Although many studies have shown associations between IGFBP-2 and NAFLD in obesity (7, 11, 12), the present observations suggest that low plasma IGFBP-2 levels can indicate a higher risk for the development of NAFLD in asymptomatic, apparently healthy individuals with higher VAT. This evidence concerns the gene IGFBP2 and obesity due to melanocortin 4 receptor deficiency.