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Nonalcoholic steatohepatitis 

Nonalcoholic steatohepatitis

Nonalcoholic steatohepatitis

Stephen F. Stewart

and Chris P. Day



Increased use of noninvasive staging tools in clinical practice PIVENS trial supporting vitamin E.

Updated on 28 Nov 2012. The previous version of this content can be found here.
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date: 30 March 2017

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder in the developed world, affecting 20 to 30% of Western adults. Nonalcoholic liver disease occurs with a range of severity from simple steatosis through nonalcoholic steatohepatitis (NASH) to fatty fibrosis—and, ultimately, cirrhosis. The condition is a manifestation of the metabolic syndrome, strongly associated with obesity, insulin resistance, and dyslipidaemia; dietary and genetic factors appear to determine susceptibility to the disease and its progression.

In most patients the condition is discovered incidentally when abnormal values of serum liver-related liver tests are reported.. The diagnosis is usually one of exclusion: liver biopsy is not usually required , but is needed disease staging in some individuals. Treatment is directed at components of the metabolic syndrome: diet and exercise have been shown to reduce steatosis; metformin and pioglitazone can have beneficial effects on steatosis, inflammation and fibrosis in patients with type 2 diabetes; pharmacological antiobesity agents and other treatments are under evaluation.

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