NAFLD incidence and remission: only a matter of weight gain and weight loss?

The prevalence of non-alcoholic fatty liver disease (NAFLD) in the community is probably rising, driven by the epidemics of obesity and diabetes. A provocative study on obesity prevalence in the U.S. suggested that, given the trend observed between 1970 and 2004, all American adults would become overweight or obese by 2048, with differences between genders and ethnic ancestry [1]. Similar data exist for the prevalence of type 2 diabe-tes, which is now well above a 10% prevalence rate in several countries, with an estimated total of 382 million cases through-out the world and a prospective rise to 592 million cases in the next 25 years [2]. From the early description of NAFLD, we know that the disease is intimately connected with obesity, diabetes and the metabolic syndrome, therefore it is not surprising that NAFLD is among the top three causes of liver transplantation. Considering the rapid advances in antiviral therapy, it is expected to become the most common indication in the near future. A cor-rect identification of incident cases may help to determine addi-tional risk factors and program therapeutic interventions.