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if indeterminate or high, arrange an Enhanced Liver Fibrosis (ELF) blood test Refer to hepatology if advanced fibrosis is suspected or confirmed on ELF testing Provide lifestyle modification advice focusing on weight loss (710% body weight), Mediterranean-style diet, and increased physical activity (150 minutes of moderate-intensity exercise weekly, in line with NHS guidelines) Advise on alcohol intake in line with UK Chief Medical Officers' guidance (no more than 14 units per week, spread over 3 or more days) Optimise management of diabetes, hypertension, and dyslipidaemia Reassure you that statins are safe and should not be withheld in NAFLD when clinically indicated Patient safety advice : If you develop jaundice (yellowing of skin or eyes), severe abdominal pain, confusion, or vomiting blood, seek urgent medical attention as these may indicate serious liver complications requiring immediate assessment

Real-time PCR Total RNA was isolated from the cells using the Roche High Pure RNA isolation kit (Roche Life Science, 11828665001) and reverse transcription was performed using the iScript cDNA synthesis kit (Bio-Rad, 1708891) according to the manufacturers instructions

Patients want them

About the study The study was conducted using the Merative MarketScan Commercial and Medicare Research Databases covering 2018 through 2023

Although approved only for treating diabetes, the drug can be used off-label meaning it can be used for something that it has not been approved for in many countries, including Singapore

Linagliptin, a xanthine-based dipeptidyl peptidase-4 inhibitor with an unusual profile for the treatment of type 2 diabetes