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    NAFLD (Non-Alcoholic Fatty Liver Disease) Fibrosis Score

    Estimates amount of scarring in the liver based on several laboratory tests.
    When to Use
    Why Use

    Patients who have been identified to have NAFLD.

    • Nonalcoholic fatty liver disease (NAFLD) is now the leading cause of chronic liver disease in the world.
    • Many NAFLD patients will have little progression in their disease, however a subset will progress to liver fibrosis and cirrhosis.
    • Patients studied to develop this score were screened for other causes of liver disease and were specifically evaluated closely for concomitant alcohol. Patients with already-decompensated liver disease by clinical or imaging evidence were also excluded.
    • Patients with NAFLD should have their fibrosis scores trended over time to evaluate for progression or stabilization.
    • The NAFLD can reduce liver biopsies in those patients predicted to have a low risk of fibrosis by their score: “a liver biopsy to determine severity of fibrosis would be required in only 25% of patients with NAFLD, that is, those identified as ‘indeterminate’.”
    • Patients with nonalcoholic fatty liver disease (NAFLD) and advanced liver cirrhosis are high risk for progression to end-stage liver disease.
    • Patients with known liver fibrosis should have their fibrosis trended over time to evaluate for progression or stabilization.
    × 10³/µL


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    Next Steps
    Creator Insights


    Depending on score and local prevalence of advanced fibrosis, the score can be used to reliably predict (with high 80-low 90% accuracy) which patients are unlikely to have cellular evidence of fibrosis on biopsy.


    NAFLD Score = -1.675 + (0.037*age [years]) + (0.094*BMI [kg/m2]) + (1.13*IFG/diabetes [yes = 1, no = 0]) + (0.99*AST/ALT ratio) – (0.013*platelet count [×109/L]) – (0.66*albumin [g/dl])

    Facts & Figures

    NAFLD Score Correlated Fibrosis Severity
    < -1.455 F0-F2
    -1.455 – 0.675 Indeterminant score
    > 0.675 F3-F4

    Fibrosis Severity Scale

    • F0 = no fibrosis
    • F1 = mild fibrosis
    • F2 = moderate fibrosis
    • F3 = severe fibrosis
    • F4 = cirrhosis
    Dr. Paul Angulo

    About the Creator

    Paul Angulo, MD, is a Professor of Medicine at the University of Kentucky after spending 12 years at the Mayo Clinic in Rochester, Minnesota, where he worked as associate professor of medicine. He specializes in general hepatology, non-alcoholic fatty liver disease, cholestatic liver disease, and autoimmune hepatitis. Dr. Angulo is on the editorial board of numerous medical journals and has authored more than 240 articles, abstracts, book reviews and editorials.

    To view Dr. Paul Angulo's publications, visit PubMed

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    About the Creator
    Dr. Paul Angulo
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