NASH, or non-alcoholic steatohepatitis. is the most severe form of non-alcoholic fatty liver disease (NAFLD). It is the most common liver disease, affecting 20 - 25 million people in the U.S., and up to 250 million worldwide. The prevalence of NASH is growing rapidly as it is associated with other rapidly growing conditions, such as obesity, hyperglycemia, type 2 diabetes, hypertension, and hypertriglyceridemia.
NASH is characterized by the presence of an abnormal accumulation of fat in the liver in the absence of a history of alcoholism. As the disease progresses, it can result in excessive scarring and inflammation in the liver (fibrosis), a natural response to injury which can lead to liver cirrhosis or liver cancer.
NASH is generally without symptoms and comes to medical attention due to elevated liver enzymes during a routine exam or when the liver becomes enlarged.
There are no current drug therapies for NASH. The first line of management is lifestyle modifications, primarily weight loss, as weight loss has been shown to reduce fat in the liver, inflammation, and fibrosis.
- Perumpail BJ et al, Clinical epidemiology and disease burden of nonalcoholic fatty liver disease. World J Gastroenterol. 2017 Dec 21; 23(47): 8263–8276
- Yeh MM: Pathology of Nonalcoholic Steatohepatitis. Medscape, updated 4/14/17