San Antonio one of four sites tapped for national study on liver disease
Local doctors trying to find an easier way to diagnose the disease, which right now is only diagnosed with invasive biopsies
Courtney Friedman, Anchor/Reporter
Luis Cienfuegos, Photojournalist
Published: July 14, 2026 at 5:46 PM
SAN ANTONIO – People across the country, especially in San Antonio, are dying from a disease they don’t know they have until it’s too late
It all starts with diabetes and obesity and evolves from there
“One half of San Antonio is either pre-diabetic or diabetic, and then you have the obesity. It’s almost endemic,” said Dr. Sherwyn Schwartz, the longtime senior endocrinologist for the Evolution Research Group
KSAT has done several stories about Schwartz’s research that found a large percentage of those patients end up with fat around their liver
That can progress to a liver disease called NASH, which stands for non-alcoholic steatohepatitis
Its symptoms are usually silent. Once leg swelling, belly boating and yellow eyes show up, the disease is severe — 20% to 30% of people with NASH end up with scarring on their liver, called cirrhosis, which can be deadly
“It can shorten your lifespan by 10 to 20 years and increase the risk of liver cancer by 17 times,” Schwartz said
Schwartz said the point is to catch NASH before it turns into cirrhosis. He said if caught early enough, there are treatments to keep the disease from developing
“The only way to make a diagnosis of fatty liver to NASH is a liver biopsy. That’s a puncture. It’s invasive and it’s expensive,” Schwartz said
Schwartz and Dr. Greg Gonzaba are both longtime experts on this in San Antonio. They are one of just four teams chosen by the Foundation for the National Institutes of Health to find out an easier way to diagnose NASH
The research is being run out of Gonzaba’s primary care clinic in San Antonio
“I’m honored and humbled to be part of this national project that can help millions of Americans,” Gonzaba said
The subject is personal to Gonzaba, who lost a close friend and many others to NASH
“My friend from medical school, a 53-year-old physician in Austin, a medical director for Seaton and he passed away from fatty liver disease,” Gonzaba said
Now, he’s determined to make change
Gonzaba and his team are doing scans and blood tests as part of this research, trying to find a biomarker or indicator that someone has NASH and to what degree
“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,” he said
They’re hoping at least 200 people in San Antonio will sign up to be a part of their study
Anyone who is diabetic and overweight may qualify for the study, meaning they could get their own health checked and help keep their community healthy in the future
To see if you qualify, call 210-319-4883
Beyond the study, Gonzaba encourages people to get to the doctor for regular checkups, and request liver scans if they are at risk for fatty liver
He also encourages people to get some exercise and eat healthy to avoid any diabetes or liver disease progression
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