“…The complexity in interpreting the interplay between the liver (as the main controller of the systemic UCB level), the brain (neurological diseases) and the YPs is also present in the non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of the metabolic syndrome. NALFD is a pandemic condition involving also the pediatric population [ 174 , 175 ], and regarded as one of the newest risk factors for neurological diseases [ 176 , 177 ], with the life style and the diet regimen being key factors in the CNS pathology progression [ 178 , 179 , 180 ]. The liver and brain appear to be inter-connected at various levels (so-called liver brain axis): (1) A negative correlation between serum bilirubin concentrations and NAFLD stage has been reported [ 75 , 181 , 182 , 183 , 184 ]; (2) the modulation of HMOX1/CO/iron, in turn acting on sirtuin1 (Sirt1—see Table 2 ), a histone deacetylase controlling the adaptive mechanism to disease and the bilirubin transport in both organs [ 89 , 185 , 186 , 187 ] has been also demonstrated; and (3), the liver and brain may be connected by insulin resistance [ 183 ], a feature of the metabolic syndrome whose CNS consequences have been discussed in Section 2.4 .…”