Management of NAFLD: a stage-based approach

Nat Rev Gastroenterol Hepatol. 2016 Apr;13(4):196-205. doi: 10.1038/nrgastro.2016.3. Epub 2016 Feb 24.


NAFLD is the most prevalent form of liver disease in the USA, affecting an estimated 30% of the population. The condition is associated with increased mortality related to cardiovascular disease, malignancy and liver disease. Identification of patients who might be at increased risk of adverse outcomes is critical as it is not feasible to screen all patients with suspected NAFLD. Patients with NASH, the progressive subtype of NAFLD, should be targeted for treatment, especially if they have concomitant fibrosis because such patients are more likely than those without fibrosis to have adverse outcomes. Treatment goals in patients with NAFLD vary depending on the disease stage owing to differential risk of progression and the particularities of an individual's comorbid disease. Lifestyle intervention is important for all patients irrespective of disease stage, but other therapies should be targeted to those most likely to benefit. In this Review, we highlight risk factors for disease progression and offer a stage-based treatment approach for patients with NAFLD.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Bariatric Surgery
  • Combined Modality Therapy
  • Diet Therapy
  • Disease Progression
  • Exercise Therapy
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Non-alcoholic Fatty Liver Disease / diagnosis
  • Non-alcoholic Fatty Liver Disease / etiology
  • Non-alcoholic Fatty Liver Disease / physiopathology
  • Non-alcoholic Fatty Liver Disease / therapy*
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index


  • Gastrointestinal Agents