Development of noninvasive procedure for diagnosis of NASH and of therapeutic strategy

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The pathological features of NASH are associated with the pathological features most commonly seen in alcoholic liver disease itself. However, liver biopsy is a surgical procedure and a serious complication is inevitable at a very low rate. In this study, we investigated to find a noninvasive procedure for a diagnosis of NASH. A multivariated analysis revealed that patients with severe hepatic steatosis defined by using liver/spleen ratio<0 and age>50 years old were two most important factors. Plasma ferritin and platelet number were also useful markers of NASH. Venosection was a useful strategy for NASH with elevated ferritin levels. Randomized therapeutic trial using metformin and PPAR-γ ligand is in process.