Current Hepatology Reports

, Volume 13, Issue 2, pp 151–158

Hepatic Steatosis and Steatohepatitis: Are they Really Two Distinct Entities?

Fatty Liver Disease (SA Harrison and J George, Section Editors)

DOI: 10.1007/s11901-014-0227-5

Cite this article as:
Fielding, C.M. & Angulo, P. Curr Hepatology Rep (2014) 13: 151. doi:10.1007/s11901-014-0227-5


Non-alcoholic fatty liver disease affects nearly 30 % of Americans. A histopathological spectrum exists from simple steatosis to NASH which may progress to cirrhosis and HCC. NASH is currently the third most common indication for liver transplant with increasing incidence. Steatosis can be considered the hepatic manifestation of the metabolic syndrome as insulin resistance is a major risk factor for its development. While liver biopsy is the gold standard for diagnosis, non-invasive methods are currently being developed to appropriately determine who needs histologic evaluation. Management focuses on mitigation of risk factors, since targeted therapies to halt progression of fibrosis have not been validated. Simple steatosis does not affect overall survival, but NASH conveys increased mortality. Because of this, non-invasive strategies to diagnose patients and management algorithms are needed. This review supports the definitions of simple steatosis and NASH as two distinct entities based on pathophysiology, diagnosis, management, and prognosis.


Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis NASH NAFLD Steatohepatitis Steatosis Hepatitis Liver Cirrhosis Hepatocellular Transplant Obesity Insulin resistance Review 

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Internal MedicineUniversity of KentuckyLexingtonUSA
  2. 2.Division of Digestive Diseases and Nutrition, Department of Internal MedicineUniversity of KentuckyLexingtonUSA

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