non-alcoholic steatohepatitis (NASH); metabolic dysfunction-associated steatohepatitis (MASH)

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Etiology

Epidemiology

  • common disorder
  • most common in middle-aged women
  • common in severely obese individuals[3]

Pathology

Laboratory

Radiology

Complications

Management

More general terms

Additional terms

References

  1. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 321
  2. 2.0 2.1 2.2 2.3 2.4 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, 16, 17. American College of Physicians, Philadelphia 1998, 2006, 2009, 2012, 2015
  3. 3.0 3.1 Journal Watch 21(15):123, 2001 Dixon JB et al Nonalcoholic fatty liver disease: predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese. Gastroenterology 121:91, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11438497
  4. Zelber-Zagi S et al, A double-blind randomized placebo-controlled trial for orlistat for the treatment of nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2006, 4:639 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16630771
  5. 5.0 5.1 Belfort R et al, A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis. NEJM 2006, 355:2361 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17135584
  6. 6.0 6.1 6.2 Ekstedt M, Franzen LE, Mathiesen UL, Thorelius L, Holmqvist M, Bodemar G, Kechagias S. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology. 2006 Oct;44(4):865-73. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17006923
  7. 7.0 7.1 Williams CD et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: A prospective study. Gastroenterology 2011 Jan; 140:124 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20858492
  8. 8.0 8.1 8.2 8.3 8.4 8.5 Chalasani N et al. The diagnosis and management of non-alcoholic fatty liver disease: Practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology 2012 Jun; 55:2005 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22488764 (corresponding NGC guideline withdrawn Dec 2017)
  9. 9.0 9.1 Vilar-Gomez E et al. Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis. Gastroenterology 2015 Aug; 149:367. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25865049
    Lassailly G et al. Bariatric surgery reduces features of nonalcoholic steatohepatitis in morbidly obese patients. Gastroenterology 2015 Aug; 149:379. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25917783
  10. 10.0 10.1 Cusi K, Orsak B, Bril F et al Long-Term Pioglitazone Treatment for Patients With Nonalcoholic Steatohepatitis and Prediabetes or Type 2 Diabetes Mellitus: A Randomized, Controlled Trial. Ann Intern Med. Published online 21 June 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27322798 <Internet> http://annals.org/article.aspx?articleid=2529686
    Vilar-Gomez E, Adams LA Pioglitazone: An Addition to Our Toolbox for Patients With Diabetes and Nonalcoholic Steatohepatitis? Ann Intern Med. Published online 21 June 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27322890 <Internet> http://annals.org/article.aspx?articleid=2529687
  11. 11.0 11.1 Zelber-Sagi S, Salomone F;, Mlynarsky L. The Mediterranean Dietary Pattern as the Diet of Choice for Non-alcoholic Fatty Liver Disease: Evidence and Plausible Mechanisms. Liver Int. 2017 Jul;37(7):936-949 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28371239
  12. Diehl AM, Day C Cause, Pathogenesis, and Treatment of Nonalcoholic Steatohepatitis. N Engl J Med 2017; 377:2063-2072. Nov 23, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29166236 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMra1503519
  13. 13.0 13.1 13.2 NEJM Knowledge+ Question of the Week. Jan 23, 2018 https://knowledgeplus.nejm.org/question-of-week/488/
  14. European Association for the Study of the Liver (EASL);. European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016 Jun;64(6):1388-402 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27062661
  15. 15.0 15.1 Bril F et al. Role of vitamin E for nonalcoholic steatohepatitis in patients with type 2 diabetes: A randomized controlled trial. Diabetes Care 2019 Aug; 42:1481 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31332029 https://care.diabetesjournals.org/content/42/8/1481
  16. NEJM Knowledge+ Question of the Week. Dec 15, 2020 https://knowledgeplus.nejm.org/question-of-week/1577/
  17. 17.0 17.1 Newsome PN, Buchholtz K, CusiK et al A Placebo-Controlled Trial of Subcutaneous Semaglutide in Nonalcoholic Steatohepatitis. N Engl J Med 2021; 384:1113-1124. March 25 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33185364 https://www.nejm.org/doi/full/10.1056/NEJMoa2028395
  18. 18.0 18.1 Reuters Staff Study Supports Chemopreventive Effect of Statins on Liver Cancer in NASH Cirrhosis. Medscape. July 20, 2021 https://www.medscape.com/viewarticle/954877
    Pinyopornpanish K, Al-Yaman W, Butler RS et al Chemopreventive Effect of Statin on Hepatocellular Carcinoma in Patients With Nonalcoholic Steatohepatitis Cirrhosis. Am J Gastroenterol. 2021. July 2 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34212895 https://journals.lww.com/ajg/Abstract/9900/Chemopreventive_Effect_of_Statin_on_Hepatocellular.36.aspx
  19. 19.0 19.1 19.2 Sanyal AJ, Van Natta ML, Clark J et al. Prospective study of outcomes in adults with nonalcoholic fatty liver disease. N Engl J Med 2021 Oct 21; 385:1559. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34670043 https://www.nejm.org/doi/10.1056/NEJMoa2029349
  20. 20.0 20.1 Francque SM, Bedossa P, Ratziu V et al. A randomized, controlled trial of the pan-PPAR agonist lanifibranor in NASH. N Engl J Med 2021 Oct 21; 385:1547. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34670042 https://www.nejm.org/doi/10.1056/NEJMoa2036205
  21. 21.0 21.1 Aminian A, Al-Kurd A, Wilson R et al Association of Bariatric Surgery With Major Adverse Liver and Cardiovascular Outcomes in Patients With Biopsy-Proven Nonalcoholic Steatohepatitis. JAMA. Published online November 11, 2021. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34762106 https://jamanetwork.com/journals/jama/fullarticle/2786270
  22. 22.0 22.1 Castera L et al. High prevalence of NASH and advanced fibrosis in type 2 diabetes: A prospective study of 330 outpatients undergoing liver biopsies for elevated ALT, using a low threshold. Diabetes Care 2023 Jul; 46:1354-1362. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37043830 https://diabetesjournals.org/care/article/46/7/1354/148710/High-Prevalence-of-NASH-and-Advanced-Fibrosis-in
    Scoditti E et al. Hunting for progressive NAFLD in type 2 diabetes: Do not trust liver enzymes! Diabetes Care 2023 Jul; 46:1332-1334. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37339349 https://diabetesjournals.org/care/article/46/7/1332/151555/Hunting-for-Progressive-NAFLD-in-Type-2-Diabetes
  23. 23.0 23.1 Harrison SA, Bedossa P, Guy CD et al A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. N Engl J Med 2024; 390:497-509. Feb 8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38324483 https://www.nejm.org/doi/full/10.1056/NEJMoa2309000
  24. 24.0 24.1 Harrison SA et al. A phase 3, randomized, controlled trial of resmetirom in NASH with liver fibrosis. N Engl J Med 2024 Feb 8; 390:497. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38324483 https://www.nejm.org/doi/10.1056/NEJMoa2309000
    Loomba R et al. Randomized, controlled trial of the FGF21 analogue pegozafermin in NASH. N Engl J Med 2023 Sep 14; 389:998. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37356033 PMCID: PMC10718287 (available on 2024-03-14) https://www.nejm.org/doi/10.1056/NEJMoa2304286
  25. Rinella ME, Lazarus JV, Ratziu V et al A multi-society Delphi consensus statement on new fatty liver disease nomenclature. Hepatology. 2023. June 24. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37364790 Free article. Review. https://journals.lww.com/hep/Fulltext/9900/A_multi_society_Delphi_consensus_statement_on_new.488.aspx
    Loomba R, Wong VW. Implications of the new nomenclature of steatotic liver disease and definition of metabolic dysfunction-associated steatotic liver disease. Aliment Pharmacol Ther. 2024 Jan;59(2):150-156. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38153279 PMCID: PMC10807722 Free PMC article. Review. https://onlinelibrary.wiley.com/doi/10.1111/apt.17846

Patient information

steatohepatitis patient information