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Curr Hepatol Rep. 2017;16(4):391-397. doi: 10.1007/s11901-017-0378-2. Epub 2017 Nov 13.

Natural History of NAFLD/NASH.

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Department of Gastroenterology and Hepatology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.


Purpose of Review:

The purpose of this review is to summarize the latest knowledge on the natural history of non-alcoholic fatty liver disease (NAFLD). The review focuses on mortality, liver-related complications, and histological course.

Recent Findings:

Studies during the last decade have established NAFLD as a potentially progressive liver disease. Age and diabetes are the strongest clinical predictors of progressive disease. Fibrosis stage is the most important histological variable to predict mortality and liver-related complications. So far, no study has been able to show that non-alcoholic steatohepatitis at baseline predicts mortality or future liver-related complications when adjusting for fibrosis.


The outlines of the natural history of NAFLD have become clearer during the last decade. There is limited data on factors that predict clinical progression. Prospective longitudinal studies are needed to help us predict worse outcome in individual patients.


Liver histology; Mortality; Natural history; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Prognosis

Conflict of interest statement

Compliance with Ethical StandardsMattias Ekstedt, Patrik Nasr, and Stergios Kechagias each declare no potential conflicts of interest.This article does not contain any studies with human or animal subjects performed by any of the authors.

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