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Those who are overweight (BMI exceeds 23 for Asians and 25 for Caucasians). Those with diabetes mellitus, gout, hypertension and hyperlipidemia are at risk of developing NASH.
Liver function tests usually show an elevated ALT or AST. Fatty infiltration of the liver is also seen on ultrasound of the abdomen. It is important to exclude viral hepatitis B and C, as well as other metabolic and autoimmune causes of liver disease through blood tests.
The most accurate test for the diagnosis of NASH is a liver biopsy. The biopsy will also help to determine the stage of the disease (i.e. whether cirrhosis is present).
At this time, there are no treatments that can cure NASH. The main goal of treatment is to control the conditions that are associated with NASH, such as obesity and hyperlipidemia. Several experimental treatments are being studied, but none can be routinely recommended.
Lifestyle measures such as weight reduction are the main stay of treatment but should be done gradually as rapid weight loss has been associated with worsening of liver disease.
The typical course of NASH is still being studied. About a third may progress to fibrosis and about 20% will develop cirrhosis over a period of 9 years.
Picture of normal liver biopsy
Picture of NASH liver biopsy
You should seek advice from a liver doctor (hepatologist)to confirm the diagnosis and also on how to manage the condition.