Nonalcoholic fatty liver disease (NAFLD) is a major cause of liver disease worldwide. We
estimated the global prevalence, incidence, progression, and outcomes of NAFLD and
nonalcoholic steatohepatitis (NASH). PubMed/MEDLINE were searched from 1989 to 2015
for terms involving epidemiology and progression of NAFLD. Exclusions included selected
groups (studies that exclusively enrolled morbidly obese or diabetics or pediatric) and no
data on alcohol consumption or other liver diseases. Incidence of hepatocellular carcinoma�…

We appreciated Dr. Younossi and colleagues' meta‐analysis of the global prevalence,
incidence, progression, and outcomes of nonalcoholic fatty liver disease (NAFLD). 1 We
believe that the topic is important, and we appreciate the opportunity to offer some comment
and perspective on the concepts implicit in this work.Rather than being exclusively
considered as always “the hepatic manifestation of the metabolic syndrome,” it is
conceivable that NAFLD should actually be considered a precursor of the metabolic�…