Muhammed Umar, Sofia Chohan, Hamama tul Bushra Khaar, Muhammad Zahid, Amir Chohan, Seema Kanwal, Muhammad Hanif.
Clinical Spectrum of Non-Alcoholic Steatohepatitis (NASH) in Non Diabetic Population.
Pak J Gastroenterol Jan ;17(1):30-2.

Twenty-one patients of liver biopsy proven NASH between the ages 21 to 50 years with no history of alcohol consumption, non-diabetic and without any known hepatic disease were studied for clinical presentation, risk factors and morphology characteristics. Fifteen were male and six were females. Mean age was 31.5 ± 7.15 years, average weight 91.5 ± 33.6 kg and mean BMI 32.6 ± 9.6. Mean serum ALT was 88.4 ± 38.3 u/L. Data of lipid profile showed mean cholesterol of 219.9 ± 40.9 mg/dl and mean triglyceride 170.3 ± 42.2 mg/dl. Ultrasound abdomen was normal in 3 patients (14%) while fatty changes in liver were seen in 17 (81%) patients. Ultrasound abdomen of one patient showed coarse parenchyma of the liver. In 81% of the patients, the major presenting complaint was the pain in right hypochondrium followed by dyspeptic symptoms. 19% of the patients were asymptomatic. Liver biopsy revealed that 9 patients (42.9%) had grade 1 (mild) changes of steatohepatitis while 11 patients had grade 2 (moderate) changes. Only one (4.8%) had grade 3 (severe) steatohepatitis. It is concluded that majority of the patients with NASH have complaints of pain in right hypochondrium. They have disturbed ALT level. Obesity and dyslipidemia are the risk factors in development of NASH in absence of diabetes. Most patients of NASH have fatty changes seen on ultrasound and biopsy.

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