Clinical features of nonalcoholic steatohepatitis in Japan: evidence from the literature

Abstract

Metabolic syndrome, that is, obesity, hypertension, hyperlipidemia, and insulin resistance with hyperinsulinemia, is a new disease entity prevailing worldwide, and nonalcoholic steatohepatitis (NASH) is believed to be a hepatic expression of this syndrome. NASH is characterized by zone 3-dominant hepatic steatosis with ballooned hepatocytes and Mallory bodies, zone 3 pericellular and perivenular fibrosis with or without bridging fibrosis, and lobular inflammatory cell infiltration. Indeed, 90% of NASH has been revealed to be complicated by visceral obesity, and two-thirds of NASH patients fulfill the criteria of metabolic syndrome. Therefore, a variety of lifestyle-related diseases such as obesity, hypertension, hyperlipidemia, and diabetes mellitus may share the same background. NASH is most prevalent and well characterized in Caucasians; however, little is known about its occurrence in Asia-Oceania, because obesity has not been frequent in countries in these areas. Obesity is expected to become a serious social problem in Asia-Oceania in the next two decades, so we need to prevent a corresponding increase of NASH. For that purpose, we need to know much about not only NASH but also ourselves. To elucidate the status of NASH in Japan, recent progress in the study of NASH in Japan is reviewed in this article.

Nonalcoholic fatty liver disease in adult hypopituitary patients with GH deficiency and the impact of GH replacement therapy

“…Causes of hypopituitarism are shown in Supplementary Figure 1A, see section on supplementary data given at the end of this article. The prevalence of NAFLD in the control group (12% overall, men 18%, women 7%) was comparable with that in the previous report in the Japanese population (22,23,24). Strikingly, the prevalence of NAFLD in the GHD group was significantly increased by 6.4-fold compared with the control group (77 and 12%, P!0.001; Table 1).…”

“…Because liver biopsy was performed in only a part of the group, it is speculated that the prevalence of NASH in the hypopituitary patients with GHD was estimated to be lower than that of the true one. Nonetheless, the prevalence of NASH in this study (14/66, 21%) was apparently high compared with the prevalence of 1-3% that was previously reported for the Japanese population (24,25).…”

Visceral Fat Accumulation in Japanese High School Students and Related Atherosclerotic Risk Factors

“…The frequency of fatty liver is higher in men than in women and is most commonly found in patients with excessive alcohol intake and excessive intake of carbohydrates 41) . In those aged less than 20 years, the frequency of fatty liver is approximately 20% in men and 5% in women 42) ; however, in our study, hepatorenal echo contrast positivity, regardless of obesity, was found in 23.3% of boys (32 participants) and 30.4% of girls (55 participants).…”

Epigallocatechin-3-gallate improves nonalcoholic steatohepatitis model mice expressing nuclear sterol regulatory element binding protein-1c in adipose tissue

“…Based on annual health checks, the prevalence of fatty liver diagnosed by ultrasonography increased from 10% in 1980 to 20-40% in 2000 among adults. Thus, nonalcoholic fatty liver disease (NAFLD) is now emerging as the most common liver disease in Japan (2,3). The recent worldwide rise in the number of patients with nonalcoholic steatohepatitis (NASH) tends to parallel the increase in metabolic syndrome, which includes obesity, type 2 diabetes and hyperlipidemia (4).…”