Clinical Features of NASH
enlargement of the liver is one of the major symptoms, which is caused by
the reduction of fatty acid oxidation in the liver. This results in the
accumulation of fat in the liver. Oftentimes, patients with fatty liver
feel severe fatigue and frequent discomfort at the liver area. When the
condition become more severe as the accumulation of fat increases, other
symptoms such as jaundice, abdominal pain, nausea, vomiting, and tender
liver will occur. These symptoms can also be a sign of an underlying liver
disease that may be exacerbated by the accumulation of fat in the liver.
people become aware of the problem only after a formal examination by
their physicians. The results may reveal an enlarged liver along with
elevated levels of enzymes such as ALT, AST, GGT, and Alkaline phosphate.
Usually ALT is usually more elevated than AST since it is a liver specific
enzyme. Aside from blood work, sonograms and CAT scans can also detect
fatty liver changes and these methods are usually used for clinical
changes in the liver cells are the most obvious characterization. There is
also liver cell necrosis, mononuclear and polymorphonuclear inflammatory
cells infiltration in the liver lobes.
following are the summary of the clinical features of NASH:
peak age of onset: 47 ~ 55
Rate in Female > Rate in Male
2/3 patients above the standard body weight
blood sugar level and abnormal glucose tolerate test (GTT): 50% ~ 90%
patients have diabetes or abnormal GTT.
blood lipids: 30% ~ 90% have high blood lipids
- Concurrent mild ALT and AST elevation.
large fat drops in the liver cells, inflammatory cells infiltration in the
portal areas and the lobes, Mallory bodies, and some cases have already
progressed to cirrhosis.