NAFLD (Non-alcoholic fatty liver disease) is increasing prevalent, and usually associated with insulin resistance and metabolic syndrome. While NAFLD itself is of interest, it is those individuals with NAFLD who progress to fibrosis and cirrhosis who are of the most concern. This study appearing today in Gastroenterology uses NHANES data to show that there has been a 2.5 fold increase in NAFLD-associated cirrhosis over the last decade. A key advancement in the recognition of fibrosis and cirrhosis has been the validation of simple blood tests to determine these categories. This study used the APRI (AST/platelet ratio index) to determine cirrhosis, and serves as an excellent reference for the use of various lab-based scores for fibrosis and cirrhosis. Although the current standard treatments for NAFLD are lifestyle interventions, there have been promising trials with pioglitazone and and other medications.