Commentary
NASH is the most common cause of liver disease in Western populations, and its prevalence is increasing rapidly. It is a multifactorial and multisystem disease that can affect multiple organs such as the kidneys, heart and blood vessels, and is closely associated with the components of the metabolic syndrome.
Clinicians treating patients with NASH should not only focus on the management of NASH. The approach of associated comorbidities in individual patients is critical. The current management strategies of NASH include either limiting energy surplus alone, or in combination with targeting of downstream pathways of inflammation and fibrosis. ` In their mini-review, MD Muthiah et al. (Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, and Division of Gastroenterology and Hepatology, National University Hospital, National University Health System, Singapore) discuss the currently available treatment options for NASH, as well as those in late-stage clinical trials.
The authors discuss the challenges of managing these patients with a limited number of approved therapies. They also discuss the specific management of comorbidities in NASH patients, in particular diabetes, hypertension, dyslipidaemia and cardiovascular diseases. Finally, they present the screening protocols for both hepatocellular carcinoma and extrahepatic malignancies in these patients.
