NAFLD & NASH Latest Facts: Causes, Stages, Symptoms, Diagnosis, Risk Factors, Complications, Prevention, and Treatment

Non-alcoholic fatty liver disease is a liver condition caused by too much fat in the liver cells. It’s linked to conditions like type 2 diabetes, obesity, and cardiovascular diseases. Non-alcoholic steatohepatitis is a more severe and advanced stage of NAFLD.Healthy VS Unhealthy Livers

NAFLD occurs when the build-up of fats is not caused by alcohol abuse, and people affected by this condition usually develop one form, either steatohepatitis or fatty liver. Non-alcoholic fatty liver disease is the broad term for liver conditions that affect people who consume little to no alcohol.

Read also: Fibrosis Caused by Non-alcoholic Fatty Liver Disease Also a Strong Predictor of Long-Term Mortality

In this article, we’ll discuss common liver diseases, their prevention, and why it is essential that you do regular check-ups. Follow along to learn more.

Non-Alcoholic Steatohepatitis

Non-Alcoholic Steatohepatitis is a liver inflammation caused by the build-up of fat in the liver cells. It develops when the body stores excess fat in the liver, but chronic inflammation can lead to scarring and cirrhosis.

According to researchers, 25% of US adults have NAFLD, and only 20% will develop NASH. The risk factors are still not clearly defined, but healthcare providers consider certain conditions like high blood lipid levels, class III obesity, and type 2 diabetes as common causes.

How To Diagnose It?

There are various methods of diagnosing NASH. The NASH test liver is mainly a blood test to identify liver damage. A live function test checks liver inflammation and the levels of liver enzymes, while a lipid panel measures the fats in the blood.

A fibrosis assessment test is used to estimate the levels of fibrosis and scarring. A CT scan might be used to get accurate imaging of the liver. Some healthcare providers might order an abdominal ultrasound or liver stiffness tests like a functional liver test or magnetic resonance elastography.

A biopsy is requested to confirm nonalcoholic steatohepatitis and determine the extent of the condition.

Risk Factors

Non-alcoholic steatohepatitis has an increased risk of occurring in older and people with diabetes. Since it’s difficult to determine whether the person has NAFLD or has developed the progressive form of NASH, it’s recommended to do specific tests to determine the level of liver damage.

Additional common risk factors are insulin resistance, underactive thyroid, postmenopause, metabolic syndrome, high blood sugar and cholesterol levels, polycystic ovary syndrome, severe protein deficiency, etc.

Healthcare professionals claim that people with fats concentrated in the abdomen are also at risk of developing NASH. So, make sure to do regular exercises or outdoor activities to keep your body fit.

Non-Alcoholic Fatty Liver Disease

This is the type of liver disease that does not harm and is in its early stages. However, it can lead to severe liver damage if not treated properly. It develops in four stages, and most of the affected people will create the first stage only without recognizing the symptoms or realizing they have a certain condition.

Read also: UCLA Researchers Find a New Approach to Treating Fatty Liver Disease

The main stages are:

  1. Fatty Liver Steatosis –  a harmless build-up of fat in the liver cells that can be diagnosed if the person is being examined for a different reason
  2. Non-Alcoholic Steatohepatitis – the liver becomes inflamed and displays a more severe form of NAFLD
  3. Fibrosis – a persistent liver inflammation that can cause scar tissue around the blood vessels and the liver
  4. Cirrhosis – the patient has been suffering from liver inflammation for years; in this stage, the liver becomes lumpy and scarred and shrinks immensely. There is permanent damage that can lead to liver failure.


According to experts and healthcare professionals, the common causes of NAFLD are not known. However, physicians believe the excess fat accumulation in the liver is closely linked to being overweight or insulin resistant. Those people who suffer from insulin resistance do not interact with the sugar in response to the insulin.

Hyperglycemia or high blood sugar and high triglyceride levels are additional factors contributing to the development of non-alcoholic fatty liver disease. And if the person has multiple risk factors, it can promote fat deposits in the liver.


Usually, there are no symptoms in the early stages of NAFLD and you might not be even aware that you have it. Often, it’s diagnosed when the person does tests for a different reason.

If the disease progresses to its latter stages, it will display a range of symptoms:

  • Fatigue;
  • Weakness;
  • Dull pain in the top right abdomen;
  • Unexplained weight loss;
  • Jaundice – yellowing of the whites of the eyes and the skin;
  • Edema in the abdomen;
  • Swelling in feet, ankles, and legs;

How To Diagnose It?

Non-Alcoholic fatty liver disease is usually diagnosed via a liver function test. It’s a blood test carried out for other reasons like diagnosing hepatitis. Another way of diagnosing NAFLD is an ultrasound scan of the abdomen, where waves are used to get an image of the abdominal cavity and the organs inside.

Nevertheless, further tests might be required if you are diagnosed with NAFLD. It may involve a particular type of ultrasound scan known as a fibroscan, or in more severe cases where malignancy is suspected, a biopsy.

A liver biopsy is a minimally-invasive procedure where a small sample is taken from the liver to examine in a laboratory.

Risk Factors

Many conditions and diseases can increase the risk of developing NAFLD. But among the most common are:

  • Metabolic syndrome;
  • PCOS – polycystic ovary syndrome;
  • Sleep apnea;
  • Hypothyroidism – underactive thyroid;
  • Hypopituitarism – underactive pituitary gland;
  • High cholesterol;

Read also: Things to Do and Not to Do When You Have Fatty Liver Disease

Genetics also plays a crucial role in developing NASH or NAFLD. According to statistics, ⅔ of the families with type 2 diabetes will develop the disease. And the Asian population is more susceptible to NAFLD and metabolic syndrome.

Additional Info – Genetic variations in two genes, TM6SF2 and PNPLA3, contribute to the development of non-alcoholic fatty liver disease.


Since NAFLD and NASH are closely-related conditions, and the latter is more advanced than the first, similar measures can be implemented to prevent them. Adopting a healthy lifestyle is one way to do it, but we’ll mention a couple of other things you can do.

  • Lose weight – the normal BMI should be 18.5 to 24.9, so if you lose more than 10% of the weight, the fat in the liver cells can be substantially removed. And your condition will improve significantly;
  • Exercise – you should do some types of exercise like walking or cycling;
  • Increase the water intake;
  • A balanced diet – eat plenty of vegetables, fruits, carbohydrates, and protein. Limit the intake of salt and sugar;
  • Eat small portions of food;
  • Do not smoke;
  • Control blood sugar levels – if you are suffering from diabetes, it’s crucial to monitor your blood sugar and take the medicines as prescribed.


NAFLD and NASH can lead to further complications that can be difficult to treat. Thus, it’s important to go to regular checkups and prevent further liver damage.

The main complication of these conditions is cirrhosis. It is a response to liver injury, and certain areas of the liver develop scarring or known as fibrosis as the liver tries to prevent or fight the inflammation.

If NAFLD or NASH are not treated on time or prevented, additional complications like swelling of the veins, ascites, hepatic encephalopathy, or even liver cancer can occur. Ascites is a buildup of fluids in the abdomen, while swollen veins usually occur in the esophagus. If not treated accordingly, the veins can rupture and bleed.

Hepatic encephalopathy can lead to slurred speech and drowsiness, while the end-stage renal disease is the stage when the liver stops functioning.


At the moment, there’s no specific medication for treating NAFLD, but certain lifestyle modifications can help you reduce liver fat and improve your health. If you are struggling with associated conditions like diabetes, high blood pressure, or cholesterol, you might be given treatment for those.

Read also: A Transplant Made Possible by a Machine That Restored an Otherwise Damaged Liver

Liver Transplant

If you develop cirrhosis, the only way to treat the condition and prevent liver damage is to be on the liver transplant list. You’ll be transplanted a piece of the liver from a living donor, and since the liver can grow to its standard size and regenerate itself, you can have a fully functioning liver with this surgery.

A liver transplant is the last choice for patients where previous treatments have failed.

Lose Weight

Most healthcare providers advise reducing weight and aiming for a BMI of 18.5-24.9. If you’re extremely obese, losing more than 10% of your body weight will remove the liver fats and improve your condition.

A healthy diet can also help in maintaining a healthy weight. You can include more protein, fruits, vegetables, and carbohydrates in the diet and limit the sugar, fat, and salt intake. Eating small portions can help too!

It’s recommended to have regular appointments with your physician to be aware of your liver function and diagnose new symptoms.

Take Care of Your Health

Make sure to maintain a healthy diet, exercise regularly, and change your lifestyle to reduce or eliminate liver inflammation. If you think you have any of the common risk factors for NAFLD or NASH, consult your healthcare provider.




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