Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the developed world. NAFLD is encompasses a spectrum of liver manifestations ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), fibrosis and cirrhosis, which may ultimately progress to hepatocellular carcinoma. NASH is an aggressive form of NAFLD, associated with an increased risk of liver and non-liver-related mortality. Liver-biopsy remains the gold standard for diagnosis, but the majority of patients liver damage can be diagnosed accurately by noninvasive methods.
 Early identification and management of patients with intensive dietary and lifestyle modification are essential to prevent the development of advanced liver disease and its complications. Pharmacological therapy should be administered to patients with NASH purposed on the fibrosis inhibition, especially in case of the established predictors of high risk of disease progression (age ˃ 50 years, metabolic syndrome, type 2 diabetes mellitus, or ALT increase), as well as to the patients with active NASH with high inflammatory activity
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