Skip to main content
SpringerLink
Log in

Non-alcoholic steatohepatitis: metabolic syndrome of the liver

  • Conference paper
Pathogenesis and Clinical Practice in Gastroenterology

Part of the book series: Falk Symposium ((FASS,volume 160))

  • 638 Accesses

Abstract

Non-alcoholic fatty liver disease (NAFLD) is increa singly diagnosed worldwide and considered to be the commonest liver disorder in Western countries. It comprises a disease spectrum which includes variable degrees of simple steatosis (fatty liver), non-alcoholic steatohepatitis (NASH) and cirrhosis. Simple steatosis is benign, whereas steatohepatitis (NASH) is characterized by hepatocyte injury, inflammation and fibrosis which can lead to cirrhosis, liver failure and hepatocellular carcinoma (HCC).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bedogni G, Miglioli L, Masutti F, Tiribelli CEA. Prevalence and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology. 2005;42:44–52.

    Article  PubMed  Google Scholar 

  2. Browning JS, Dobbins LS, Nuremberg R et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology. 2004;40:1387–95.

    Article  PubMed  Google Scholar 

  3. Nomura H, Kashiwaqi S, Hayashi J, Kajiyama W, Tani S, Goto M. Prevalence of fatty liver in a general population of Okinawa, Japan. Jpn J Med. 1988;27:142–9.

    PubMed  CAS  Google Scholar 

  4. Bedogni G, Miglioli L, Masutti F et al. Incidence and natural course of fatty liver in the general population: the Dionysos study. Hepatology. 2007;46:1387–91.

    Article  PubMed  Google Scholar 

  5. Neuschwander-Tetri B, Caldwell S. Non alcoholic steatohepatitis: summary of an AASLD single topic conference. Hepatology. 2003;37:1202–19.

    Article  PubMed  Google Scholar 

  6. Machado M, Marques-Vidal P, Cortez-Pinto H. Hepatic histology in patients undergoing bariatric surgery. J Hepatol. 2006;45:600–6.

    Article  PubMed  Google Scholar 

  7. Wanless IR, Lentz JS. Fatty liver hepatitis (steatohepatitis) and obesity: an autopsy study with analysis of risk factors. Hepatology. 1990;12:1106–10.

    Article  PubMed  CAS  Google Scholar 

  8. Cheung P, Kapoor A, Puri P et al. The impact of fat distribution on the severity of nonalcoholic fatty liver disease and the metabolic syndrome. Hepatology. 2007;46:1091–100.

    Article  PubMed  Google Scholar 

  9. Targher G, Bertolini L, Padovani R et al. Relation between carotid artery wall thickness and liver histology in subjects with non-alcoholic fatty liver disease. Diabetes Care. 2006;29:1325–30.

    Article  PubMed  Google Scholar 

  10. Targher G, Bertolini L, Padovani R et al. Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease among type 2 diabetic patients. Diabetes Care. 2007;30:1212–18.

    Article  PubMed  Google Scholar 

  11. Marchesini G, Bugianesi E, Forlani G et al. Nonalcoholic fatty liver, steatohepatitis and the metabolic syndrome. Hepatology. 2003;37:917–23.

    Article  PubMed  Google Scholar 

  12. Franzese A, Vajro P, Argenziano A et al. Liver involvement in obese children. Ultrasonography and liver enzyme levels at diagnosis and during follow up in an Italian population. Dig Dis Sci. 1997;42:1428–32.

    Article  PubMed  CAS  Google Scholar 

  13. Tominaga K, Kurata J, Chen Y et al. Prevalence of fatty liver in Japanese children and relationship to obesity. An epidemiological ultrasonographic survey. Dig Dis Sci. 1995;40:2002–9.

    Article  PubMed  CAS  Google Scholar 

  14. Molleston J, White F, Teckman J et al. Obese children with steatohepatitis can develop cirrhosis in childhood. Am J Gastroenterol. 2002;97:2460–2.

    Article  PubMed  Google Scholar 

  15. Ekstedt M, Franzen LE, Mathiesen UL et al. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology. 2006;44:865–73.

    Article  PubMed  CAS  Google Scholar 

  16. Day CP. Natural history of NAFLD: remarkably benign in the absence of cirrhosis. Gastroenterology. 2005;129:375–8.

    Article  PubMed  CAS  Google Scholar 

  17. Sanyal AJ, Banas C, Sargeant C et al. Similarities and differences in outcomes of cirrhosis due to nonalcoholic steatohepatitis and hepatitis C. Hepatology. 2006;43:682–9.

    Article  PubMed  Google Scholar 

  18. Nair S, Mason A, Eason J, Loss G, Perillo R. Is obesity an independent risk factor for hepatocellular carcinoma in cirrhosis? Hepatology. 2002;36:150–55.

    Article  PubMed  Google Scholar 

  19. Calle E, Rodriguez C, Walker-Thurmond K, Thun M. Overweight, obesity and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med. 2003;348:1625–38.

    Article  PubMed  Google Scholar 

  20. McCullough A. The clinical features, diagnosis and natural history of non alcoholic fatty liver disease. Clin Liver Dis. 2004;8:521–33.

    Article  PubMed  Google Scholar 

  21. Adams LA, Lymp JF, St Sauver J et al. The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology. 2005;129:113–21.

    Article  PubMed  Google Scholar 

  22. De Alwis N, Day CP. Genetics of alcoholic liver disease and nonalcoholic fatty liver disease. Semin Liver Dis. 2007;27:44–54.

    Article  Google Scholar 

  23. Musso G, Gambino R, De Michieli F et al. Dietary habits and their relations to insulin resistance and postprandial lipemia in nonalcoholic steatohepatitis. Hepatology. 2003;37:909–16.

    Article  PubMed  CAS  Google Scholar 

  24. Zelber-Sagi S, Nitzan-Kaluski D, Goldsmith R et al. Long term nutritional intake and the risk of nonalcoholic fatty liver disease (NAFLD): a population based study. J Hepatol. 2007;47:711–17.

    Article  PubMed  CAS  Google Scholar 

  25. Naveau S, Giraud V, Borotto E, Aubert A, Capron F, Chaput JC. Excess weight risk factor for alcoholic liver disease. Hepatology. 1997;25:108–11.

    Article  PubMed  CAS  Google Scholar 

  26. Dixon J, Bhathal P, O’Brian P. Non-alcoholic fatty liver disease: predictors of non-alcoholic steatohepatitis and liver fibrosis in the severely obese. Gastroenterology. 2001;121:91–100.

    Article  PubMed  CAS  Google Scholar 

  27. Suzuki A, Angulo P, St Sauver J, Muto A, Okada T, Lindor K. Light to moderate alcohol consumption is associated with lower frequency of hypertransaminasemia. Am J Gastroenterol. 2007;102:1912–19.

    Article  PubMed  Google Scholar 

  28. De Alwis N, Day CP. Genes and nonalcoholic fatty liver disease. Curr Diab Rep. 2008 (In press).

    Google Scholar 

  29. Targher G, Bertolini L, Scala L, Zoppini G, Zenari L, Falezza G. Non alcoholic hepatic steatosis and its relation to increased plasma biomarkers of inflammation and endothelial dysfunction in nondiabetic men. Role of visceral adipose tissue. Diabet Med. 2005;22:1354–8.

    Article  PubMed  CAS  Google Scholar 

  30. Fracanzani A, Burdick L, Raselli L et al. Risk of early atherosclerosis evaluated by carotid artery intima-media thickness in patients with non alcoholic fatty liver disease: a case control study. Hepatology. 2005;42:610–11A.

    Article  Google Scholar 

  31. Schwimmer J, Deutsch R, Behling C, Lavine J. Fatty liver as a determinant of atherosclerosis. Hepatology. 2005;42:610A.

    Article  Google Scholar 

  32. Targher G, Bertolini L, Rodella S, Zoppini G, Lippi G, Day CP. Nonalcoholic fatty liver disease is independently associated with an increased prevalence of chronic kidney disease and proliferative/laser treated retinopathy in type 2 diabetic patients. Diabetologia. 2008 (In press).

    Google Scholar 

  33. Targher G, Arcaro G. Non-alcoholic fatty liver disease and increased risk of cardiovascular disease. Atherosclerosis. 2007;191:235–40.

    Article  PubMed  CAS  Google Scholar 

  34. Schwimmer J, Hhorram O, Chiu V, Schwimmer W. Abnormal aminotransferase activity in women with polycystic ovary syndrome. Fertil Steril. 2005;83:494–7.

    Article  PubMed  CAS  Google Scholar 

  35. Cerda C, Perez-Ayuso RM, Riquelme A et al. Nonalcoholic fatty liver disease in women with polycystic ovary syndrome. J Hepatol. 2007;47:412–17.

    Article  PubMed  CAS  Google Scholar 

  36. Setji T, Holland N, Sanders L, Pereira K, Diehl A, Brown A. Nonalcoholic steatohepatitis and nonalcoholic fatty liver disease in young women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91:1741–7.

    Article  PubMed  CAS  Google Scholar 

  37. Volk R, Somers V. Obesity related cardiovascular disease: implications of obstructive sleep apnea. Diabet Obes Met. 2005;8:250–60.

    Google Scholar 

  38. Tanne F, Gagnadoux F, Chazouilleres O et al. Chronic liver injury during obstructive sleep apnea. Hepatology. 2005;41:1290–6.

    Article  PubMed  Google Scholar 

  39. Skelly M, James P, Ryder S. Findings on liver biopsy to investigate abnormal liver function tests in the absence of diagnostic serology. J Hepatol. 2001;35:195–9.

    Article  PubMed  CAS  Google Scholar 

  40. Pendino G, Mariano A, Surace P et al. Prevalence and etiology of altered liver tests: a population based survey in a Mediterranean town. Hepatology. 2005;41:1151–9.

    Article  PubMed  Google Scholar 

  41. Mofrad P, Contos MJ, Haque M et al. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatology. 2003;37:1286–92.

    Article  PubMed  Google Scholar 

  42. Javor E, Ghany M, Cochran E et al. Leptin reverses nonalcoholic steatohepatitis in patients with severe lipodystrophy. Hepatology. 2005;41:753–60.

    Article  PubMed  CAS  Google Scholar 

  43. Tanoli T, Tue P, Yablonskiy D, Schonfeld G. Fatty liver in familial hypobetalipoproteinaemia: roles of the APOB defects, intra-abdominal adipose tissue, and insulin sensitivity. J Lipid Res. 2004;45:941–7.

    Article  PubMed  CAS  Google Scholar 

  44. Trombini P, Piperno A. Ferritin, metabolic syndrome and NAFLD: elective attractions and dangerous liaisons. J Hepatol. 2007;46:549–52.

    Article  PubMed  CAS  Google Scholar 

  45. Bugianesi E, Manzini P, D’Antico S et al. Relative contribution of iron burden. HFE mutations and insulin resistance to fibrosis in nonalcoholic fatty liver. Hepatology. 2004;39:179–87.

    Article  PubMed  CAS  Google Scholar 

  46. Adams LA Lindor KD, Angulo P. The prevalence of autoantibodies and autoimmune hepatitis in patients with non alcoholic fatty liver disease. Am J Gastroenterol. 2004;90:1316–20.

    Article  Google Scholar 

  47. Loria P, Carulli N, Lonardo A. The prevalence of autoantibodies and autoimmune hepatitis in patients with nonalcoholic fatty liver disease. Am J Gastroenterol. 2005;100:1200–1.

    Article  PubMed  Google Scholar 

  48. Saadeh S, Younossi ZM, Remer EM et al. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology. 2002;123:745–50.

    Article  PubMed  Google Scholar 

  49. Cox I, Sharif A, Cobbold J, Thomas H, Taylor-Robinson S. Current and future applications of in vitro magnetic resonance spectroscopy in hepatobiliary disease. World J Gastroenterol. 2006;12:4773–83.

    PubMed  CAS  Google Scholar 

  50. Yoneda M, Fujita K, Inamori M, Nakajima A. Transient elastography in patients with non alcoholic fatty liver disease (NAFLD). Gut. 2007;56:1330–1.

    Article  PubMed  Google Scholar 

  51. Guha IN, Parkes J, Roderick PR, Harris S, Rosenberg WM. Non-invasive markers associated with liver fibrosis in non-alcoholic fatty liver disease. Gut. 2006;55:1650–60.

    Article  PubMed  CAS  Google Scholar 

  52. Angulo P, Hui JM, Marchesini G et al. The NAFLD fibrosis score: a non-invasive system that accurately identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45:846–54.

    Article  PubMed  CAS  Google Scholar 

  53. Rosenberg WM, Voelker M, Thiel R et al. Serum markers detect the presence of liver fibrosis: a cohort study. Gastroenterology. 2004;127:1704–13.

    Article  PubMed  Google Scholar 

  54. Guha I, Parkes J, Roderick P et al. Non-invasive markers of fibrosis in non alcoholic fatty liver disease: validating the European Liver Fibrosis panel and exploring simple markers. Hepatology. 2008 (in press).

    Google Scholar 

  55. Wieckowska A, Zein NN, Yerian LM, Lopez AR, McCullough AR, Feldstein AE. In vivo assessment of liver cell apoptosis as a novel biomarker of disease severity in nonalcoholic fatty liver disease. Hepatology. 2006;44:27–33.

    Article  PubMed  CAS  Google Scholar 

  56. Day CP. From fat to inflammation. Gastroenterology. 2006;130:207–10.

    Article  PubMed  CAS  Google Scholar 

  57. Harrison SA, Day CP. Benefits of lifestyle modification in NAFLD. Gut. 2007;56:1760–9.

    Article  PubMed  CAS  Google Scholar 

  58. Westerbacka J, Lammi K, Hakkinen A.A.R., Salminen I, Aro A, Yki-Jarvinen H. Dietary fat content modifies liver fat in overweight nondiabetic subjects. J Clin Endocrinol Metab. 2005;90:2804–9.

    Article  PubMed  CAS  Google Scholar 

  59. Ueno T, Sugawara S, Sujaku K et al. Therapeutic effects of diet and exercise in obese patients with fatty liver. J Hepatol. 1997;27:103–10.

    Article  PubMed  CAS  Google Scholar 

  60. Harrison SA, Fincke C, Helinski D, Torgerson S, Hayashi P. A pilot study of orlistat treatment in obese, nonalcoholic steatohepatitis patients. Aliment Pharmacol Ther. 2004;20:623–8.

    Article  PubMed  CAS  Google Scholar 

  61. Hussein O, Grosovski M, Schlesinger S, Szvalb S, Assy N. Orlistat reverses fatty infiltration and improves hepatic fibrosis in obese patients with nonalcoholic steatohepatitis (NASH). Dig Dis Sci. 2007;52:2512–19.

    Article  PubMed  Google Scholar 

  62. Van Gaal LF, Rissanen AM, Scheen AJ et al. Effects of the cannabinoid-1 receptor blocker rimonabant on weight reduction and cardiovascular risk factors in overweight patients: 1-year experience from the RIO-Europe study. Lancet. 2005;365:1389–97.

    Article  PubMed  Google Scholar 

  63. Gary-Bobo M, Elachouri G, Galla J et al. Rimonabant reduces obesity associated hepatic steatosis and features of the metabolic syndrome in obese Zucker fa/fa rats. Hepatology. 2007;46:122–9.

    Article  PubMed  CAS  Google Scholar 

  64. Teixeira-Clerc F, Julien B, Grenard P et al. CB1 cannabinoid receptor antagonism: a new strategy for the treatment of liver fibrosis. Nat Med. 2006;12:671–6.

    Article  PubMed  CAS  Google Scholar 

  65. Dixon J, Bhathal P, Hughes N, O’Brien P. Improvement in liver histological analysis with weight loss. Hepatology. 2004;39:1647–54.

    Article  PubMed  Google Scholar 

  66. Klein S, Mittendorfer B, Eagon C et al. Gastric bypass surgery improves metabolic and hepatic abnormalities associated with nonalcoholic fatty liver disease. Gastroenterology. 2006;130:1564–72.

    Article  PubMed  CAS  Google Scholar 

  67. Adachi M, Osawa Y, Uchinami H, Kitamura T, Accili D, Brenner D. The forkhead transcription factor FoxO1 regulates proliferation and transdifferentiation of hepatic stellate cells. Gastroenterology. 2007;132:1434–46.

    Article  PubMed  CAS  Google Scholar 

  68. Juurinen L, Tiikkainen M, Hakkinen A, Hakkarainen A, Yki-Jarvinen H. Effects of insulin therapy on liver fat content and hepatic insulin sensitivity in patients with type 2 diabetes. Am J Physiol Endocrinol Metab. 2006;292:E829–35.

    Article  PubMed  Google Scholar 

  69. Bugianesi E, Gentilcore E, Manini R et al. A randomized controlled trial of metformin versus vitamin E or prescriptive diet in nonalcoholic fatty liver disease. Am J Gastroenterol. 2005;100:1082–90.

    Article  PubMed  CAS  Google Scholar 

  70. Galli A, Crabb DW, Ceni E et al. Antidiabetic thiazolidinediones inhibit collagen synthesis and hepatic stellate cell activation in vivo and in vitro. Gastroenterology. 2002;122:1924–40.

    Article  PubMed  CAS  Google Scholar 

  71. Belfort R, Harrison SA, Brown K et al. A placebo controlled trial of pioglitazone in subjects with non-alcoholic steatohepatitis. N Engl J Med. 2006;355:2297–307.

    Article  PubMed  CAS  Google Scholar 

  72. Singh S, Loke Y, Furberg C. Long-term risk of cardiovascular events with rosiglitazone. A meta-analysis. J Am Med Assoc. 2007;298:1189–95.

    Article  CAS  Google Scholar 

  73. Lincoff M, Wolski K, Nicholls S, Nissen S. Pioglitazone and risk of cardiovascular events in patients with type 2 diabetes mellitus. J Am Med Assoc. 2007;298:1180–8.

    Article  CAS  Google Scholar 

  74. Lutchman G, Modi A, Kleiner D et al. The effects of discontinuing pioglitazone in patients with nonalcoholic steatohepatitis. Hepatology. 2007;46:424–9.

    Article  PubMed  CAS  Google Scholar 

  75. Ip E, Farrell G, Hall P, Robertson G, Leclercq I. Administration of the potent PPAR alpha agonist, Wy-14,643, reverses nutritional fibrosis and steatohepatitis in mice. Hepatology. 2004;39:1286–96.

    Article  PubMed  CAS  Google Scholar 

  76. Laurin J, Lindor K, Crippin J et al., Ursodeoxycholic acid or clofibrate in the treatment of nonalcoholic induced steatohepatitis: a pilot study. Hepatology. 1996;23:1464–7.

    Article  PubMed  CAS  Google Scholar 

  77. Browning J. Statins and hepatic steatosis: perspectives from the Dallas Heart Study. Hepatology. 2006;44:466–71.

    Article  PubMed  CAS  Google Scholar 

  78. Hirose A, Ono M, Saibara T et al. Angiotensin II type 1 receptor blocker inhibits fibrosis in rat nonalcoholic steatohepatitis. Hepatology. 2007;45:1375–81.

    Article  PubMed  CAS  Google Scholar 

  79. Yokohama S, Yoneda M, Haneda M et al. Therapeutic efficacy of an angiotensinogen II receptor antagonist in patients with nonalcoholic steatohepatitis. Hepatology. 2004;40:1222–5.

    Article  PubMed  CAS  Google Scholar 

  80. Oben J, Roskams T, Yang S et al. Norepinephrine induces hepatic fibrosis in leptin deficient ob/ob mice. Biochem Biophys Res Commun. 2003;308:284–92.

    Article  PubMed  CAS  Google Scholar 

  81. Ichikawa Y. Comparative effects of telmisartan and valsartan on insulin resistance in hypertensive patients with metabolic syndrome. Intern Med. 2007;46:1331–6.

    Article  PubMed  Google Scholar 

  82. Merat S, Malekzadeh R, Sohrabi M et al. Probucol in the treatment of nonalcoholic steatohepatitis: a double blind randomized controlled study. J Hepatol. 2003;38:414–18.

    Article  PubMed  CAS  Google Scholar 

  83. Abdelmalek M, Angulo P, Jorgensen R, Sylvestre P, Lindor K. Betaine, a promising new agent for patients with nonalcoholic steatohepatitis: results of a pilot study. Am J Gastroenterol. 2001;96:2711–17.

    Article  PubMed  CAS  Google Scholar 

  84. Facchini F, Hua N, Stoohs R. Effect of iron depletion in carbohydrate-intolerant patients with clinical evidence of nonalcoholic fatty liver disease. Gastroenterology. 2002;122:931–9.

    Article  PubMed  CAS  Google Scholar 

  85. Lavine J. Vitamin E treatment of nonalcoholic steatohepatitis in children: a pilot study. J Pediatr. 2000;136:734–8.

    Article  PubMed  CAS  Google Scholar 

  86. Harrison SA, Torgerson S, Hayashi P, Ward J, Schenker S. Vitamin E and Vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis. Am J Gastroenterol. 2003;98:2485–90.

    Article  PubMed  CAS  Google Scholar 

  87. Adams LA, Zein C, Angulo P, Lindor K. A pilot trial of pentoxyfylline in nonalcoholic steatohepatitis. Am J Gastroenterol. 2004;99:2365–8.

    Article  PubMed  CAS  Google Scholar 

  88. Satapathy S, Sakhuja P, Malhotra V, Sharma B, Sarin S. Beneficial effects of pentoxifylline on hepatic steatosis, fibrosis and necroinflammation in patients with non alcoholic steatohepatitis. J Gastroenterol Hepatol. 2007;22:634–8.

    PubMed  CAS  Google Scholar 

  89. Ozcan U, Yilmaz E, Ozcan L et al. Chemical chaperones reduce ER stress and restore glucose homeostasis in a mouse model of type 2 diabetes. Science. 2006;313:1137–40.

    Article  PubMed  Google Scholar 

  90. Lindor K, Kowdley K, Heathcote E et al. Ursodeoxycholic acid for treatment of non alcoholic steatohepatitis: results of a randomized trial. Hepatology. 2004;39:770–8.

    Article  PubMed  CAS  Google Scholar 

  91. Dufour J, Oneta C, Gonvers J et al. Swiss Association for the Study of the Liver: randomized placebo controlled trial of ursodeoxycholic acid with vitamin E in nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol. 2006;4:1437–43.

    Article  Google Scholar 

  92. Contos MJ, Cales W, Sterling RK et al. Development of nonalcoholic fatty liver disease after orthotopic liver transplantation for cryptogenic cirrhosis. Liver Transplant. 2001;7:363–73.

    Article  CAS  Google Scholar 

  93. Ong J, Younossi Z, Reddy V et al. Cryptogenic cirrhosis and post-transplantation nonalcoholic fatty liver disease. Liver Transplant. 2001;7:797–801.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Clinical Medical Sciences Floor 4, William Leech Building, The Medical School, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK

    C. P. Day

Authors
  1. C. P. Day
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Gastroenterology, Medical Centre Ljubljana, Slovenia

    I. Ferkolj

  2. University of Vienna, Vienna, Austria

    A. Gangl

  3. University of Mainz, Mainz, Germany

    P. R. Galle

  4. University Hospital Rebro, Zagreb, Croatia

    B. Vucelic

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer and Falk Foundation e.V.

About this paper

Cite this paper

Day, C.P. (2008). Non-alcoholic steatohepatitis: metabolic syndrome of the liver. In: Ferkolj, I., Gangl, A., Galle, P.R., Vucelic, B. (eds) Pathogenesis and Clinical Practice in Gastroenterology. Falk Symposium, vol 160. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-8767-7_17

Download citation

  • DOI: https://doi.org/10.1007/978-1-4020-8767-7_17

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-1-4020-8766-0

  • Online ISBN: 978-1-4020-8767-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation