The Global Burden of Non-alcoholic Steatohepatitis

Resumen

Non-alcoholic fatty liver disease (NAFLD) is growing globally in parallel to the epidemics of obesity and type 2 diabetes mellitus. Presently, 25% of the adult population is affected globally but in those with Type 2 diabetes mellitus (T2DM), the global prevalence is 55.5%. Despite the very high prevalence of NAFLD, it is the subtype of non-alcoholic steatohepatitis (NASH) that predominantly leads to the development of fibrosis, cirrhosis, hepatocellular carcinoma (HCC), liver transplantation and/or death. Currently, the prevalence of NASH in general population ranges from 1.5–6.5% but can be as high as 37.3% in those with T2DM. As such, NASH is now among the top indication for liver transplantation and is increasingly linked to HCC in the United States. To date, there are no approved pharmaceutical agents to treat NASH and management relies on life style modifications. In this review, we discuss NASH, its pathophysiological, patients reported and economic outcomes as well as potential therapeutic targets.