≥100 mg/dL or current use of oral antidiabetic medications. The participants were further classified into four subgroups: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO).
Results
A significant difference was observed in the microalbuminuria ratio among the four groups. The MHNO group was considered as the reference group, and the MHO, MUNO, and MUO groups were at an increased risk for microalbuminuria by 1.42 fold (95% confidence interval [95% CI], 1.03–1.96), 2.02 fold (95% CI, 1.61–2.53), and 3.40 fold (95% CI, 2.70–4.26), respectively, after adjusting confounding factors.
Conclusion
The MUNO group had a higher risk of developing microalbuminuria than the MHNO group. Thus, based on this result, differences were observed in the risk of developing microalbuminuria among individuals with various obesity subtypes.

Citations

• National trends of metabolically healthy and unhealthy obesity before and during the COVID-19 pandemic, 2007 to 2021: A representative serial study in South Korea
  Ji Ho Kim, Yesol Yim, Hyunyi Yoo, Hyunjeong Kim, Selin Woo, Yerin Hwang, Dong Keon Yon
  Medicine.2026; 105(9): e47797.     CrossRef
• Metabolically healthy obesity is associated with higher risk of both hyperfiltration and mildly reduced estimated glomerular filtration rate: the role of serum uric acid in a cross-sectional study
  Hong Zhang, Rui Chen, Xiaohong Xu, Minxing Yang, Wenrong Xu, Shoukui Xiang, Long Wang, Xiaohong Jiang, Fei Hua, Xiaolin Huang
  Journal of Translational Medicine.2023;[Epub]     CrossRef
• Association Between Chinese Visceral Adipose Index and Albuminuria in Chinese Adults: A Cross-Sectional Study
  Fang Yu, Aizhong Liu, Zhiming Deng, Shenglian Gan, Quan Zhou, Haowen Long
  International Journal of General Medicine.2023; Volume 16: 2271.     CrossRef
• Association between Adiposity Indexes and Kidney Disease: Findings from the Longitudinal Study of Adult Health (Elsa-Brazil)
  Alexandra Dias Moreira, Gustavo Velasquez-Melendez, Roberto Marini Ladeira, Geraldo Bezerra da Silva Junior, Maria de Jesus Fonseca, Sandhi Maria Barreto
  Journal of the American Nutrition Association.2022; 41(3): 275.     CrossRef