<qa>  What is the gold standard to unequivocally diagnose SH?Clinical evaluation and current imaging modalities, and serological and laboratory tests can be strongly suggestive of the presence of hepatic steatosis, but none of these is capable of distinguishing steatohepatitis SH from uncomplicated steatosis; likewise, these evaluations can generally detect advanced liver disease e.g. portal hypertension, but none can truly assess the degree of liver necroinflammatory injury, lesser stages of fibrosis and architectural remodeling. Liver biopsy evaluation, therefore, remains the gold standard to unequivocally diagnose SH and to document the severity of hepatic injury and fibrosis. 