Nonalcoholic steatohepatitis and hepatocellular carcinoma: Beyond the boundaries of the liver

Core Tip

Core Tip: Nonalcoholic steatohepatitis (NASH) is a metabolic liver disease which also involves multiple organs like the heart, lungs, and kidneys. NASH may arise primarily, followed by involvement of other organs, or it may come late in the course of metabolic syndrome. The multidisciplinary approach is needed towards a patient with diabetes, obesity, and metabolic syndrome to address all issues related to the liver, heart, etc. Genetic and molecular signatures have provided a ray of hope for estimating risk in these patients; however, it has many practical issues. The impact of environmental pollutants and toxins as a causative factor in NASH, especially lean patient population, should also be considered. We need population based studies from different geographical areas for estimation of metabolic, environmental, and genetic risk factors.