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gi-hepatology

NAFLD Activity Score (NAS)

Histological scoring system for NAFLD severity on liver biopsy. Scores steatosis, lobular inflammation, and hepatocyte ballooning. NAS ≥5 is associated with NASH diagnosis.

Score interpretation

Not NASH 0–2

NAS 0–2 — unlikely to be NASH

→ Diagnose as simple steatosis or borderline; lifestyle modification; annual follow-up

Borderline / Indeterminate 3–4

NAS 3–4 — borderline NASH

→ Clinical context required for NASH diagnosis; address metabolic risk factors; consider repeat biopsy if disease progresses

Consistent with NASH 5–8

NAS ≥5 — consistent with NASH diagnosis

→ Treat NASH: weight loss ≥10%, exercise, vitamin E (non-diabetics), consider pharmacotherapy (GLP-1 agonists); hepatology referral

Interpretation bands for the NAS. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.