從1980年開始，非酒精性脂肪肝疾病及非酒精性脂肪肝炎NAFLD-NASH疾病的病理機轉假設，從兩個連續的疾病風險因子所造成的疾病進展，已漸漸移至多重並行疾病因子造成的疾病進展，最近有很多研究發現代謝症候群跟NAFLD-NASH有些相關性，另外最近學界新共識的新名詞為代謝異常症候群相關的脂肪肝疾病(MAFLD)，這新名詞被廣泛的用在相關的疾病論述裡面，另外有25%健康的肝臟隨著環境、飲食因素漸漸進展到脂肪肝，6.3%可能隨著持續的環境跟飲食因素會進展到NAFLD-NASH甚至到肝硬化或肝癌，直到最近有許多資料顯示NAFLD-NASH疾病機轉上是由多重並行的疾病路徑所造成，所以在治療上必須要多重的治療途徑進行，才可減少相關的疾病進展，以及相關的併發症發生。

Since 1980, the pathogenesis of NAFLD-NASH had shifted from two-hit hypothesis to hypothesis of multiple parallel hits. Recent study established the relationship between metabolic syndrome and NAFLD-NASH and the new term of metabolic dysfunction fatty liver disease (MAFLD) had been widely used. 25% of healthy livers will progress to fatty livers and 6.3% progress to NAFLD-NASH, cirrhosis and hepatocellular carcinoma. Until recently, it is well-established that multi-pathways approaches are required for management of NAFLD-NASH or MAFLD and their related complications.