Pelusi S, et al. - In this investigation, researchers determined the prevalence of fibrosis in subjects without nonalcoholic steatohepatitis (NASH) and risk factors for fibrosis. Data were analyzed from 1738 subjects (44.9% with severe obesity) in a cross-sectional liver biopsy cohort enrolled at referral centers in Italy and Finland. Investigators found that one-third of subjects with significant fibrosis did not have NASH in an analysis of biopsy specimens collected from patients with NAFLD at a single time point. In a separate cohort, this finding was validated. Fasting hyperglycemia, severe steatosis, mild inflammation or ballooning, and the PNPLA3 I148M variant identified those at risk of significant fibrosis in patients without NASH.