by Sandra Douglas

Created on: May 06, 2011   Last Updated: May 10, 2011

Nonalcoholic steatohepatitis, commonly known as NASH, is a form of liver disease characterized by fat deposits in the liver, inflammation and liver damage. In the early stages, NASH is a silent disease with few or no symptoms. If untreated, NASH may progress to cirrhosis of the liver, a serious condition in which the scarred and damaged liver no longer functions properly. It is estimated that nonalcoholic steatohepatitis affects 2 to 5% of Americans.

As the rates of obesity increase in adults and children, NASH is becoming more common, though not everyone with fat deposits in the liver is diagnosed with NASH. An estimated 20% of Americans have fat deposits in the liver that do not cause damage. When little or no liver damage is caused, the condition is known as “fatty liver” or Nonalcoholic Fatty Liver Disease (NAFLD). The difference with NASH is that the liver begins to show signs of disease that resemble alcoholic liver disease, even though the person drinks little or no alcohol.

Who is At Risk for Nonalcoholic Steatohepatis?

In addition to occurring in people with obesity, NASH is also seen in those who have diabetes, high blood levels of cholesterol and triglycerides, and heart disease. It occurs more often in those who are middle-aged and overweight. Though researchers are still trying to determine the exact cause of the disease, they note a relationship between NASH and these other diseases.

The exact cause of the liver injury of NASH is not known. Many people with fat deposits in their livers do not go on to develop NASH. Not everyone with diabetes, heart disease, and elevated blood lipids will develop NASH. Other people who do not have any risk factors will develop NASH. The disease can even occur in children.

How Is It Diagnosed?

Most people in the early stages of NASH do not know they have the disease. They often feel fine when a routine blood test reveals elevated liver enzymes. Abnormal levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are often the first signs of liver disease. Because the liver is able to compensate even when there is significant damage, a person may not experience symptoms until the disease has progressed. Even then, the first signs may be fatigue, weight loss, and decreased appetite.

The first step in diagnosing the condition is to rule out other causes of elevated liver enzymes, such as viral hepatitis, excessive alcohol use, or damage caused by medications or chemicals. Once other causes

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