Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

The diagnosis of nonalcoholic fatty liver disease should carry important prognostic information

The diagnostic reach of nonalcoholic fatty liver disease (NAFLD) is broad, stretching from simple steatosis to cirrhosis. Expanded disease definitions are an important cause of waste in health care. Now is the time to revise the definition of NAFLD to include only those who have developed advanced fibrosis.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1: Comparing NAFLD with CHD.


  1. Younossi, Z. M. et al. The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe. Hepatology 64, 1577–1586 (2016).

    Article  Google Scholar 

  2. Estes, C. et al. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology 67, 123–133 (2018).

    CAS  Article  Google Scholar 

  3. Dulai, P. S. et al. Increased risk of mortality by fibrosis stage in non-alcoholic fatty liver disease: systematic review and meta-analysis. Hepatology 65, 1557–1565 (2017).

    CAS  Article  Google Scholar 

  4. Kim, D. et al. Association between noninvasive fibrosis markers and mortality among adults with nonalcoholic fatty liver disease in the United States. Hepatology 57, 1357–1365 (2013).

    CAS  Article  Google Scholar 

  5. Hagstrom, H. et al. Fibrosis stage but not NASH predicts mortality and time to development of severe liver disease in biopsy-proven NAFLD. J. Hepatol. 67, 1265–1273 (2017).

    Article  Google Scholar 

  6. European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD) & European Association for the Study of Obesity (EASO). EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J. Hepatol. 64, 1388–1402 (2016).

    Google Scholar 

  7. Tuzcu, E. M. et al. High prevalence of coronary atherosclerosis in asymptomatic teenagers and young adults: evidence from intravascular ultrasound. Circulation 103, 2705–2710 (2001).

    CAS  Article  Google Scholar 

  8. US Preventive Services Task Force. Risk assessment for cardiovascular disease with nontraditional risk factors: US Preventive Services Task Force recommendation statement. JAMA 320, 272–280 (2018).

    Google Scholar 

  9. Rowe, I. A. Too much medicine: overdiagnosis and overtreatment of non-alcoholic fatty liver disease. Lancet Gastroenterol. Hepatol. 3, 66–72 (2018).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Ian A Rowe.

Additional information

Related links

NAFLD Simulator:

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Rowe, I.A., Parker, R. The diagnosis of nonalcoholic fatty liver disease should carry important prognostic information. Nat Rev Gastroenterol Hepatol 16, 449–450 (2019).

Download citation

  • Published:

  • Issue Date:

  • DOI:


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing