Table 2

 Investigations of suspected NAFLD/NASH

1. Basic profile—full blood count, liver function tests, urea and electrolytes, INR
2. Serum lactate, pyruvate, urate
3. Serum copper, caeruloplasmin, 24 hour urinary copper
4. HBV, HCV serology
5. CF alleles, (sweat test if symptoms suggest CF or heterozygous genetic result)
6. α1 antitrypsin phenotype
7. Plasma fatty acids and acyl carnitine profile
8. Urinary steroid metabolites
9. Abnormal glucose tolerance test (GTT)
    Basal >7.0 mmol/l
    2 hour peak after 75 g (1 g/kg) glucose >7.8 mmol/l
10. Hyperinsulinism on GTT (85% of subjects)
    Basal >50
    At 30–120 min >100
11. Specific tests as suggested by history and examination
12. Liver biopsy
13. Investigations specific to rare metabolic conditions and as indicated by other results including liver biopsy