The ‘silent’ liver disease: A new public health concern for the 21st Century

(BPT) – By the time you finish reading this article, 14 American adults will have been newly diagnosed with diabetes. Thirty-three percent of Americans are obese, and by 2030, this rate is expected to rise to 50 percent. Nonalcoholic Fatty Liver Disease (NAFLD) is a growing epidemic associated with diabetes and obesity. NAFLD is a chronic liver disease characterized by the build-up of extra fat in the liver cells that is not caused by alcohol use. While it is normal for the liver to contain some fat, certain people accumulate extra fat. Left untreated, the accumulation of fat in the liver can progress to a more severe form of NAFLD called Nonalcoholic Steatohepatitis (NASH).

NASH is fatty liver with inflammation (tissue injury). Over time, the buildup of fat in the liver causes the liver cells to become damaged. In some patients, this eventually leads to liver fibrosis (scarring) and cirrhosis (severe scarring), which results in other health complications, including liver failure, liver cancer and even death. The exact cause of NASH is unknown, but known risk factors include type 2 diabetes, obesity, insulin resistance, high cholesterol and high blood pressure.

NASH has become known as the “silent” liver disease. Many people with risk factors likely have NASH but are unaware because they may experience minimal to no symptoms. NASH can progress for years or decades undiagnosed. “NASH is an underappreciated, yet serious health concern that warrants more public attention,” says Dr. Stephen Harrison, one of the world’s leading experts studying NASH. “If you suspect you might have NASH, it’s important to speak with a healthcare provider about your options for managing the condition.”

Here are some facts about NASH

1. As the rates of diabetes and obesity continue to climb, the incidence of NASH will rise, as well.

2. More than 10 percent of the global adult population is estimated to be living with NASH.

3. At least one-third of Americans are estimated to have NAFLD and approximately 6 million have progressed to NASH.

4. Of the more than 400 million obese adults worldwide, approximately 75 percent are likely to have NAFLD and up to 20 percent have progressed to NASH.

5. By 2020, NASH is expected to become the leading cause for liver transplantations in the U.S.


In many patients NASH can exist with no symptoms and normal blood tests. If you have diabetes, obesity, high cholesterol, insulin resistance, and/or high blood pressure, you may have NASH and should talk to your doctor and request further evaluation. Your doctor may order special tests and a liver biopsy to diagnose NASH and the amount of liver scarring.

Treatment options

The current standard of care for NASH involves lifestyle counseling with diet and exercise. There are no approved therapies for the treatment of NASH.

Enrolling in a clinical trial

New treatment options are being investigated in clinical trials. Clinical trials are essential to advancing medicine and play an important role in getting new drugs approved to treat a particular condition. To learn more about an ongoing clinical trial for NASH, visit

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