DPP4 and Insulin resistance: The proposed mechanism by which vildagliptin produces its beneficial effect in patients of NAFLD include: it improves insulin resistance a key metabolic abnormality in patients of NAFLD.9 Second it decreases serum DPP-4 activity because patients with NAFLD have increase DPP-4 which co relates with hepatic steatosis10 and finally decrease level of DPP-4 reduces inflammation in patients of NAFLD which is pathognomonic features in these patients.11