Interní Med. 2007; 9(5): 210-212

Nonalcoholic steatosis and steatohepatitis

doc. MUDr. Radan Brůha CSc, MUDr. Karel Dvořák

IV. interní klinika VFN a 1. LF UK, Praha

Nonalcoholic steatohepatitis (NASH) is characterized by liver impairment, which is morphologically similar to alcoholic liver disease. The most frequent cause of NASH is metabolic syndrome with obesity, insulin resistance and hyperlipidemia. NASH can lead to liver cirrhosis with its serious complications. The diagnosis of NASH is usually based on elevated liver enzymes and exclusion of other causes of liver disease. Liver biopsy is important for evaluation of fibrosis and inflammation but the differentiation from alcoholic aetiology is usually based on clinical data. The treatment is empiric and is directed to the treatment of metabolic syndrome. The basic intervention is weight reduction with physical activity and diet. Important is the treatment of hyperlipidemia (fibrates, statines). Clinical studies evaluating the effect of insulin-sensitizing medicaments (metformine, glitazones) are promising. The effect of many other medicaments protecting he­patocytes was not sufficiently proved (silymarin, essentiale phospholipids, ursodeoxycholic acid).

Keywords: nonalcoholic steatohepatitis, NASH, metabolic syndrome, cirrhosis

Published: June 21, 2007  Show citation