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Patients with simple steatosis are at an increased risk of cardiovascular complications compared to patients without NAFLD, particularly if there is concomitant diabetes.(11) NASH is associated with greater risk of cardiovascular complications than simple steatosis, an association that may be explained by shared risk factors.(12) The increased mortality seen among patients with advanced liver fibrosis is also associated with complications of metabolic syndrome, cardiovascular disease, chronic kidney disease and cancer.(13) DIAGNOSIS Making an initial diagnosis of NAFLD requires meeting two criteria: demonstration of hepatic steatosis (by imaging or liver biopsy) and exclusion of secondary causes of hepatic steatosis or alternate causes of liver disease (Table 1)