How to Identify the Patient with Nonalcoholic Steatohepatitis Who Will Progress to Cirrhosis

Zachary H Henry; Curtis K Argo

doi:10.1016/j.gtc.2019.09.002

How to Identify the Patient with Nonalcoholic Steatohepatitis Who Will Progress to Cirrhosis

Gastroenterol Clin North Am. 2020 Mar;49(1):45-62. doi: 10.1016/j.gtc.2019.09.002. Epub 2019 Dec 24.

Authors

Zachary H Henry¹, Curtis K Argo²

Affiliations

¹ Division of Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, VA, USA.
² Division of Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, VA, USA. Electronic address: cka3d@virginia.edu.

PMID: 32033764
DOI: 10.1016/j.gtc.2019.09.002

Abstract

Non-alcoholic fatty liver disease (NAFLD) figures prominently into the clinical hepatology landscape. NAFLD represents a disease spectrum comprising simple steatosis, steatosis with elevated liver enzymes, and non-alcoholic steatohepatitis (NASH), the entity with clear potential for fibrosis progression. Risk factors associated with fibrosis progression in NASH include histologic findings of lobular inflammation and any fibrosis as well as clinical comorbidities that include type 2 diabetes, obesity, and metabolic syndrome. Liver biopsy remains the gold standard in evaluating NASH; however, noninvasive methods are accumulating evidence for a growing role in identifying patients at increased risk to develop NASH, fibrosis, and potentially cirrhosis.

Keywords: Cirrhosis; Fatty liver; Fibrosis; Obesity; Steatohepatitis.

Publication types

Review

MeSH terms

Disease Progression
Humans
Liver Cirrhosis / etiology*
Non-alcoholic Fatty Liver Disease / complications
Non-alcoholic Fatty Liver Disease / diagnosis*