Nonalcoholic fatty liver disease with advanced fibrosis as a multi-systemic disease: proceed with caution

Accompanying the current epidemics of metabolic syndrome (MS) and obesity caused by westernization of lifestyles, the incidences of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) have been increasing worldwide over the last few decades (1). Now, NAFLD has a global prevalence estimated at 25% of the world population, with some geographical; the highest prevalences are in the South America and Middle East. Namely, NAFLD has become recognized as the most common liver disease worldwide (2).