LAUSR

Controls F0 F1 F2 F3 F4 Hagström et al., 2017 Fibrosis stage predicts mortality in patients with NAFLD Fibrosis stage predicts mortality in patients with non-alcoholic fatty liver disease (NAFLD) NAFLD is a growing cause of chronic liver disease worldwide. Identifying patients with NAFLD who are at an increased risk ofmortality and liver-specificmorbidity is crucial. In this issue, Hagstr€ om et al. conducted a retrospective cohort study of 646 biopsy-proven patients with NAFLD and matched controls. During a follow-up of 20 years, 12% of patients with NAFLD developed severe liver disease (only 2.2% in controls). The risk of severe liver disease increased per stage of fibrosis (HR ranging from 1.9 in F0 to 104.9 in F4). Similar resultswere seen for overallmortality. Importantly, the presence of NASH did not change these estimates significantly. This important study strongly suggests that all patients with NAFLD should undergo non-invasive assessment of fibrosis stage. Preventive and therapeutic manoeuvers aimed at attenuating the progression of liver fibrosis in patients with NAFLD should be implemented.