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To the Editor: Drs Clark and Diehl¹ did not mention truncal obesity or family history of nonalcoholic steatohepatitis or cryptogenic cirrhosis among the risk factors for NAFLD. These appear to be risk factors for NAFLD,^2-3 and could be used to identify patients at high risk.⁴

Luca Mascitelli, MD
Casa di Cura "Città di Udine"
Udine, Italy

Francesca Pezzetta, MD
Ospedale San Michele
Gemona del Friuli, Italy

1. Clark JM, Diehl AM. Nonalcoholic fatty liver disease: an underrecognized cause of cryptogenic cirrhosis. JAMA. 2003;289:3000-3004. FREE FULL TEXT 2. Ruderman N, Chisholm D, Pi-Sunyer X, Schneider S. The metabolically obese, normal-weight individual revisited. Diabetes. 1998;47:699-713. ABSTRACT 3. Struben VMD, Hespenheide EE, Caldwell SH. Nonalcoholic steatohepatitis and cryptogenic cirrhosis within kindreds. Am J Med. 2000;108:9-13. WEB OF SCIENCE | PUBMED 4. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002;346:1221-1231. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290:1577.

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