As fatty liver is known to be the liver component of the metabolic syndrome, the NAFLD finding was not surprisingly paralleled with associations between copeptin and measures of obesity and impaired glucose tolerance, findings which are completely corresponding to our previous studies in which we established elevated copeptin as an independent risk factor involved in development of diabetes and the metabolic syndrome [7–9]. This evidence concerns the gene AVP and obesity due to melanocortin 4 receptor deficiency.