What is the difference between NASH and NAFLD?

The main difference between NASH and NAFLD is that NASH, or non-alcoholic steatohepatitis, is an accumulation of fat, inflammation, and damage to the liver cells. But NAFLD, or non-alcoholic fatty liver, is a pathological condition with excessive buildup of fat in the liver. In addition, NASH is one type of NAFLD, while the two types of NAFLD are NASH and NAFL, or the non-alcoholic fatty liver. In addition, NAFL only shows the accumulation of fat in the liver.  

NASH and NAFLD are two pathological conditions that, along with insulin resistance, show an excessive accumulation of fat in the liver. Generally, these conditions arise due to causes other than alcohol consumption.  

Key areas covered  

1. What is NASH - definition, characteristics, meaning 2. What is NAFLD - definition, characteristics, meaning 3. What are the similarities between NASH and NAFLD - overview of the common characteristics 4. What is the difference between NASH and NAFLD - comparison of main differences

key terms  

Fat accumulation, inflammation, NAFL, NAFLD, NASH Difference Between NASH and NAFLD - Comparative Summary

What is NASH  

NASH (non-alcoholic steatohepatitis) is the most severe form of NAFLD, the non-alcoholic fatty liver disease. In general, NAFLD can progress to NASH and eventually lead to serious complications such as cirrhosis , liver cancer , liver failure, or cardiovascular disease . Of these, cirrhosis is a more severe form of liver damage or advanced liver scarring that can affect liver function. In addition, people with cirrhosis of the liver are at higher risk of developing liver cancer and may need a liver transplant. Also, people with NAFLD have a roughly 20% chance of developing NASH.

What is the difference between NASH and NAFLD?

Figure 1: Stages of liver damage

In addition, the aforementioned scarring or fibrosis develops due to the accumulation of fat, inflammation, and liver cell damage. Symptoms of NASH include tiredness, abdominal swelling (ascites), enlarged blood vessels just under the skin, enlarged spleen, red palm, and jaundice (yellowing of the skin and eyes).  

What is NAFLD  

NAFLD (non-alcoholic fatty liver disease) is a major cause of liver disease, which is characterized by the development of excessive fat in the liver due to causes other than alcohol consumption. It also occurs along with insulin resistance, which in turn builds up the three risk factors of NAFLD; Obesity, type 2 diabetes, and metabolic syndrome combined with a large waistline, high blood pressure, low HDL cholesterol, high triglycerides, and diabetes. Consequently, they cause obesity. Because of this, the treatment for NAFLD is weight loss through diet and exercise.

Key difference - NASH vs NAFLD

Figure 2: NAFLD prevalence

Additionally, the other health problems that can develop into NAFLD are high cholesterol, high triglycerides, sleep apnea, hyperthyroidism, hyperphyseal hyperphysis, POS, etc. The most common symptoms of NAFLD include fatigue, enlarged liver, and upper right abdominal pain. There are also two types of NAFLD; NASH and NAFL. Here the NAFL (non-alcoholic fatty liver) is only characterized by the accumulation of fat in the liver. Hence, there is no inflammation and is therefore less severe than NASH. It doesn't go into NASH either. In addition, although NAFLD is a leading cause of liver disease in the United States, it is less common among African Americans. Therefore, the likelihood of developing NAFLD depends on ethnicity.  

Similarities Between NASH and NAFLD   

  • NASH and NAFLD are two pathological conditions that indicate an excessive accumulation of fat in the liver.   
  • Plus, along with NAFL, they're the top three causes of liver disease.   
  • Basically, both occur together with insulin resistance, which arises from causes other than alcohol consumption .   
  • They mainly occur in people who are overweight.   
  • Generally, both cause fewer or no symptoms until the liver damage is significant. However, certain health conditions such as obesity, metabolic syndrome, and type 2 diabetes can occur.   
  • Apart from that, the possible symptoms are fatigue, enlarged liver, pain in the upper right abdomen, etc.   
  • Usually the diagnosis is made by physical exam, medical history, and tests such as blood tests, imaging tests , liver biopsy, etc.   
  • In addition, weight loss is the treatment for these diseases as it reduces fat, inflammation, and fibrosis in the liver . Eating a healthy diet is also important.  

Difference Between NASH and NAFLD  

definition  

NAFLD (non-alcoholic fatty liver disease) refers to pathological conditions of the accumulation of excess, non-alcoholic fat in the liver . But NASH (non-alcoholic steatohepatitis) refers to the inflammation and damage of the liver caused by the accumulation of fat in the liver.

Correspondence  

NASH is a type of NAFLD, while the two types of NAFLD are NASH and NAFL, or the non-alcoholic fatty liver.  

meaning  

NASH has the accumulation of fat, inflammation and damage to the liver cells. In contrast, NAFLD is a pathological condition with excessive accumulation of fat in the liver, while NAFL only has an accumulation of fat in the liver.  

Symptoms  

Symptoms of NASH include tiredness, swelling of the abdomen (ascites), enlarged blood vessels just under the skin, enlarged spleen, red palm, and jaundice. Meanwhile, symptoms of NAFLD include fatigue, enlarged liver, and pain in the upper right abdomen.  

Heaviness  

NASH is more severe because it leads to cirrhosis, but NAFLD is less severe.  

diploma  

NAFLD is a pathological condition characterized by the accumulation of fat due to causes other than alcohol consumption. While NASH is one type of this, the second is type of NAFL, or the non-alcoholic fatty liver. That is; NASH, or non-alcoholic steatohepatitis, is the severe form of NAFLD. In general, the main distinguishing features of NASH are the accumulation of fat along with inflammation and liver cell damage. And it can lead to cirrhosis. However, NAFL is less severe because its only distinguishing feature is the development of fat in the liver without inflammation. Therefore, the main difference between NASH and NAFLD is in the distinctive features and severity.  

References:

1. "NAFLD & NASH Definition & Facts." National Institute of Diabetes and Digestive and Kidney Diseases , US Department of Health and Human Services, Nov. 1, 2016, available here.

Image courtesy:

1. “Stage of liver damage high” By NIDDK (Public Domain) via Commons Wikimedia 2. “NAFLD-Prevalence-2019” By Signimu - Own work (CC0) via Commons Wikimedia

About the author: Lakna

Lakna, a graduate in molecular biology and biochemistry, is a molecular biologist and has a broad and strong interest in discovering things related to nature