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they also produce ROS contributing even more to the oxidative stress.7 Linkage of the metabolic syndrome to non-alcoholic fatty liver disease NAFLD can be considered as the hepatic representation of the metabolic syndrome.29 The development of NAFLD is strongly associated with the metabolic syndrome as reflected by the fact that approximately 90% of the patients with NAFLD have more than one feature of metabolic syndrome and about 33% have three or more criteria.36 Furthermore, with the addition of each of the components of the metabolic syndrome the risk of steatosis increases exponentially.37 Nonalcoholic fatty liver disease has been consistently associated with obesity (60-95%), type 2 diabetes mellitus (28-55%) and dyslipidemia (27-92%).11 The presence of the metabolic syndrome is associated with a potentially progressive and severe liver disease

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During the first round, study titles and abstracts were independently reviewed by two reviewers (XM and XW) using the Rayyan platform