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The purpose of this study was to assess the relationship between nonalcoholic fatty liver disease (NAFLD) and arterial stiffness in nondiabetic, nonhypertensive postmenopausal women with and without metabolic syndrome.We divided 1007 postmenopausal women into two groups (NAFLD and controls) and then three groups (NAFLD with metabolic syndrome, NAFLD without metabolic syndrome, and controls), respectively. To exclude the influence of confounding factors, we studied a specifically selected group with no additional cardiovascular risk. Carotid intima–media thickness (CIMT), carotid–femoral pulse wave velocity (cf-PWV), and flow-mediated dilatation (FMD) were measured in all study patients and controls.Patients with NAFLD had significantly greater CIMT than did controls (P < 0.001). cf-PWV was also significantly higher in patients with NAFLD than in controls (P < 0.001). We found significantly decreased FMD in patients with NAFLD than in control patients (P < 0.001). Although patients with NAFLD and metabolic syndrome had greater CIMT and cf-PWV and less FMD than healthy patients did (P < 0.05), there were no significant differences in CIMT, cf-PWV, and FMD (P > 0.05) between patients with NAFLD with and without metabolic syndrome.The presence of NAFLD is associated with an increased risk of arterial stiffness in postmenopausal women, independent of the presence of metabolic syndrome.