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Nonalcoholic fatty liver disease (NAFLD) is a very common disorder. It is a spectrum of liver disease ranging from steatosis to steatohepatitis. It involves the accumulation of fat in the liver of people who drinks little or no alcohol. The most common form of NAFLD is fatty liver. It is a non-serious condition.  Nonalcoholic steatohepatitis is a type of NAFLD. 

NASH is associated with accumulation of fibrous tissue in the liver. In NASH, fat accumulation is associated with inflammation and liver cell damage. NASH is a serious condition that may lead to severe liver scarring, cirrhosis, and even hepatocellular cancer. Chronic liver disease and cirrhosis can develop in patients with NASH. The progression of Cirrhosis is variable, depending on age, and the presence of obesity and type 2 Diabetes Mellitus.


  • Drugs
  • Inborn error of metabolism
  • Insulin resistance and Type 2 Diabetes Mellitus
  • Obesity
  • Dyslipidemia

A hypothesis has been proposed to explain why some patients who develop NAFLD  do not progress to NASH, and others do. Insulin resistance may lead to steatosis (accumulation of fat in the liver), but some type of oxidative stress causes the disease to progress to NASH.


Patient with NAFLD AND NASH  may be asymptomatic, but some patient with NASH can experience     

  • Weakness
  • Malaise
  • Hepatomegaly (Enlarged liver)
  • Abdominal pain in the center or the right upper part of the abdomen.



Medical history, physical examination, and test are used by doctors to diagnose NAFLD and NASH. Test may include

  • Blood test
  • An abdominal ultrasound
  • A CT scan or An MRI scan
  • Sometimes Liver biopsy



  • Few studies have suggested that weight loss may be associated with regression of fat in the liver. Gradual and healthy weight loss in people who are overweight or obese by following a healthy diet and exercising regularly for 30-45 mins. Extreme, rapid weight loss can accelerate NASH developing into cirrhosis and increase the chance of gallstone development.
  • Insulin-sensitizing drugs such as metformin
  • Treatment of dyslipidemia
  • Decrease the amount of liver inflammation by administrating anti-oxidant medications such as Vitamin E capsules. Some studies suggest that Vit E may be beneficial in reducing NASH by reducing tumor necrosis factor alpha activity (TNF alpha is involved in inflammation).


 This is Copyright Content by Gadge's Diabetes Care Edited and written by Madiha Khan


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