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Experts don't know why some people with a buildup of fat in the liver get NASH and some don't. It could be that something in the environment triggers the inflammation in those people. Or maybe it runs in their families.
Things that put people at risk for NASH and for liver damage include:
Insulin resistance and type 2 diabetes.
High cholesterol and high triglycerides.
Most people who have NASH are 40 to 50 years old and have one or more of the problems listed above. But NASH can happen in people who have none of these risk factors.