Clinical Effects of New Approach on Patients With Non-alcoholic Steatohepatitis

Prior treatment

• Prior or planned bariatric surgery.
• Use of other drugs known to have possible positive effects on steatosis.

Other illness

• Current or history of significant alcohol consumption.
• Use of drugs historically associated with nonalcoholic fatty liver disease (NAFLD) (amiodarone, methotrexate, systemic glucocorticoids, tetracyclines, tamoxifen, estrogens at doses greater than those used for hormone replacement, anabolic steroids, valproic acid, and other known hepatotoxins).
• Evidence of other forms of chronic liver disease as Hepatitis B, Hepatitis C, Wilson's disease, Alpha-1-antitrypsin(A1AT) deficiency, Hemochromatosis, drug-induced liver disease.
• If there are any conditions where fibroscan could be contra-indicated. The patients refuse participating or completing study.

Lab values

• Uncontrolled diabetes defined as Hemoglobin A1c 9.5% or higher.

Other

• The presence of contra-indications of NAC or rosuvastatin.
• Pregnancy, planned pregnancy, potential for pregnancy and unwillingness to use effective birth control during the trial and breast feeding.

• All patients are diagnosed to have fatty liver grading 1, 2 or 3 on abdominal ultrasound with Hepatic steatosis index \> 36 to be considered as a NAFLD patient.
• NASH diagnosis using Fibroscan detecting the degree of steatosis and fibrosis.
• NASH diagnosis is by non-invasive Scoring such as (FAST Score) Cytokeratin-18 \>240 U/L Mild to moderate elevation of hepatic liver enzymes: serum aminotransferases (\>2 but \<5 times upper normal limit)
• Stable dietary habits and physical activity pattern.