Arterial Stiffness and Nonalcoholic Fatty Liver Disease: Which is the Chicken and Which is the Egg?

Nonalcoholic fatty liver disease (NAFLD) is diagnosed when there is an accumulation of fat in the liver (>5%) in the absence of alcohol abuse or other chronic liver diseases (CLD) [1]. It is the most frequent cause of elevated liver enzyme levels worldwide [2]. NAFLD can progress to nonalcoholic steatohepatitis (NASH) with liver inflammation, fibrosis, cirrhosis or finally to hepatocellular cancer (HCC). However, cardiovascular disease (CVD) is the most frequent cause of death or disability in NASH patients [3].