The importance of visceral adipose tissue detected by imaging methods to assess nonalcoholic fatty liver disease properly

Dear Editor, We read the article entitled “The Effect of Symbiotic Supplementation on Liver Enzymes, C‑reactive protein (CRP), and ultrasound findings in patients with nonalcoholic fatty liver disease (NAFLD): A Clinical Trial” with great interest.[1] In this study, authors reported that symbiotic supplementation improved the grade of hepatosteatosis in NAFLD patients without any change in alanine aminotransferase, aspartate aminotransferase, and CRP levels. With this aspect, the current study offers a new perspective on the management of NAFLD. However, there is a lack of information about the association between amount of visceral adipose tissue (VAT) which is an important factor for fat accumulation in liver, presence of diabetes, metabolic syndrome (MetS), hyperlipidemia, and NAFLD. Therefore, we would like to make some important contributions in this regard.