A Myriad of Pathways to NASH

Soledad Larrain, Mary E. Rinella*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations


Nonalcoholic steatohepatitis (NASH) is defined histopathologically by the presence of macrovesicular steatosis, cellular ballooning, and inflammation. NASH represents a complex multifactorial disease that typically occurs within the context of the metabolic syndrome. NASH lacks homogeneity, and other forms of NASH can present atypically. Less than 50% of patients with NASH respond to pharmacologic treatment, which speaks to this heterogeneity. The authors discuss drugs, disease entities, and nutritional states that can cause or exacerbate underlying NASH indirectly through worsening insulin resistance or directly by interfering with lipid metabolism, promoting oxidative injury, or activating inflammatory pathways.

Original languageEnglish (US)
Pages (from-to)525-548
Number of pages24
JournalClinics in liver disease
Issue number3
StatePublished - Aug 2012


  • Drug
  • Endocrine
  • Metabolism
  • NASH
  • Nonalcoholic fatty liver disease
  • Nonalcoholic steatohepatitis
  • Nutrition

ASJC Scopus subject areas

  • Hepatology


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