Sugiyama A, Kurisu A, Ouoba S, et al. - In Japanese residents having health examinations, drinking status has no effect on the prevalence or incidence of fatty liver. Obesity control efforts must be prioritized from a public health standpoint in order to lessen the burden of fatty liver disease in Japan.

• In 75,670 inhabitants, the prevalence of fatty liver was determined by ultrasonography.

• The person-year method was used to calculate the incidence of fatty liver in 31,062 inhabitants who received ultrasonography at least twice during the period without fatty liver the first time.

• Fatty liver was found in 27.6% of non-drinkers, 28.5% of moderate-drinkers, and 28.0% of heavy-drinkers.

• Non-drinkers had a fatty liver incidence of 3,084/100,000 person-years (2,997–3,172/100,000), moderate-drinkers had a fatty liver incidence of 3,754/100,000 person-years (3,481–4,042/100,000), and heavy-drinkers had a fatty liver incidence of 3,861/100,000 person-years (3,295–4,497/100,000).

• The prevalence and incidence of fatty liver were not related to drinking status.

• Obesity was identified as the most significant independent risk factor.