ABOUT NON-ALCOHOLIC STEATOHEPATITIS
Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome, it is an umbrella term that is characterized by the accumulation of fat within the liver and describes a range of clinical phenotypes. Non-alcoholic steatohepatitis (NASH) is the progressive manifestation of NAFLD (marked by the NAFLD activity score), a diagnosis of NASH which is confirmed by the histological presence of steatosis, hepatocyte ballooning, and lobular inflammation. NASH patients have a worse prognosis and progress towards cirrhosis at a faster rate compared to those with simple steatosis. Furthermore, NASH liver disease life expectancy is associated with an increased risk of mortality and the development of clinical outcomes such as hepatocellular carcinoma (HCC) and cardiovascular disease (CVD). The key prognostic feature of NASH is the severity of associated liver fibrosis, which is currently evaluated by liver biopsy. Fibrosis progression due to NASH is not a linear process, patients fluctuate through the many stages of the disease, exhibiting alternating phases of inflammation and fibrogenesis and reduced activity and fibrosis regression.
How many have non-alcoholic steatohepatitis?
Up-to-date, the global prevalence of NAFLD is estimated to be around 24% and is set to increase in parallel with obesity and type II diabetes. Of those with NAFLD, 20% have the progressive subtype NASH.
How is non-alcoholic steatohepatitis treated?
At present, there is no approved therapy for the treatment of NASH. Pioglitazone and vitamin E have shown limited efficacy and are used off-label to treat patients. Over 50 compounds targeting a plethora of mechanisms are currently under investigation as a potential treatment for NASH.
How is non-alcoholic steatohepatitis diagnosed?
NAFLD and NASH are primarily diagnosed and monitored through the use of a liver biopsy. Hepatic steatosis can be determined through ultrasound; however, a diagnosis of NASH and can only be confirmed through the use of a liver biopsy to determine steatohepatitis pathology.