Nonalcoholic steatohepatitis (NASH), or fatty liver disease, is a common, often "silent" liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly. Nonalcoholic steatohepatitis is common in obese individuals (up to 90%) as well as in type 2 diabetic individuals (up to 75%). People with type 1 diabetes in very poor control may also develop this syndrome, although it is much less common.
Image credit: NIDDK/NIH
NASH affects 2 to 5 percent of Americans. An additional 10 to 20 percent of Americans have fat in their liver, but no inflammation or liver damage, a condition called "fatty liver." Although having fat in the liver is not normal, by itself it probably causes little harm or permanent damage. If fat is suspected based on blood test results or scans of the liver, this problem is called nonalcoholic fatty liver disease (NAFLD). If a liver biopsy is performed in this case, it will show that some people have NASH while others have simple fatty liver.
Both NASH and NAFLD are becoming more common, possibly because of the greater number of Americans with obesity. In the past 10 years, the rate of obesity has doubled in adults and tripled in children. Obesity also contributes to diabetes and high blood cholesterol, which can further complicate the health of someone with NASH. Diabetes and high blood cholesterol are also becoming more common among Americans.
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Last week, Lindsey railed about that portion of the diabetes community that seems to seek pity for complications that seem to arise from the deliberate neglect of that insulin-sucking monkey on our shoulders. While I agree that deliberate self-mistreatment for its own (or pity's) sake is more indicative of mental illness than anything else, I'm more likely to ask about the reasons why a person might...