The obesity epidemic as well as continuing high rates of alcohol consumption ensure that many patients with liver disease have multiple causes of their liver injury. The presence of co-toxic insults exacerbates the underlying liver disease, hastens progression to end stage liver disease and increases the risk of liver cancer.  Non-alcoholic fatty liver disease (NAFLD) is now the most common liver disease in Western countries and can develop into the more aggressive non-alcoholic steatohepatitis (NASH). Approximately one third of adults will develop NAFLD in their lifetime. Iron overload is commonly seen in patients with NAFLD and indeed even mild increases in liver iron may play an important role in the transition of NAFLD to NASH. We are undertaking a series of studies examining the relationship between altered iron metabolism in NASH and the role of adipose tissue (fat tissue) and the liver in the development of NAFLD.