Nonalcoholic fatty liver disease in type 2 diabetes: awareness is the first step toward change

In a recent article published in J Hepatol , Younossi et al . provided a comprehensive systematic review and meta- analysis on the prevalence of NAFLD, NASH and advanced fibrosis in patients with type 2 diabetes mellitus (T2DM) across the globe (1). Among the 80 studies included in the final analysis (for a total of 49,419 patients) the prevalence of NAFLD was between 50–70% in all continents, except for Africa, where a prevalence of 30.4% was reported. This lower prevalence of NAFLD in Africa is consistent with prior reports showing a lower prevalence of NAFLD among African-American individuals (2,3). Of note, once African- American patients develop NAFLD, their progression to NASH and advanced fibrosis is similar to other ethnic groups, and still a significant cause of cirrhosis in this population (4).