E-mail
Contact Us
NASH
home Application Area
Introduction to Diabetes
Nonalcoholic steatohepatitis, or NASH, is the most severe form of nonalcoholic fatty liver disease (NAFLD), a condition in which the liver builds up excessive fat deposits.
The liver is part of the digestive system. The organ helps break down food, store energy, filter waste products, and remove toxins.1 Even healthy livers contain some fat, but if your liver has more than 5%  fat, you may have some form of NAFLD. If that fat is accompanied by inflammation, it is called NASH.
NASH and Genetics

Some other causes under study include:

  • An immune system reaction to excessive fatty liver tissue
  • The release of toxic inflammatory chemicals (cytokines) by liver cells or fat cells
  • Self-destruction (apoptosis) of liver cells

Oxidative stress, the effect of unstable molecules called free radicals
Genetics seem to contribute to NAFLD and NASH. Research has identified gene changes that might play a role, including a certain variation in the PNPLA3 gene. This gene gives cells instructions for making adiponutrin, a protein found in liver cells and fat cells. Scientists believe that a particular change in the PNPLA3 gene could cause increased fat production and decreased breakdown of fats in the liver, which may contribute to development of NASH.

Ongoing research could shed further light on the role of PNPLA3 and other genes in NASH. Researchers have already confirmed that variations in PNPLA3 can be inherited. Genetically inherited variations of the HSD17B13  protein also may play a role in the development of NAFLD and NASH, as well as severity. Emerging research is attempting to clarify how lifestyle factors such as diet and exercise may affect how the body expresses these genetic variations.1
NASH Risk Factors
Researchers understand NAFLD and NASH risk factors more than their causes. The most common risk factors include.

--Obesity

--Type 2 diabetes or prediabetes

--Abnormal fat levels in the blood

--Age

--Race

--Menopause

--Obstructive sleep apnea

Additional NASH risk factors such as rapid, excessive weight loss and polycystic ovary syndrome (an imbalance of hormones caused by the ovaries) have been identified. However, these risk factors are not considered the most common or well-studied.
NASH Symptoms

NAFLD, including NASH, is usually a silent disease, meaning it has few, if any, symptoms. People with NASH may feel tired or feel discomfort in the upper right side of the abdomen, but most people don't notice symptoms until they develop NASH cirrhosis.

How Fast Does NASH Progress?

The NASH progression to cirrhosis starts when inflamed liver tissue turns into scar tissue (fibrosis), which can prevent the liver from functioning properly. Of those who have NASH, one-third or more go on to develop cirrhosis , which also increases the risk of developing liver cancer.
Most people have NAFLD for years before developing cirrhosis or other complications of NASH.

Global Impact of NASH
NAFLD is becoming more common around the world, in both developing and developed countries. By 2030, the number of people in China with NASH is expected to reach 48.26 million. In Europe, Spain had 1.8 million cases in 2016, with the number expected to increase 49% by 2030. German cases of NASH stood at 3.33 million in 2016 and are projected to climb 43% by 2030. And, researchers anticipate 27 million cases of NASH in the U.S. by 2030.