Letter to the editor June 10, 2024 June 10, 2024

Response to the letter to the editor Fibrosis or steatosis: which is the best screening target? Comment on the Brazilian evidence-based guideline for screening, diagnosis, treatment, and follow-up of metabolic dysfunction-associated steatotic liver disease (MASLD) in adult individuals with overweight or obesity

DOI: 10.20945/2359-4292-2024-0093

DEAR EDITOR AND COLLEAGUES,

The letter by Mateus Severo raises important questions regarding the screening and diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) in adult individuals with overweight or obesity. The points presented in the letter have been discussed in detail by the authors during the Brazilian Evidence-Based guideline elaboration () and deserves further clarification.

Liver steatosis is the most common manifestation and the hallmark feature of MASLD. It is now considered to be an independent risk factor for cardiovascular diseases () and it is also strongly correlated to metabolic disturbances (). Therefore, it may indicate that overweight and obese individuals with liver steatosis deserves a specific and individualized approach. Although the authors strongly agree that the identification of liver fibrosis is one of the major goals in the evaluation of patients with MASLD, they also reinforce that screening for liver steatosis should not be neglected.

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