Question

A 54-year-old man has persistently elevated ALT and steatosis on ultrasound. He drinks <14 units/week. BMI 33. Most appropriate first-line management?

Accepted Answer

Weight loss and physical activity programme

Answer

Start pioglitazone immediately

Answer

Start metformin regardless of glucose

Answer

Vitamin E supplementation universally

Answer

Liver biopsy immediately

Practice question

A 54-year-old man has persistently elevated ALT and steatosis on ultrasound. He drinks <14 units/week. BMI 33. Most appropriate first-line management?