Martin Zima
Hepatic steatosis has been traditionally regarded as a benign condition. In the last years has been recognised that fatty liver may evolve into severe condition termed nonalcoholic steatohepatitis. This term was first used in 1980 by Ludwig. The pathogenesis of nonalcoholic steatohepatitis is multifactorial. Insulin resistance is thought to be pivotal in the development of steatosis, after which a second oxidative stress and lipid peroxidation produces nonalcoholic steatohepatitis. Liver biopsy is the gold standard for diagnosis and prognosis. Treatment is directed toward weight loss and comorbidity management. The treatment agenda includes cytoprotective, antioxidant, antidiabetic, insulin-sensitizing and antihyperlipidemic agents. The effect of the treatment is uncertain.