Mixed

Routine clinical and laboratory variables (including AST, ALT, demographics, and comorbidities) can predict advanced fibrosis in adults with NAFLD, but these same variables perform only modestly for predicting the presence or severity of NASH.

If you have NAFLD, do not rely solely on standard liver blood tests (AST/ALT) to gauge your liver health. This research demonstrates that these tests are poor predictors of actual liver damage (NASH) and can be misleading. However, combining these blood tests with your age, weight, diabetes status, and other basic health markers creates a much more accurate picture of your risk for advanced scarring (fibrosis). If you are at high risk for fibrosis based on these combined factors, discuss non-invasive scoring or biopsy with your specialist, as 'normal' enzymes do not guarantee safety.