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According to the current guidelines, the diagnosis of NAFLD may be performed with ultrasound, although it has limited sensitivity for people with a low degree of steatosis (<20%) and for individuals with a high body mass index (BMI) (>40 kg/m2). [...]while in non-obese subjects the prevalence of NAFLD is 16%, about two-thirds of patients with liver steatosis are overweight or obese [12], and in this population weight loss has been shown to be the most effective strategy for NAFLD improvement. Considering the independent burden associated with the disease, recent recommendations suggest performing a screening for NAFLD in all subjects with metabolic syndrome and/or obesity to prevent possible complications, as the majority of patients with liver steatosis and even NASH are asymptomatic [14]. [...]a growing body of evidence emphasizes the importance of a broader patient assessment and demonstrates that NAFLD is a disease with systemic pathophysiologic consequences. [...]in patients with NAFLD a clinical evaluation with the assessment of blood pressure, waist circumference, BMI, plasma cholesterol, triglyceride levels, plasma glucose or glycosylated haemoglobin estimated that glomerular filtration rate (eGFR) and albuminuria is fundamental to recognize the presence of concomitant cardio-metabolic complications [15].