International Journal of Preventive Medicine (Int J Prev Med)2008-78021282021101825132513ENDepartment of Biochemistry, Gata Haydarpasa Training Hospital, IstanbulDepartment of Cardiology, Gata Haydarpasa Training Hospital, Istanbul20211018Dear Editor, We read the article entitled “The Effect of Symbiotic Supplementation on Liver Enzymes, C‑reactive protein (CRP), and ultrasound findings in patients with nonalcoholic fatty liver disease (NAFLD): A Clinical Trial” with great interest.[1] In this study, authors reported that symbiotic supplementation improved the grade of hepatosteatosis in NAFLD patients without any change in alanine aminotransferase, aspartate aminotransferase, and CRP levels. With this aspect, the current study offers a new perspective on the management of NAFLD. However, there is a lack of information about the association between amount of visceral adipose tissue (VAT) which is an important factor for fat accumulation in liver, presence of diabetes, metabolic syndrome (MetS), hyperlipidemia, and NAFLD. Therefore, we would like to make some important contributions in this regard.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2513http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2513/717718354