The prevalence of obesity and the metabolic syndrome (MS), and subsequently the hepatic manifestation of MS, nonalcoholic fatty liver disease (NAFLD), has become a common entity in clinical practice. Most patients with NAFLD face medical complications related to metabolic syndrome in other organs and systems; however, a small but significant group of patients with a most aggressive form of fatty liver: the no alcoholic steatohepatitis (NASH), with the risk of developing cirrhosis and liver cancer. These patients are generally asymptomatic, often this disease goes unrecognized. This is particularly true for NASH, where liver biopsy is currently required to make the diagnosis......TO UNLOCK AND READ THE WHOLE WORK SUBSCRIBE.