Since the publication of the guidelines for the assessment and management of non alcoholic
fatty liver disease (NAFLD) by the Asia–Pacific Working Party on NAFLD in 2007, 1 our
understanding of the clinical characteristics and natural history of NAFLD has improved, and
there have been developments in the assessment and treatment of NAFLD. It is therefore
timely to update the guidelines in light of new evidence. This document presents the
recommendations of the Asia–Pacific Working Party on NAFLD. The exercise was supported …

How to assess efficacy of interventions. In clinical practice, and particularly among those
who appear to have mild liver disease, it may be sufficient to note changes (normalization) of
liver tests and serum lipids/blood glucose in relation to lifestyle intervention and weight
reduction. However, this is not sufficient for clinical trials because (i) liver pathology is not
defined unless biopsy is performed and (ii) the only legitimate surrogate marker for an
improved clinical outcome of liver disease is improvement in liver fibrosis. Towards the latter …