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非酒精性脂肪性肝病是全球慢性肝病的首要原因。非酒精性脂肪性肝病的疾病谱广泛，主要包括单纯性脂肪肝、脂肪性肝炎、肝纤维化及肝硬化。非酒精性脂肪性肝病患者的临床表现和疾病转归差异巨大，与遗传、表观遗传、种族、性别、年龄、饮食、运动、饮酒、肠道微生态、并存疾病，以及激素和代谢状态等危险因素的异质性有关。重视非酒精性脂肪性肝病患者发病机制和临床异质性的研究，有助于该病的分层管理和提高临床试验的效果。“,”Nonalcoholic fatty liver disease is the leading cause of chronic liver disease worldwide. Non-alcoholic fatty liver disease has a wide spectrum of diseases including simple fatty liver, steatohepatitis, liver fibrosis, and cirrhosis. The clinical manifestations and disease outcomes of patients with non-alcoholic fatty liver disease vary widely, and are related to the heterogeneity of risk factors, such as heredity, epigenetics, race, gender, age, diet, exercise, alcohol drinking, intestinal microecology, coexisting diseases, and hormone and metabolic status. Emphasizing the study of pathogenesis and clinical heterogeneity of patients with non-alcoholic fatty liver disease will help to layer the management of disease and improve the effectiveness of clinical trials.