Moderate weight loss (5% to 10%) is effective for clearance of liver fat, histologic improvement of steatohepatitis, and reversal of biopsy-proven fibrosis ( 1, 6). Hence, more than 90% of patients with obesity and T2DM may have NAFLD ( 5). Moreover, a strong association between NAFLD and type 2 diabetes mellitus (T2DM) has been demonstrated, probably caused by hepatic insulin resistance. Obesity, insulin resistance, hepatic steatosis, and inflammation are closely related, often coexist, and act synergistically with increased risk for cardiovascular disease ( 3, 4). Nonalcoholic fatty liver disease (NAFLD), including hepatic steatosis, steatohepatitis, fibrosis, and cirrhosis, has a prevalence in the general population of about 25% ( 1) and may progress to liver failure and hepatocellular carcinoma ( 1, 2).
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