{
  "society": "APASL",
  "version": "2024",
  "publication_date": "2024-09-15",
  "title": "APASL 2024 clinical practice guidance for MASLD in Asia-Pacific",
  "status": "published",
  "recommendations": [
    {
      "recommendation_id": "APASL-2024-R01",
      "topic": "definition",
      "text_en": "APASL adopts MASLD nomenclature; emphasizes Asian BMI cutoffs (overweight >= 23, obese >= 25).",
      "text_kr_summary": "APASL MASLD 채택; 아시아 BMI 23/25.",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["37363821"],
      "related_nits": [],
      "related_drugs": []
    },
    {
      "recommendation_id": "APASL-2024-R02",
      "topic": "screening",
      "text_en": "Screen Asian adults with BMI >= 23 plus >= 1 cardiometabolic factor using FIB-4.",
      "text_kr_summary": "BMI>=23 + 심대사 위험인자 시 FIB-4 선별.",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["33271056"],
      "related_nits": ["FIB-4"],
      "related_drugs": []
    },
    {
      "recommendation_id": "APASL-2024-R03",
      "topic": "fib4_cutoff",
      "text_en": "FIB-4 < 1.3 low risk; > 2.67 high risk; for Asian populations age >=65 use 2.0.",
      "text_kr_summary": "아시아인 65세 이상 FIB-4 2.0.",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["17326139"],
      "related_nits": ["FIB-4"],
      "related_drugs": []
    },
    {
      "recommendation_id": "APASL-2024-R04",
      "topic": "lsm_cutoff",
      "text_en": "VCTE LSM: < 8 kPa exclude; 8-12 kPa indeterminate; >= 12 kPa advanced fibrosis (Asian validated).",
      "text_kr_summary": "LSM 8/12 kPa 아시아 검증.",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["32492533"],
      "related_nits": ["LSM"],
      "related_drugs": []
    },
    {
      "recommendation_id": "APASL-2024-R05",
      "topic": "weight_loss",
      "text_en": "Weight loss target 5-7% in Asian populations sufficient for steatosis improvement.",
      "text_kr_summary": "아시아인 체중감소 5-7%로 지방 호전.",
      "strength": "strong",
      "evidence_grade": "A",
      "cite_pmids": ["25865049"],
      "related_nits": [],
      "related_drugs": []
    },
    {
      "recommendation_id": "APASL-2024-R06",
      "topic": "glp1",
      "text_en": "GLP-1 RA (semaglutide) recommended for Asian MASLD patients with T2DM; consider lower starting dose.",
      "text_kr_summary": "아시아 T2DM MASLD 세마글루타이드 (저용량 시작).",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["33185364"],
      "related_nits": [],
      "related_drugs": ["semaglutide"]
    },
    {
      "recommendation_id": "APASL-2024-R07",
      "topic": "monitoring",
      "text_en": "Annual FIB-4 in T2DM; biennial in non-diabetic.",
      "text_kr_summary": "T2DM 매년, 비당뇨 격년 FIB-4.",
      "strength": "conditional",
      "evidence_grade": "C",
      "cite_pmids": ["33340572"],
      "related_nits": ["FIB-4"],
      "related_drugs": []
    },
    {
      "recommendation_id": "APASL-2024-R08",
      "topic": "hcc_screening",
      "text_en": "HBV-MASLD double etiology cases require HCC surveillance from F2 onward (lower threshold than Western).",
      "text_kr_summary": "HBV+MASLD F2부터 HCC 감시.",
      "strength": "strong",
      "evidence_grade": "B",
      "cite_pmids": ["29624699"],
      "related_nits": [],
      "related_drugs": []
    },
    {
      "recommendation_id": "APASL-2024-R09",
      "topic": "cap_steatosis",
      "text_en": "CAP cutoffs Asian validated: 248/268/280 dB/m for steatosis grading.",
      "text_kr_summary": "CAP 아시아 248/268/280.",
      "strength": "conditional",
      "evidence_grade": "B",
      "cite_pmids": ["28986335"],
      "related_nits": ["CAP"],
      "related_drugs": []
    },
    {
      "recommendation_id": "APASL-2024-R10",
      "topic": "metabolic_surgery",
      "text_en": "Metabolic surgery may be considered in BMI >= 32.5 kg/m^2 Asian patients with MASLD/MASH.",
      "text_kr_summary": "아시아인 BMI>=32.5 MASLD에 대사수술 고려.",
      "strength": "conditional",
      "evidence_grade": "B",
      "cite_pmids": ["31430417"],
      "related_nits": [],
      "related_drugs": []
    }
  ]
}