 Similar to other types of chronic liver disease, liver-related morbidity and mortality are dictated by the severity of liver damage. This concept explains observations that NAFL has a relatively benign prognosis, whereas NAFLD-related cirrhosis may be complicated by portal hypertension and hepatocellular carcinoma, eventuating in death from liver disease.2 Studies disease.2 Studies in the US and France independently demonstrated 3 easily-assessed clinical parameters that identify individuals with cryptogenic hepatitis who are likely to have advanced fibrosis on liver biopsy. These parameters are older age greater than 45-50 years, overweight or obese body mass index, and type 2 diabetes. The probability of having bridging fibrosis or cirrhosis on liver biopsy is approximately 66 in individuals with cryptogenic hepatitis who are older and either overweightobese or diabetic.16,17 Identification of individuals who have NASH with fibrosis has important prognostic implications. Follow-up of patients with NASH and fibrosis demonstrates that almost 30 of these individuals become cirrhotic within 5-10 years. In contrast, only about 3 of individuals with milder forms of non-alcoholic fatty liver disease develop cirrhosis after more than a decade of follow-up. Therefore, NASH with fibrosis progresses to cirrhosis both more consistently and more rapidly than simple NAFL.2,13 