How is NASH developing ?

In collaboration with SOS Hepatitis (SOS Hépatites)

My Liver Exam invites you to read this article, dealing with NASH, commonly called “fatty liver disease”, which affects more and more people in the world.

If you would like to know more, do not hesitate to read our NASH article: “What is called Fatty Liver Disease?”

From steatosis to NASH

Steatosis is generally defined as an accumulation of fat in liver cells (hepatocytes). It is very common and, most of the time, it does not matter. But in 20% of cases1, this steatosis causes inflammation, and a real liver disease: NASH. Like other chronic liver diseases, Non-Alcoholic Steato-Hepatitis can develop into cirrhosis and cancer.

Steatosis may have several causes:

  • Excessive alcohol consumption,
  • Drug intoxication,
  • A disease: chronic hepatitis (in particular chronic hepatitis B or C), but also hypertension, sleep apnea, Wilson’s disease (toxic accumulation of copper in the body), etc.
  • Unhealthy food habits,
  • Inactivity.

Metabolic steatopathy

Steatosis is a metabolic disease that can be linked to obesity, diabetes or insulin resistance*.

In English, metabolic steatopathy is often referred as NAFLD, for Non-Alcoholic Fatty Liver Disease. This is one way to distinguish it from alcoholic steatosis, while recalling its relation with it.

In 80% of cases1, metabolic steatopathy is benign; this is called simple steatosis. Your liver is fat – often a little big, but that’s it.

But in 20% of cases, fatty liver makes the bed of a real hepatitis, susceptible, like the other chronic hepatitis, to evolve towards cirrhosis or cancer.

NASH, or non-alcoholic steatohepatitis

NASH is the association of steatosis and inflammation typical of hepatitis, in people who do not drink or little, and who do not have viral or drug hepatitis. As with other chronic hepatitis, this inflammation eventually destroys liver cells and causes fibrosis process.

Who is concerned with NASH?

It is still difficult to determine why some people develop NASH, and others don’t. What is known, on the other hand, is that NASH primarily concerns people:

– Overweight, especially those with metabolic syndrome (abdominal obesity),

– Patients with type 2 diabetes, not insulin dependent *.

Beyond these two categories of patients, many people are likely to develop NASH without knowing it. Indeed, causes are multiple, and diagnosis is, most of the time, not established. In addition, NASH and the progression to cirrhosis and liver cancer cannot be associated with any symptoms.

Unhealthy food habits, but not only

NASH is sometimes nicknamed “junk food disease”, or “soda disease”. The American example shows that a diet too high in saturated fats, sugars and sweetened beverages (rich in fructose glucose syrup) strongly exposes consumers to NASH.

But such a vision is reductive: you can develop a NASH simply by eating too much, compared to your daily physical needs.

NASH is a more comprehensive indicator of our nutritional imbalances and way of life, where stress and food compensation alternate.

NASH, new hepatitis of cured patients?

Among people with hepatitis C, cirrhosis may return insidiously, due to the development of a NASH.

On a daily basis

There is no miracle cure for NASH. But some factors increase the risk, especially in terms of lifestyle. A diet with too much fat, and low physical activity, will promote the development of NASH.

For more information, do not hesitate to consult our article on these foods which help to purify the liver naturally.

Liver icon ®@EstherQueen999

Associated content : What is liver steatosis?


  1. Cohen and al. Science 2011