Non-alcoholic fatty liver disease (NAFLD): summary of NICE guidance

  title={Non-alcoholic fatty liver disease (NAFLD): summary of NICE guidance},
  author={Jessica Glen and Lefteris Floros and Chris Day and Rachel Pryke},
  journal={British Medical Journal},
#### What you need to know There has been a lack of national guidance and care pathways for primary care on when to offer testing for NAFLD. Investigation and referral of suspected NAFLD vary widely. There is currently no licensed treatment for NAFLD, and most people are managed by their general practitioner with a focus on lifestyle advice such as weight loss. Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disease from fatty liver to non-alcoholic steatohepatitis, fibrosis, and… 

Non-invasive imaging techniques in assessing non-alcoholic fatty liver disease: a current status of available methods

Ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), elastography, and spectroscopy will be discussed in order to lay out the advantages and disadvantages of their diagnostic potential and application.

Current Modalities of Fibrosis Assessment in Non-alcoholic Fatty Liver Disease

This review discusses, comprehensively, the various tools available to the clinician for the assessment of fibrosis, including the various scoring systems used in liver biopsy, the non-invasive means of serum biomarkers, such as the highly-validated NAFLD fibrosis score, and the imaging-based modalities,such as transientElastography and magnetic resonance elastography.


The epidemiology, risk factors, sign & symptoms diagnosis & finally draw a conclusion of nonalcoholic fatty liver disease are discussed.

Treatments for NAFLD: State of Art

A narrative review discusses in detail the different available approaches with the potential to prevent and treat non-alcoholic fatty liver disease and its advanced forms.

Screening for Nonalcoholic Fatty Liver Disease in the Primary Care Clinic.

A tripartite algorithm is described to help PCPs identify patients with NAFLD using liver enzymes and abdominal ultrasound, assess the presence of advanced liver fibrosis using clinical prediction rules, and, if appropriate, determine when to refer patients to specialist care.

Applying Non-Invasive Fibrosis Measurements in NAFLD/NASH: Progress to Date

This review provides a concise overview of different non-invasive measurements used for NAFLD/NASH and considers Liver biopsy, considered the ‘gold standard’ in the diagnosis ofNAFLD, as a critical element of risk stratification needed to determine therapeutic approach and also the response to treatment.

Dietary patterns in non-alcoholic fatty liver disease (NAFLD): Stay on the straight and narrow path!

  • N. KatsikiA. StoianM. Rizzo
  • Medicine
    Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis
  • 2022

SWOT analysis of noninvasive tests for diagnosing NAFLD with severe fibrosis: an expert review by the JANIT Forum

The JANIT Forum identified currently available NITs able to accurately select NAFLD patients at high risk of NASH for HCC surveillance/therapeutic intervention and evaluate the effectiveness of therapeutic interventions.

Non-alcoholic fatty liver disease in pregnancy

A 24-year-old woman in her first pregnancy who presented with non-specific symptoms and raised alanine aminotransferase with ultrasonography of her liver showing changes of steatosis and suspicious for cirrhosis, leading to a diagnosis of NAFLD is described.

Non-invasive methods to evaluate liver fibrosis in patients with non-alcoholic fatty liver disease

This review introduces the non-invasive methods, summarizes their benefits and limitations, and assesses their diagnostic performance for NAFLD-induced fibrosis.



Epidemiology of Non-Alcoholic Fatty Liver Disease

The majority of individuals with NAFLD do not develop NASH, and noninvasive markers such as the fatty liver index obtained from the Dionysos Study may be useful to screen forNAFLD in the general population.

The natural history of non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years

Children with NAFLD may develop end-stage liver disease with the consequent need for liver transplantation andNAFLD in children seen in a tertiary care centre may be associated with a significantly shorter survival as compared to the general population.

Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies.

Global epidemiology of nonalcoholic fatty liver disease—Meta‐analytic assessment of prevalence, incidence, and outcomes

As the global epidemic of obesity fuels metabolic conditions, the clinical and economic burden of NAFLD will become enormous, and random‐effects models were used to provide point estimates of prevalence, incidence, mortality and incidence rate ratios.

The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis

The review suggests the prevalence of non-alcoholic fatty liver disease in young people is high, particularly in those who are obese and in males, with estimated prevalence being highest in Asia.

Fibrosis stage is the strongest predictor for disease‐specific mortality in NAFLD after up to 33 years of follow‐up

NAFLD patients have increased risk of death, with a high risk ofdeath from cardiovascular disease and liver‐related disease, and the NAS was not able to predict overall mortality, whereas fibrosis stage predicted both overall and disease‐specific mortality.

Long term follow-up and liver-related death rate in patients with non-alcoholic and alcoholic related fatty liver disease

Patients with fatty liver disease showed a markedly higher risk of developing liver-related death compared to the general population and the AFLD group had higher liver- related mortality and had a worse survival than the NAFLD group.

European Association for the Study of the Liver

The 6th meeting was held in London on 2, 3, and 4 September under the presidency of B. H. Billing (United Kingdom). The following are the abstracts of the first 36 papers. Altogether 157 abstracts