title: Hepatic steatosis and steatohepatitis: Are they really two distinct entities?
abstract: Non-alcoholic fatty liver disease affects nearly 30% of Americans. A histopathological spectrum exists from simple steatosis to NASH which may progress to cirrhosis and HCC. NASH is currently the third most common indication for liver transplant with increasing incidence. Steatosis can be considered the hepatic manifestation of the metabolic syndrome as insulin resistance is a major risk factor for its development. While liver biopsy is the gold standard for diagnosis, non-invasive methods are currently being developed to appropriately determine who needs histologic evaluation. Management focuses on mitigation of risk factors, since targeted therapies to halt progression of fibrosis have not been validated. Simple steatosis does not affect overall survival, but NASH conveys increased mortality. Because of this, non-invasive strategies to diagnose patients and management algorithms are needed. This review supports the definitions of simple steatosis and NASH as two distinct entities based on pathophysiology, diagnosis, management, and prognosis.
authors: Department of Internal Medicine, University of Kentucky, Lexington, KY, 304B Charles T. Wethington Bldg., 900 South Limestone, Lexington, KY 40536-0200, (859) 323-9918 office, (859) 323-1197 fax, cory.fielding@uky.edu.
authors: Cory M
authors: CM
authors: Fielding
authors: Division of Digestive Diseases and Nutrition, Department of Internal Medicine, University of Kentucky, Lexington, KY, 800 Rose Street, Room MN649, Lexington, KY 40536-0298, (859) 323-3555 office, (859) 257-8860 fax, paul.angulo@uky.edu.
authors: Paul
authors: P
authors: Angulo
keywords: NAFLD; NASH; Non-alcoholic fatty liver disease; cirrhosis; hepatitis; hepatocellular; insulin resistance; liver; non-alcoholic steatohepatitis; obesity; review; steatohepatitis; steatosis; transplant