The global epidemic of obesity has led to the rise of non-alcoholic fatty liver disease (NAFLD) as a significant cause of cirrhosis, end-stage liver disease and need for liver transplantation.(1) NAFLD is common, with a global estimate of 25% of adults (2), however only a small proportion will progress to cirrhosis and develop liver related morbidity. As with other chronic liver diseases, the severity of underlying liver fibrosis aids prediction of outcome, with patients with bridging fibrosis or cirrhosis being at greatest risk of future liver related morbidity.(3) Nonetheless, key questions remain largely unanswered including what proportion of subjects develop progressive disease, how fast this occurs, and how to identify and monitor these individuals.

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社论：NASH 进展的 20% 规则：NASH 导致的晚期纤维化和肝硬化的自然史

全球肥胖流行导致非酒精性脂肪性肝病 (NAFLD) 上升，成为肝硬化、终末期肝病和肝移植需求的重要原因。(1) NAFLD 很常见，全球估计有25% 的成年人 (2)，但只有一小部分会进展为肝硬化并出现与肝脏相关的疾病。与其他慢性肝病一样，潜在肝纤维化的严重程度有助于预测结果，患有桥接纤维化或肝硬化的患者未来发生肝脏相关发病的风险最大。(3) 尽管如此，关键问题仍然很大程度上没有得到解答，包括受试者的比例是多少发展为进行性疾病、这种情况发生的速度以及如何识别和监测这些人。