Stage 1: simple fatty liver (steatosis) - common

Stage 2: non-alcoholic steatohepatitis (NASH), 20-30% progress to cirrhosis

Stage 3: fibrosis

Stage 4: cirrhosis

Enhanced liver fibrosis (ELF) score to measure liver damage using an algorithm of three serum biomarkers (hyaluronic acid, procollagen III amino terminal peptide, tissue inhibitor of metalloproteinase 1)

Lifestyle changes most important (weight loss, exercise)

Consider referral if FIB-4 score >1.3

Non-alcoholic fatty liver disease (NAFLD): assessment and management (NICE), Non-alcoholic fatty liver disease (NAFLD) (CKS), Non-alcoholic fatty liver disease (NHS Choices), Non-alcoholic fatty liver disease (NAFLD): summary of NICE guidance (BMJ, 2016)​, FIB-4 calculator to estimate liver scarring (Hepatitis C Online)