Non alcoholic steatohepatitis (NASH) – every physician's concern

Abstract

Non-alcoholic steatohepatitis (NASH) has undergone turbulent development in the last 30 years, becoming the most common chronic liver disease in the western world. The relationship of NASH with obesity and particularly with insulin resistance was crucial in pathogenesis understanding; nowadays non-alcoholic steatohepatitis is considered to be an integral part of the metabolic syndrome. It represents a serious socioeconomic issue with a prevalence of 20-30% in overweight or obese people. NASH may exist individually or in coincidence with other liver diseases, thus complicating their course. NASH is routinely diagnosed using liver ultrasound and elevated liver enzymes; however, this probably leads to significant underdiagnosing. There is no proven effective pharmacological treatment yet; life-style changes like weight loss and increased physical activity are usually recommended. An increasing number of patients diagnosed with NASH are to be expected and an integrated interdisciplinary approach in their treatment will be necessary.