Nonalcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome characterized by diffuse hepatocellular steatosis, excluding alcohol and other definite hepatoprotective factors, including simple fatty liver and its evolution into steatohepatitis (NASH) and cirrhosis. Insulin resistance and genetic susceptibility are closely related to its development. With the high prevalence of obesity and diabetes, NAFLD has now become one of the common chronic liver diseases in China. Xiaofeng Liu, Department of Gastroenterology, General Hospital of Jinan Military Region The main causes of death in NAFLD are metabolic syndrome-related tumors and atherosclerotic vascular events, while disability and death from liver disease are almost exclusively seen in those with NASH complicated by liver cirrhosis. For this reason the primary goal of NAFLD treatment is to control metabolic disorders and prevent diabetes and cardiovascular events; the secondary goal is to reverse hepatic steatosis and reduce the occurrence of cholecystitis and gallstones; the additional requirements are to prevent and treat NASH, stop the progression of liver disease, and reduce the occurrence of cirrhosis and HCC. (i) Prevention and treatment of primary diseases or related risk factors. (ii) Basic treatment Therapeutic lifestyle change (TLC) is the first-line measure and the most important method for the treatment of NAFLD. All patients with NAFLD who are overweight, visceral obesity and rapid weight gain in a short period of time need to control their weight and reduce their waist circumference through lifestyle changes. To develop a reasonable energy intake as well as diet restructuring, moderate aerobic exercise, and correction of poor lifestyle and behavior. 1. Dietary treatment Total caloric intake should be controlled, with dietary fat based on unsaturated fatty acids and limited intake of saturated fatty acids, and carbohydrates based on slowly absorbed complex sugars and fiber and limited intake of fast-absorbing carbohydrates. Alcohol should be completely abstained from. 2. Exercise therapy Physical exercise (aerobic exercise) is beneficial for insulin resistance and metabolic syndrome and its related components (obesity, dyslipidemia, diabetes mellitus). 3. Avoid aggravating liver damage to prevent drastic weight loss, drug abuse and other factors that may induce the deterioration of liver disease; (iii) Pharmacological treatment 1. Insulin sensitizers In combination with type 2 diabetes, impaired glucose tolerance, increased fasting glucose and visceral obesity, metformin and thiazolidinediones (pioglitazone and rosiglitazone) can be considered in order to improve insulin resistance and control blood glucose. Antioxidant and anti-inflammatory therapy include antioxidants (vitamins A, C, E and carotenoids, selenium, glutathione precursor β-betaine), anti-inflammatory drugs targeting TNF-α (ketococcinolone, etanercept, infliximab), and the application of probiotics and prebiotics to prevent intestinal bacterial overgrowth, reduce the production of endogenous ethanol and endotoxin in the intestine and its associated hepatic oxygen stress and inflammation damage. 3. Lipid-lowering drugs For dyslipidemia with more than 3-6 months of basic treatment and/or weight-loss and hypoglycemic drugs, but still with mixed hyperlipidemia or hyperlipidemia combined with more than 2 risk factors, additional lipid-lowering drugs such as fibrates, statins or probucol should be considered. 3. Weight-loss drugs If the weight loss is less than 0.45 kg per month in 6 months of basic treatment, or the body mass index [BMI (kg/m2) = weight ((kg)/height squared (m2)] is more than 27 kg/m2 combined with two or more abnormal indicators of blood lipids, blood glucose and blood pressure, weight-loss drugs such as sibutramine or orlistat can be considered, and the weight loss should not exceed 1.2 kg per week ( The weight loss should not exceed 1.2kg per week (not more than 0.5kg per week for children). NAFLD with abnormal liver function, metabolic syndrome, ineffective after 3-6 months of basic treatment, and those with NASH confirmed by liver biopsy and chronic progressive course of the disease, can be treated with adjuvant drugs for liver disease, to antioxidant, anti-inflammatory, anti-fibrotic, depending on the performance of the drugs and the disease activity and stage of disease, can reasonably choose polyenyl phosphatidylcholine, vitamin E, silymarin and However, multiple drugs should not be applied simultaneously. It can be used for the treatment of fatty liver with high blood lipids or elevated transaminases. 5 capsules once, orally, 3/d. (E) Surgical treatment 1. Surgical weight loss For patients with severe obesity, bariatric surgery is the safest and most effective treatment measure. For those with BMI > 40kg/m2 or BMI > 35kg/m2 combined with sleep apnea syndrome and other obesity-related diseases, proximal gastric bypass surgery can be considered for weight loss. Liver transplantation is mainly used for the treatment of patients with NASH-related end-stage liver disease and partial cryptogenic cirrhosis with liver function loss.