DISEASE SCANNER

Global Incurable Diseases Tracker

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Hepatologic Disease

Non-Alcoholic Steatohepatitis

HIGH SEVERITY

The progressive form of non-alcoholic fatty liver disease (NAFLD), characterized by hepatic steatosis with inflammation and hepatocyte injury, with or without fibrosis. Can progress to cirrhosis and hepatocellular carcinoma. Now called MASH (metabolic dysfunction-associated steatohepatitis).

Global Affected

115.0M

Countries

111

Symptoms

Often asymptomatic
Fatigue
Right upper quadrant discomfort
Hepatomegaly
Weight gain/obesity
Type 2 diabetes
Metabolic syndrome
Pruritus (advanced)
Jaundice (advanced)
Ascites (cirrhosis)

Treatment Options

Resmetirom
Weight loss (7-10%)
GLP-1 receptor agonists
Pioglitazone
Vitamin E (non-diabetic)
Bariatric/metabolic surgery
Management of comorbidities
Liver transplantation (ESLD)

Risk Factors

1Obesity
2Type 2 diabetes
3Insulin resistance
4Metabolic syndrome
5Hypertension
6Dyslipidemia
7Age
8Hispanic ethnicity
9Polycystic ovary syndrome
10Hypothyroidism
11Obstructive sleep apnea
12Certain genetic variants (PNPLA3)

Diagnostic Methods

  • 1Liver enzymes (ALT, AST)
  • 2Liver ultrasound
  • 3FibroScan (elastography)
  • 4MRI-PDFF (steatosis quantification)
  • 5Liver biopsy (gold standard)
  • 6FIB-4 or NAFLD fibrosis score
  • 7Magnetic resonance elastography
  • 8Assessment for metabolic syndrome

Prognosis

20-30% progress to cirrhosis over 10-20 years. Leading indication for liver transplant in US. Cardiovascular disease leading cause of death. HCC risk increased. With weight loss and new therapies, fibrosis can regress.

Prevention

  • Weight management
  • Healthy diet (Mediterranean)
  • Regular exercise
  • Diabetes prevention/control
  • Limit alcohol
  • Avoid fructose-sweetened beverages
  • Regular screening in at-risk

Research Status

Resmetirom (THR-β agonist) first FDA-approved treatment March 2024. GLP-1 agonists (semaglutide) showing significant benefit. Pioglitazone and vitamin E (non-diabetics). FGF21 analogs in trials. Obeticholic acid (FXR agonist) had issues. Bariatric surgery effective.

Sources

  • https://liverfoundation.org
  • https://www.cdc.gov/
  • https://www.hematology.org/education/patients
  • https://www.ncbi.nlm.nih.gov/books
  • https://rarediseases.org/rare-diseases

Medical Disclaimer

This information is for educational purposes only. Always consult healthcare professionals for medical advice, diagnosis, and treatment.