II. Definition
- Nonalcoholic Fatty Liver Disease
- Spectrum of disorders of liver fat infiltration not due to Alcohol, medication or hereditary disorder
- Severity ranges from Steatosis to severe fibrosis (NASH)
IV. Epidemiology
- Most common cause of liver disease in western countries
- NAFLD Prevalence: 10-30% of U.S. population (17% in Framingham study)
- Nonalcoholic Steatohepatitis (NASH) accounts for one third of NAFLD cases
- Occurs in up to 3-5% of the U.S. population
- Affects up to 66% of age >50 years with Obesity or Diabetes Mellitus
- Frequent cause of mild Liver Function Test Abnormality
- Most common cause of mildly abnormal ALT and AST in U.S. (accounts for up to 51% of cases)
- Most common cause of cryptogenic Cirrhosis (U.S. adult)
- By 2030, projected U.S. Prevalence 100 Million cases, will become the top indication for liver transplant
V. Types
- Nonalcoholic Fatty Liver (>5% hepatic Steatosis without inflammation)
- Insulin Resistance is a major inciting factor of hepatic Steatosis
- Lipotoxicity from free Fatty Acids
- Nonalcoholic Steatohepatitis (>5% hepatic Steatosis with Hepatic Injury and inflammation, with risk of Cirrhosis)
- Hepatocyte injury with cell ballooning and inflammation
- Inflammatory factors include Cytokines and oxidative stress
- Progresses to hepatic fibrosis and Cirrhosis, and increased risk of Hepatocellular Carcinoma
VI. Risk Factors
-
Obesity
- NASH occurs in 66% of all obese patients (BMI>30) over age 50 years old
- Occurs in 90% of patients at BMI>39
-
Hyperglycemia (75% of NASH patients)
- Metabolic Syndrome
- Type II Diabetes Mellitus (33-66% will develop NAFLD)
- Polycystic Ovary Syndrome
-
Hyperlipidemia (especially Hypertriglyceridemia)
- More than half of those with Hyperlipidemia will develop NAFLD
- High Triglyceride to HDL ratio is associated with up to 78% Prevalence of NAFLD
- Rapid weight loss
- Starvation
- Gastric Bypass
-
Genetic Associations
- Patatin-Like Phospholipase Domain-Containing Protein 3 (PNPLA3)
- Associated with 2 fold increased risk of NAFLD with hepatic fibrosis
- Patatin-Like Phospholipase Domain-Containing Protein 3 (PNPLA3)
- Refeeding Syndrome
- Total Parenteral Nutrition
- Older age (Prevalence increases with age)
- Hispanic descent
- More common in women
- Obstructive Sleep Apnea
- Hypothyroidism
- HIV Infection
- Chemotherapeutic Agents
- Asparaginase
- Cisplatin
- Fluorouracil
- Irinotecan
- Methotrexate
- Tamoxifen
- Other Medications
VII. Symptoms
- Asymptomatic in most cases
- Fatigue
- Malaise
- Right upper quadrant pain
VIII. Signs
- Hepatomegaly (50%)
IX. Differential Diagnosis
X. Labs: Liver specific (first-line)
- Precautions
- Routine NAFLD screening for those at risk is not recommended in U.S.
- Liver Function Tests and Hepatic Ultrasound have insufficient NAFLD Test Sensitivity for screening
-
Liver Transaminases (ALT, AST)
- Normal in some cases
- Typically 2-3 fold increase in transaminases
- If over 1000 consider other cause
- Viral Hepatitis
- Hepatotoxin exposure
- If over 1000 consider other cause
- AST/ALT ratio <0.8 (not true in late disease)
- If AST exceeds ALT, consider Alcoholic Hepatitis
- Alkaline Phosphatase may be increased up to 2 fold
- Gamma-Glutamyltransferase (GGT) increased in some cases
- If over 2 times normal consider Alcoholic Hepatitis
- Cirrhosis screening (includes Liver synthetic function)
XI. Labs: Secondary causes - common
- See Liver Function Test Abnormality
- Metabolic Syndrome and other causes of lipid abnormalities
- Viral Hepatitis
- Hemochromatosis (Bronze diabetes with Arthritis, Heart Failure, Family History)
XII. Labs: Secondary causes - uncommon (consider if other testing negative)
-
Autoimmune Hepatitis (esp. women, history of Thyroid disease)
- Antinuclear Antibody
- Smooth Muscle Antibody
- Consider liver and Kidney microsomal antibodies
-
Alpha-1-Antitrypsin Deficiency
- Alpha-1-Antitrypsin total level
- Alpha-1-Antitrypsin Phenotype
-
Wilson Disease (consider in <40 years old, with liver disease or neuropsychiatric disorder, Family History)
- Ceruplasmin
- Consider 24 hour urinary copper
XIII. Imaging
- Right upper quadrant Ultrasound (Preferred first-line)
- Finding
- Increased liver echoes (fatty infiltrates)
- Disadvantages
- Does not determine disease severity
- Fibrosis and Steatosis are indistinguishable on Ultrasound
- Efficacy
- Test Sensitivity: 82-89% (increases with greater fat infiltration)
- Test Specificity: 93%
- Finding
-
CT Abdomen (unenhanced)
- Precautions
- CT with contrast decreases the Test Specificity compared to unenhanced CT
- Advantages
- Better sensitivity than Ultrasound
- Better identification of other liver abnormalities
- Disadvantages
- CT-associated Radiation Exposure
- Higher cost than Ultrasound
- Efficacy
- Test Sensitivity: 88-95%
- Test Specificity: 90-99%
- Precautions
- MRI Abdomen with elastography
- Advantages
- Highest accuracy
- Disadvantages
- Expensive
- Efficacy: Steatosis
- Test Sensitivity: 96%
- Test Specificity: 93%
- Efficacy: Fibrosis
- Test Sensitivity: 94%
- Test Specificity: 73%
- Advantages
XIV. Diagnosis: Noninvasive Tests for Advanced Fibrosis in NAFLD patients
- AST/ALT ratio (AAR)
- Score 0.8 or higher is suggestive of NAFLD with advanced fibrosis (Test Sensitivity: 74%, Test Specificity: 78%)
- Alternatively, Alcoholic Hepatitis also presents with AST > ALT
- AST/Platelet Count ratio index (APRI)
- AST/Platelet Count ratio index <0.3 to 0.5 excludes significant liver fibrosis or Cirrhosis
- AST/Platelet Count ratio index >1.5 rules in significant liver fibrosis or Cirrhosis
- Loaeza-del-Castillo (2008) Ann Hepatol 7(4):350-7 [PubMed]
- NAFLD Fibrosis Score (preferred)
- http://nafldscore.com/
- Liver fibrosis risk based on age, Hyperglycemia, BMI, Platelet Count, Serum Albumin, AST, ALT
- Score <-1.455 excludes advanced fibrosis while score >0.675 suggests advanced liver fibrosis (90% Test Sensitivity)
- Consider MR Elastography (or Fibroscan) for Fibrosis Score >-1.455
- Angulo (2007) Hepatology 45(4):846-54 [PubMed]
-
Fibrosis Probability Score (FIB-4 Index, preferred)
- https://www.hepatitisc.uw.edu/page/clinical-calculators/fib-4
- Clinical score based on age, Platelet Count, AST and ALT
- Efficacy: Test Sensitivity: 85%, Test Specificity: 65%
- Score <1.45 excludes advanced fibrosis while score >3.25 suggests advanced liver fibrosis
- Consider MR Elastography (or Fibroscan) for Fibrosis Probability Score >1.45
- Magnetic Resonance Elastography (MR Elastography)
- MR Elastography score > 3.62 kPa is suggestive of advanced fibrosis
- Vibration-Controlled Transient Elastography (Fibroscan)
- MR Elastography is preferred (more accurate)
- Imaging study with high sensitivity for even mild liver fibrosis
- May be limited by operator experience and morbidly obese
- Fibroscan > 9.9 kPa is suggestive of advanced fibrosis
- Myers (2012) Hepatology 55(1): 199-208 [PubMed]
-
Alcoholic Liver Disease to NAFLD Index
- Used to distinguish Alcoholic Liver Disease from NAFLD (based on ALT, AST, MCV, height, weight, gender)
- https://www.mayoclinic.org/medical-professionals/model-end-stage-liver-disease/alcoholic-liver-disease-nonalcoholic-fatty-liver-disease-index
-
BARD Score
- Score <2 has a strong Negative Predictive Value (90-97%) for NAFLD with fibrosis
-
HAIR Score
- Severely obese (BMI >35 kg/m2) patient assessment for risk of Nonalcoholic Steatohepatitis (NASH)
- Assign one point each for Hypertension, elevated ALT, Insulin Resistance
- Score 2 or 3 predicts progressive liver injury
- Other tests
- See MRI Abdomen with elastography above
- Enhanced Liver Fibrosis panel (Test Sensitivity and Test Specificity approach 100%)
- FibroTest or FibroSure (Test Sensitivity: 15%, Test Specificity: 98%)
- Fibrometer (Test Sensitivity: 79%, Test Specificity: 96%)
XV. Diagnosis: Liver Biopsy
- Non-invasive tests listed above are preferred (see complications)
- Indications
- Liver Disease etiology is unclear (distinguish NASH from conditions listed below)
- Increased risk of NASH or advanced fibrosis
- Grades degree of fatty infiltration
- Hepatic Steatosis (fat accumulation in liver)
- Intracellular fat in >5% of hepatocytes
- Nonalcoholic Steatohepatitis (Steatosis AND liver cell injury and inflammation)
- Hepatocyte ballooning
- Mallory hyaline
- Perivenular inflammatory infiltrate (Lymphocytes, Neutrophils)
- Hepatocyte necrosis and apoptosis
- Hepatocyte fibrosis may be present
- Hepatic Steatosis (fat accumulation in liver)
- Distinguishes NASH from other causes of liver injury and inflammation
- Complications of liver biopsy occur in >6% of patients
- Major Bleeding (4.5%)
- Death (1.6%)
XVI. Evaluation: Initial
- History and exam
- Consider comorbid history
- Premature COPD in alpha-1 antitrypsin deficiency
- Obesity
- Calculate Body Mass Index (BMI)
- Measure Waist Circumference
- Consider differential diagnosis (see above)
- Alcoholic Hepatitis
- Ask about excessive Alcohol use
- Hepatoxic Medication
- Viral Hepatitis
- Alcoholic Hepatitis
- Consider Family History
- Evaluate for likelihood of NASH
- Consider comorbid history
- Labs
- Start with liver specific first-line labs and common secondary cause labs above
- Consider uncommon secondary cause labs as above (based on history, risk factors)
- Diagnostics
- Consider liver imaging (e.g. RUQ Ultrasound)
XVII. Management: Approach
- Step 1: Initial
- Confirm likelihood of NASH as underlying cause
- Start with initial evaluation as above
- Confirm Liver Function Test Abnormality
- Consider RUQ Ultrasound
- Institute lifestyle change (e.g. weight loss, Healthy Diet, Exercise, hyperlidemia management)
- Step 2: Month 6 (following lifestyle change)
- Repeat Liver Function Tests
- If Abnormal Liver Function Testing
- Consider liver imaging (RUQ Ultrasound) if not already done
- Step 3: Evaluate with noninvasive tests for liver fibrosis (see above)
- Perform scoring
- NAFLD Fibrosis Score (abnormal >-1.455) or
- Fibrosis Probability Score or FIB-4 Index (abnormal >1.45)
- Obtain Elastography Imaging if either score is abnormal
- Magnetic Resonance Elastography (MR Elastography, preferred)
- MR Elastography score > 3.62 kPa is suggestive of advanced fibrosis
- Vibration-Controlled Transient Elastography (Fibroscan)
- Fibroscan > 9.9 kPa is suggestive of advanced fibrosis
- Magnetic Resonance Elastography (MR Elastography, preferred)
- Perform scoring
- Step 4: Gastroenterology referral indications (for evaluation and often liver biopsy)
- Noninvasive tests and inmaging suggest fibrosis (see Step 3)
- Persistently elevated Liver Function Tests despite interventions
- Suspected secondary cause of Steatosis other than NASH (e.g. Hemochromatosis, Autoimmune Hepatitis)
- Step 5: Monitoring
- Repeat liver transaminases at least every 2 years for those with hepatic Steatosis on imaging
XVIII. Management: Interventions
- See Prevention of Liver Disease Progression
-
Weight Reduction
-
Liver Function Tests improve or normalize with as little as 5-10% weight loss
- Hepatic Steatosis improves with 3-5% weight loss
- NAFLD histopathologic changes improve with 7-10% weight loss
- Fibrosis may not improve after weight loss
- Low to moderate fat intake and low carbohydrate
- Avoid high fructose corn syrup (beverages, foods)
- Consider Mediterranean Diet
- Consider Xenical which does improve liver enzymes and liver histology
- Physical Activity 150 to 200 minutes of moderate to vigorous Exercise
- Consider Bariatric Surgery
- NASH resolved in 85% of 109 patients in one study
- Lassailly (2015) Gastroenterology 149(2): 379-88 [PubMed]
-
Liver Function Tests improve or normalize with as little as 5-10% weight loss
- Avoid Hepatotoxins
- Restrict Alcohol intake (2 standard drinks/day for men, 1/day for women)
- Eliminate Hepatotoxins
- Maximize Glucose control
- Conditions
- Medications: Glucophage (Metformin)
- Recommended in Type II Diabetes
- Previously recommended to reduce transaminases and Steatosis in non-diabetics
- However, subsequent studies find no associated improvement in liver histology
- Medications: Glitazones
- Medications: Liraglutude
- Appears to improve NASH, but still investigational as of 2020
-
Lipid Reduction as needed with AntiHyperlipidemic
- AntiHyperlipidemic may be used if AST,ALT <3x normal
- Monitor AST and ALT every 3 months
- Statins (preferred) decrease transaminases, Steatosis
- Discontinue Statin if liver enzymes increase 2 fold at 3 months after starting medication
- Mixed results with Ursodeoxycholic Acid
- Control Hypertension
- Supplements that may offer benefit
- L-Carnitine
- Vitamin E 800 IU/day (variable efficacy, risk of Prostate Cancer, Hemorrhagic CVA)
- Avoid Milk Thistle (ineffective)
- Omega-3 Fatty Acids have not been found effective in NAFLD
- Vitamin D Supplementation has not been found effective
- References
XIX. Prognosis
- Nonalcoholic Fatty Liver (Hepatic Steatosis without inflammation)
- Rare progression to Cirrhosis
- However NAFLD overall is associated with increased cardiovascular mortality risk
- Nonalcoholic Steatohepatitis (5% of general population, up to 66% of age >50 years with Diabetes Mellitus, Obesity)
- Hepatocellular Carcinoma: 1-5% risk
- Cirrhosis risk: 20% overall
- Advanced fibrosis in 15-30% of cases
- Advanced fibrosis progresses to Cirrhosis in 12-35%
XX. Complications
- Portal Hypertension
-
Cirrhosis if associated with severe comorbid condition
- Morbid Obesity (BMI >30)
- Type II Diabetes Mellitus
- AST to ALT ratio >1
-
Coronary Artery Disease
- Results in greatest morbidity
- Treat underlying Hyperlipidemia
-
Diabetic Retinopathy
- Associated with increased Incidence in those with NAFLD and Diabetes Mellitus
XXI. References
- Angulo (2002) N Engl J Med 346:1221-31 [PubMed]
- Bayard (2006) Am Fam Physician 73:1961-68 [PubMed]
- Careyva (2016) Am Fam Physician 94(12): 980-6 [PubMed]
- Chalasani (2018) Hepatology 67(1): 328-57 [PubMed]
- Kumar (2000) Mayo Clin Proc 75:733-9 [PubMed]
- Oh (2017) Am Fam Physician 96(11): 709-15 [PubMed]
- Sanyal (2002) Gastroenterology 123:1705-25 [PubMed]
- Westfall (2020) Am Fam Physician 102(10): 603-12 [PubMed]
- Wilkins (2013) Am Fam Physician 88(1): 35-42 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
Definition (MSHCZE) | steatóza jater – nahromadění tuku v jaterních buňkách, časté při obezitě, alkoholismu, hyperlipoproteinemii, diabetu, těžké malnutrici; akutně u některých intoxikací, Reyově syndromu aj. Játra bývají zvětšená; s. je možné diagnostikovat morfologicky, je patrná i při sonografii (zvýšená echogenita při výraznějším postižení), bývají větš. změny jaterních testů vč. alkalické fosfatázy. Mikroskopicky se rozlišuje častější velkokapénková a malokapénková forma. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
Definition (MSH) | Lipid infiltration of the hepatic parenchymal cells resulting in a yellow-colored liver. The abnormal lipid accumulation is usually in the form of TRIGLYCERIDES, either as a single large droplet or multiple small droplets. Fatty liver is caused by an imbalance in the metabolism of FATTY ACIDS. |
Definition (CSP) | yellow discoloration of the liver due to fatty degeneration of liver parenchymal cells. |
Concepts | Disease or Syndrome (T047) |
MSH | D005234 |
SnomedCT | 197321007, 390002007, 5360002, 371330000 |
English | Liver, Fatty, LIVER FATTY, LIVER FATTY CHANGE, LIVER FATTY DEGENERATION, LIVER FATTY INFILTRATION, LIVER FATTY METAMORPHOSIS, Fatty change of liver, Fatty infiltration of liver, Fatty changes in liver, Fatty Liver, fatty liver, fatty liver (diagnosis), Liver fatty change, Degeneration fatty liver, Liver fatty degeneration, Fatty liver infiltration, Infiltration fatty liver, Liver fatty infiltration, Liver fatty, Fatty liver metamorphosis, Liver fatty metamorphosis, Metamorphosis fatty liver, Hepatic lipidosis, Fatty liver, Fatty Liver [Disease/Finding], fatty livers, hepatic lipidosis, changes fatty liver, liver steatosis, fatty infiltration liver, change fatty liver, fatty liver metamorphosis, liver fatty change, liver fatty infiltration, hepatic steatosis, steatosis of liver, fatty liver infiltration, fatty change liver, Fatty change of liver (disorder), Fatty liver (disorder), Lipidosis of liver, degeneration; fatty, liver, degeneration; liver, fatty, fat; liver, fatty; degeneration liver, fatty; liver degeneration, infiltrate; liver, fatty, liver; degeneration, fatty, liver; fat, liver; infiltrate, fatty, hepatitic steatosis |
French | STEATOSE HEPATIQUE, Dégénérescence graisseuse du foie, Stéatose par infiltration, Infiltration graisseuse du foie, Stéatose avec métamorphose, Stéatose par infiltration graisseuse, Altération de la stéatose du foie, DEGENERESCENCE GRAISSEUSE DU FOIE, INFILTRATION GRAISSEUSE DU FOIE, METAMORPHOSE GRAISSEUSE DU FOIE, TRANSFORMATION GRAISSEUSE DU FOIE, Stéatose hépatique, Stéatose du foie |
Spanish | HIGADO GRASO, Hígado graso, Metamorfosis grasa de hígado, Transformación grasa de hígado, Infiltración grasa de hígado, Degeneración grasa del hígado, HIGADO, CAMBIO GRASO, HIGADO, INFILTRACION GRASA, HIGADO, METAMORFOSIS GRASA, hígado graso, lipidosis hepática, hígado graso (trastorno), Hígado Graso |
German | FETTLEBER, Leber, Verfettung, Infiltration, Fettleber, fettige Infiltration der Leber, Metamorphose, Fettleber, Leber, fettige Metamorphose, fettige Degeneration der Leber, fettige Metamorphose der Leber, Leber, fettige Degeneration, Leber, fettige Infiltration, LEBER FETTIGE DEGENERAT, LEBER FETTIGE INFILTRAT, LEBER FETTIGER UMBAU, LEBERSTEATOSE, Fettleber |
Dutch | leververvetting, leververvettingsverandering, vette lever infiltratie, leververvetting infiltratie, infiltratie van leververvetting, leververvettingsdegeneratie, leververvetting metamorfose, degeneratie vette lever, vette lever, vette lever metamorfose, metamorfose vette lever, degeneratie; lever, vettig, degeneratie; vettig, lever, infiltraat; lever, vettig, lever; degeneratie, vettig, lever; infiltraat, vettig, lever; vet, vet; lever, vettig; degeneratie lever, vettig; leverdegeneratie, Leversteatose, Leververvetting, Vetlever |
Italian | Infiltrazione grassa del fegato, Metamorfosi grassa del fegato, Trasformazione grassa del fegato, Degenerazione adiposa del fegato, Trasformazione adiposa del fegato, Infiltrazione lipidica epatica, Degenerazione grassa del fegato, Steatosi epatica |
Portuguese | Degenerescência gorda do fígado, Metamorfose de fígado gordo, Fígado gordo, Alteração gorda do fígado, Infiltração gorda do fígado, Metamorfose gorda do fígado, Infiltração de fígado gordo, Figado gordo, DEGENERESCENCIA GORDA DO FIGADO, GORDURA NO FIGADO, INFILTRACAO LIPIDICA NO FIGADO, METAMORFOSE LIPIDICA DO FIGADO, TRANSFORMACAO LIPIDICA DO FIGADO, Esteatose Hepática, Esteatohepatite, Fígado Gorduroso |
Japanese | 肝脂肪浸潤, 肝脂肪変性, カンシボウヘンセイ, カンシボウシンジュン, シボウカン, 脂肪肝 |
Swedish | Fettlever |
Finnish | Rasvamaksa |
Russian | PECHENI ZHIROVAIA DISTROFIIA, ПЕЧЕНИ ЖИРОВАЯ ДИСТРОФИЯ |
Czech | Hepatální steatóza, Jaterní steatóza, Degenerativní jaterní steatóza, Steatóza jater, ztučnělá játra, ztučnění jater |
Polish | Stłuszczenie wątroby, Choroba stłuszczeniowa wątroby |
Hungarian | Zsíros májdegeneratio, máj zsíros átalkulása, Máj zsíros infiltrációja, Zsíros máj metamorphosis, Zsíros máj infiltratio, Máj zsíros elváltozása, Zsíros máj, Zsírmáj, degeneratio adiposa hepatis, Máj zsíros infiltratioja, Máj zsíros metamorphosisa |
Norwegian | Fettlever |
Ontology: Fatty degeneration (C0152254)
Definition (NCI) | A morphologic finding indicating intracytoplasmic fat accumulation in the liver parenchyma. |
Concepts | Pathologic Function (T046) |
SnomedCT | 190803000, 29185008 |
English | fatty change, fatty degeneration, fatty metamorphosis, steatosis, changes fatty, Fatty Change, Lipoid degeneration, Fatty change, Fatty metamorphosis, Steatosis, Fatty degeneration, Fatty degeneration (morphologic abnormality) |
Spanish | acumulación grasa intraparenquimatosa, degeneración grasa (anomalía morfológica), degeneración grasa, degeneración lipoidea, esteatosis, metamorfosis grasa |
Ontology: Non-alcoholic Fatty Liver Disease (C0400966)
Definition (NCI) | A term referring to fatty replacement of the hepatic parenchyma which is not related to alcohol use. |
Definition (MSH) | Fatty liver finding without excessive ALCOHOL CONSUMPTION. |
Concepts | Disease or Syndrome (T047) |
MSH | D065626 |
ICD10 | K76.0 |
SnomedCT | 197315008, 371329005, 5360002 |
English | NAFLD - Nonalcoholic fatty liver disease, nonalcoholic fatty liver, nonalcoholic fatty liver (diagnosis), NAFLD - Nonalcoholic Fatty Liver Disease, Nonalcoholic fatty liver disease (NAFLD), non-alcoholic fatty liver, Nonalcoholic fatty liver disease, Nonalcoholic fatty liver (disorder), Nonalcoholic fatty liver, Liver, Nonalcoholic Fatty, Non-alcoholic Fatty Liver Disease, Fatty Liver, Nonalcoholic, Nonalcoholic Fatty Livers, Fatty Livers, Nonalcoholic, Livers, Nonalcoholic Fatty, Nonalcoholic Fatty Liver, Nonalcoholic Fatty Liver Disease, Non alcoholic Fatty Liver Disease, NAFLD, Non-alcoholic fatty liver, Non-alcoholic fatty liver (disorder) |
Spanish | esteatohepatitis no alcohólica, Hígado graso no alcohólico, hígado graso no alcohólico, hígado graso no alcohólico (trastorno), esteatosis hepática no alcohólica (trastorno), esteatosis hepática no alcohólica, hígado graso de causa no alcohólica |
Czech | Nealkoholická jaterní steatóza |
Dutch | niet-alcoholische leververvetting |
French | Stéatose hépatique non éthylique |
German | nicht-alkoholische Fettleber |
Hungarian | Nem-alkoholos zsírmáj |
Italian | Steatosi epatica non alcolica |
Japanese | 非アルコール性脂肪肝, ヒアルコールセイシボウカン |
Portuguese | Fígado gordo não alcoólico |
Ontology: Steatohepatitis (C2711227)
Definition (MSH) | Inflammation of the liver related to lipid accumulation in fatty liver. |
Definition (MSHCZE) | Mikroskopický obraz steatózy jater se známkami zánětu v periportálních oblastech infiltrace a vznikem lipogranulomů. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
Concepts | Disease or Syndrome (T047) |
MSH | D005234 |
SnomedCT | 442191002, 197321007 |
Italian | Steatosi epatica |
Dutch | steatose lever, lever; steatose, steatose; lever, hepatische steatose |
German | Steatosis der Leber, Steatosis hepatis |
Portuguese | Esteatose hepática, Estenose hepática |
Japanese | 脂肪肝, シボウカン |
English | Liver steatosis, hepatic steatosis, Hepatic steatosis, Steatosis hepatic, Steatohepatitis (disorder), Liver Steatosis, Steatohepatitis, Steatosis, Liver, Steatoses, Liver, Steatosis of Liver, Steatohepatitides, Visceral Steatosis, Liver Steatoses, Visceral Steatoses, Steatoses, Visceral, Steatosis, Visceral, Steatosis of liver, Steatosis of liver (disorder), liver; steatosis, steatosis; liver |
Czech | Jaterní steatóza, steatohepatitida, steatóza jater, jaterní steatóza |
Spanish | esteatohepatitis, esteatohepatitis (trastorno), esteatosis hepática (trastorno), esteatosis hepática, Esteatosis hepática |
French | Stéato-hépatite, Stéatose viscérale, Stéatohépatite, Stéatose hépatique |
Hungarian | Máj steatosis, Steatosis hepatis |
Norwegian | Leversteatose |
Ontology: Nonalcoholic Steatohepatitis (C3241937)
Definition (NCI) | Fatty replacement and damage to the hepatocytes not related to alcohol use. It may lead to cirrhosis and liver failure. |
Concepts | Disease or Syndrome (T047) |
MSH | D065626 |
ICD10 | K75.81 |
SnomedCT | 442685003 |
English | nonalcoholic steatohepatitis (diagnosis), nonalcoholic steatohepatitis, Nonalcoholic steatohepatitis, NASH - Nonalcoholic steatohepatitis, Nonalcoholic steatohepatitis (disorder), NASH - Nonalcoholic Steatohepatitis, Nonalcoholic steatohepatitis (NASH), Non-alcoholic steatohepatitis, Nonalcoholic Steatohepatitides, Steatohepatitis, Nonalcoholic, Nonalcoholic Steatohepatitis, Steatohepatitides, Nonalcoholic |
Spanish | esteatohepatitis no alcohólica (trastorno), esteatohepatitis no alcohólica, esteatosis hepática no alcohólica (trastorno), esteatosis hepática no alcohólica, Esteatohepatitis no alcohólica |
Czech | Nealkoholická steatohepatitida |
German | nicht-alkoholische Fettleber |
Hungarian | Nem-alkoholos steatohepatitis |
Italian | Steatoepatite non alcolica |
Japanese | 非アルコール性脂肪性肝炎, ヒアルコールセイシボウセイカンエン |
Portuguese | Esteatose hepática não alcoólica |
Dutch | niet-alcoholische steatohepatitis |
French | Stéatose hépatique non alcoolique |