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Others counter that therapy for fatty liver disease nonalcoholic fatty liver and NASH are identical and liver biopsies have nonalcoholic fatty liver risks and exhibit sampling variability that limit utility.” In a recent study, investigators collected paired liver biopsy specimens from 51 patients with NAFLD. The authors report steatosis grade was the only feature showing substantial agreement among specimens, whereas ballooning degeneration, a key diagnostic criteria for NASH, would have been missed in 25% of patients if only one biopsy had been performed (Gastroenterology. 2005;128[7]:1898-1906). “I do not use liver biopsies to prognosticate,” Abrams says. “I nonalcoholic fatty liver tell patients they have fatty liver disease, they may have NASH, they could progress to end-stage liver disease, and explain weight loss is the only currently successful therapy for both fatty liver disease and NASH.”
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