Tada T, et al. - In over 1,500 middle-aged (36–64 years) patients with nonalcoholic fatty liver disease (NAFLD) and less severe live fibrosis (FIB-4 index < 1.3), researchers assessed clinical risk factors for the progression of liver fibrosis. A total of 186 patients progressed to advanced fibrosis (FIB-4 index > 2.67) during follow-up. The investigators noted that the 3-, 5-, 7-, and 10-year cumulative incidences of progression to advanced fibrosis were 4.4%, 6.7%, 11.0%, and 16.7%, respectively. In middle-aged patients with NAFLD, even those with less severe liver fibrosis, type 2 diabetes mellitus was linked to progression to advanced liver fibrosis.