Nonalcoholic fatty liver disease（non-alcoholic fatty liver disease，nafld) refers to a series of pathological syndromes characterized by steatosis in more than 5% of hepatocytes on the basis of excluding long-term excessive alcohol consumption and other liver diseases that can lead to fatty liver. Currently,NAFLD has replaced hepatitis B as the number one chronic liver disease and the leading cause of abnormal liver function on physical examination in China. 
Studies have shown thatThe number of people suffering from NAFLD in China has exceeded 200 million, of which the prevalence of ** is 6% to 27%, and the prevalence of children is 63%, and it is expected that the total number of people affected in China will reach 3 in 20301.4 billion. There is growing evidence that NAFLD is a multisystem disease that is thought to be associated with a variety of diseases, including chronic liver disease, cardiovascular disease, type 2 diabetes, and chronic kidney disease.
Patients with NAFLD have an insidious onset, and most patients are asymptomaticA small number of patients complain of fatigue, right upper quadrant discomfort, and hepatomegaly. In view of the difficulty of detecting NAFLD, it is recommended that relevant key populations go to specialized outpatient clinics for further screening and evaluationFatty liver or hepatic fatty infiltrates on ultrasound; Unexplained abnormal liver function; Obesity, hypertriglyceride (TG) emia, type 2 diabetes mellitus (T2DM), hypertension, hyperuricemia, and long-term alcohol drinkers.
Ultrasound can provide a preliminary assessment of the extent and extent of hepatic steatosis, and liver biopsy is the gold standard for diagnosing NAFLDHowever, the need for liver biopsy in each patient with NAFLD is still controversial and needs to be judged clinically on a case-by-case basis.
Gender, age, obesity, type 2 diabetes, dyslipidemia, etc. are risk factors related to NAFLD, among which a high-calorie diet rich in saturated fatty acids and fructose, which is closely related to obesity, and a sedentary and inactive lifestyle are one of the controllable and important risk factors for NAFLD.
Currently,There are no standard medications and surgical procedures approved for NAFLD**。Therefore, the current management of NAFLD is focused on reducing the associated risk factorsAnd movement is still the cornerstone of NAFLD. 
1. Dietary suggestions
1) Patients with fatty liver disease who are overweight and/or obese need to control the total amount of dietary calories, and it is recommended to reduce the daily energy diet by 2090 4180 kJ (500 1000 kcal), adopt a low-energy balanced diet, and can also use energy-restricted meal replacement or intermittent fasting**, for the purpose of thisLose body weight by 5% to 10% in half a year
2) Patients with NAFLD should adopt a balanced diet with low sugar and low fat, avoid or reduce sugary beverages, reduce the intake of saturated fat (animal fat, palm oil, etc.) and trans fat (fried food), and increase the content of dietary fiber (legumes, whole grains, vegetables and fruits, etc.).
3) Patients with NAFLD should abstain from alcohol or avoid excessive alcohol consumption.
2. Exercise recommendations
Moderate aerobic exercise is recommended(such as cycling, brisk walking, swimming, dancing, etc.), more than 4 times a week, cumulative time of 150 250 min, target heart rate after exercise 170 age. It is best to do light or moderate resistance muscle exercises (dumbbell lifts, push-ups, elastic bands, etc.) 2 or 3 times a week for greater metabolic improvement.
2) Patients with obesity-associated fatty liver disease who have achieved short-term weight loss goals should be treated with a long-term (1-year) gradual weight loss and maintenance program. Patients are recommended to be followed up once a month, and continuous monitoring of body weight (weekly or more frequent) is encouraged, dietary calorie reduction is continuous, and a high level of physical activity (200-300 minutes per week) is encouraged.
3. Medication recommendations for other chronic diseases
1) Patients with fatty liver disease who have impaired fasting blood glucose and impaired glucose tolerance T2DM are recommended to use insulin sensitizers such as metformin and pioglitazone for the prevention and treatment of diabetes.
2) Patients with fatty liver disease who are at high risk of cardiovascular and cerebrovascular disease (CVD) change their lifestyle for more than 3 to 6 months, and their serum low-density lipoprotein cholesterol (LDL C) is still 4At 14 mmol, it is recommended to use statins to reduce LDL C by at least 30% to 50% to reduce the occurrence of CVD.
4. Recommendations for the use of hepatoprotective drugs
In recent years, many patients with NAFLD have taken health products such as "liver protection tablets", but the clinical use of hepatoprotective and anti-inflammatory drugs as an adjunct** is limited to the following conditions: patients with NASH confirmed by liver biopsy; Patients with NAFLD who may have significant liver injury and/or progressive liver fibrosis suggestive of clinical features, laboratory changes, and imaging studies, such as persistently elevated serum aminotransferase levels and markedly increased liver elasticity, especially if there are comorbid mets and T2DM; Those who intend to use other drugs that may induce liver damage and affect the implementation of the basic ** program, or those who have increased liver enzymes in the basic ** process**; Combined with drug-induced liver injury, autoimmune hepatitis, chronic viral hepatitis and other liver diseases.