Fujii H, et al. - In nondiabetic patients with nonalcoholic fatty liver disease (NAFLD), investigators evaluated the utility of the homeostasis model assessment parameter of insulin resistance (HOMA-IR), an index of insulin resistance (IR) and one of the most important metabolic factors, as a predictive factor for advanced fibrosis. Participants in the study were 361 patients with biopsy-proven NAFLD who had not received a diagnosis of type 2 diabetes mellitus. The results of this retrospective, cross-sectional multicenter study indicated that HOMA-IR was an independent predictor of advanced liver fibrosis in nondiabetic patients with NAFLD. Since most NAFLD patients are nondiabetic, it is important to set goals to improve IR to reduce liver fibrosis subsequently.