Table 3.

Modifiable risk factors for NAFLD.

Factor	Association with NAFLD	Risk of Progression to NASH	Treatment
Obesity [34,35,36,37,38,39,40,41,42]	Increase prevalence	Increase risk	Weight loss, Bariatric Surgery
Insulin resistance [45,46]	Increase prevalence	Increase risk	Lifestyle modifications Pioglitazone may improve histological features of NASH. Limited evidence available on clinical utility of Glucagon like peptide 1 antagonists (GLP-1)
Hyperlipidemia [60,61,62,63,64,65,66,67,68,69,70]	Increase prevalence	Increase risk	Statins have shown to improve hepatic fibrosis. It can also reduce cardiovascular mortality
Intestinal Microbiota and oxidative stress [71,72,73,74]	Higher prevalence of small intestinal bacterial overgrowth in NAFLD.	Increase risk	Rifaximin has demonstrated benefit but further research is needed.Antioxidants like vitamin E have shown benefit in patients with NAFLD
Metabolic Syndrome [38,50,75]	Increase prevalence	Increase risk	Lifestyle modifications, statins, pioglitazone, weight loss.