In this prospective study, adult patients ranging in age from 18-80, routinely seen in the Brooke Army Medical Center Gastroenterology clinics will be eligible for enrollment. Approximately 950 adult patients will be enrolled. In phase I the prevalence of NAFLD and NASH will be determined, non-invasive imaging techniques for the diagnosis of NAFLD and NASH will be explored, and the relationship between colon polyps and NAFLD will be evaluated. Phase II will be offered to participants that qualified for a liver biopsy. In phase II the prevalence and severity of CAD, endothelial dysfunction, and diastolic dysfunction within the population of subjects with NAFLD will be determined.