San Antonio has been selected as one of four sites nationwide for a national study on liver disease aimed at developing non-invasive diagnostic tools for non-alcoholic steatohepatitis (NASH). The Foundation for the National Institutes of Health chose four research teams to create easier diagnostic methods for the condition, which currently requires an invasive liver biopsy for definitive diagnosis.

The local research effort is led by Drs. Greg Gonzaba and Sherwyn Schwartz and is based out of Gonzaba’s primary care clinic in San Antonio. The team is conducting scans and blood tests to identify a non-invasive biomarker or indicator that could reliably detect NASH without the need for a biopsy. Researchers hope to enroll at least 200 participants in San Antonio, with eligibility focused on individuals who are diabetic and overweight.

Schwartz, the senior endocrinologist for the Evolution Research Group, emphasized the local relevance of the study, noting that “one half of San Antonio is either pre-diabetic or diabetic, and then you have the obesity. It’s almost endemic.” He added that NASH “can shorten your lifespan by 10 to 20 years and increase the risk of liver cancer by 17 times.”

NASH often presents no symptoms until it reaches an advanced stage, at which point patients may experience leg swelling, belly bloating, and yellowing of the eyes. Between 20% and 30% of people with NASH develop cirrhosis, a condition involving scarring of the liver. Gonzaba, who lost a 53-year-old physician friend in Austin to fatty liver disease, said, “I’m honored and humbled to be part of this national project that can help millions of Americans.”

Gonzaba drew a parallel to diabetes care, explaining, “To make an analogy, an A1C is a test that screens and or we use to track diabetes. If we could find something very non-invasive and simple like that for NASH, that would be ideal.”

The development of a simple diagnostic test for NASH could transform early detection and treatment for a disease that affects millions but remains underdiagnosed due to the invasiveness of current methods. With San Antonio’s high rates of diabetes and obesity—key risk factors for NASH—the city represents a critical population for this research, which aligns with a broader national effort expected to conclude in July 2026.