Background: Non-Alcoholic Steatohepatitis (NASH) is an aggressive form of Non-Alcoholic Fatty Liver disease (NAFLD), with liver inflammation and scarring. Due to a lack of clinical biomarkers and asymptomatic nature, NASH is often under-diagnosed. It is the most common cause of chronic liver disease in the USA. Liver biopsy is the gold standard to diagnose NASH, but it is invasive and life-threatening and histologic evaluation of a liver biopsy sample is imperfect as a reference because of sampling variability due to the irregular distribution of fibrosis. Aim: Validating AST/ALT ratio as a stand-alone scoring system in NASH is scarce and so this study aims to establish a correlation between FibroScan values and AST/ALT ratio. Methodology: All NASH patients, who underwent FibroScan were included. Their demographics, FibroScan, AST, ALT values were recorded in M S Excel and Pearson correlation between FibroScan values and AST/ALT ratios of 150 NASH patients was calculated using SPSS. Results: Out of 150 NASH patients, 72% were males and 57.33% belonged to 40-50 years age group. FibroScan values and AST/ALT ratio showed positive Pearson correlation of 0.245, (p value=0.003). FibroScan values and splenic size also showed a positive Pearson correlation of 0.289 (p value<0.001). Conclusion: Males of 40-50 years age group had higher distribution of NASH, so middle aged males should be screened routinely as they are at a higher risk. FibroScan value with AST/ALT ratio and splenic size showed a positive correlation, thus showing that AST/ALT ratio and splenic size increases with increase in liver stiffness.
NAFLD (Non-alcoholic fatty liver disease) is a condition of high importance due to its increased prevalence, estimated at 24% of the global population, and its potential progression to advanced liver disease, cirrhosis, and hepatocellular carcinoma. Onequarter of NAFLD patients have NASH (non-alcoholic steatohepatitis), which is histologically described as liver steatosis, inflammation, fibrosis, hepatocyte injury, and death. Metabolic disruptions, such as obesity, diabetes, and dyslipidemia, are considered to have a great impact on the development of NASH. Patients may have NAFLD for a long time before progressing into NASH, which highlights the necessity of periodic imaging and biochemical evaluation of the liver, and also presents an optimal window of therapeutic intervention. The challenge in developing treatment for NASH stems from the slow progression of the disease and the reliance on sequential biopsies as the diagnostic and staging tools. Several non-invasive tests have been developed as potential future alternatives to the current invasive gold standard. This review aims to assess the current available methods of diagnosis and treatment targeting inflammation.
