People with cirrhosis over time may develop liver failure and need a liver transplant. Mayo Clinic. 1989, 20: 594-. Shamard Charles, MD, is a physician-journalist and public health doctor who advances health policy through health communication and health promotion. Non-alcoholic fatty liver disease (NAFLD) Non-alcoholic fatty liver disease (NAFLD) is the term for a range of conditions caused by a build-up of fat in the liver. The patients were linked to the Hospital Discharge Register, the Causes of Death Registry and Centre for Addiction Medicine. Other than this, the problem of the fatty liver may result in cardiovascular problems and chronic kidney diseases, along with other severe health conditions. Int J Mol Sci. How Long Will It Take To Recover From Non-Alcoholic Fatty Liver Disease & How Long Does The Symptoms Last? Shamard Charles, MD, MPH is a public health physician and journalist. Your health care providermay suspect fatty liver disease with abnormal test results, especially if you are obese. But if liver cirrhosis is diagnosed early and the underlying cause is treated, further damage can be limited. When the inflammation continues, fibrosis spreads to multiple liver tissues. This however we do not anticipate having significant effect on the results, especially since ballooning degeneration increases cell size and this is not greatly affected by fading colours. NASH that turns into cirrhosis could cause symptoms like fluid retention, internal bleeding, muscle wasting, and confusion. If youre not sure what to do next, consider these steps: Cirrhosis is a chronic condition that can shorten someones life expectancy. Each time your liver is injured whether by excessive alcohol consumption or another cause, such as infection it tries to repair itself. Google Scholar, Deleuran T, Grnbk H, Vilstrup H, Jepsen P: Cirrhosis and mortality risks of biopsy-verified alcoholic pure steatosis and steatohepatitis: a nationwide registry-based study. Cirrhosis itself can affect diet and metabolism, so people should try: Cirrhosis is a severe condition, causing scarring and permanent damage to the liver. Evaluation and prognosis of patients with cirrhosis. PubMed Central The index liver biopsies were formalin fixed and treated routinely in the pathology laboratory. Get regular screening tests for liver cancer if you already have cirrhosis. If you are living with fatty liver disease, learn as much as you can about your condition and work closely with your medical team. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Wilson R, et al. Decompensated Cirrhosis: Symptoms, Causes, Treatment, Life Expectancy The aims of this study were 1) to examine the natural history and outcome of patients with fatty liver disease with non-alcoholic and alcoholic etiologies. Liver cirrhosis. If you just have fat but no damage to your liver, the disease is called nonalcoholic fatty liver disease (NAFLD). For some people, the fatty liver may reverse, whereas for others, the fatty liver may . https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567, https://stanfordhealthcare.org/medical-conditions/liver-kidneys-and-urinary-system/nonalcoholic-steatohepatitis-nash.html, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1774026/, https://www.gastrojournal.org/article/0016-5085(95)90726-2/pdf, https://www.medscape.com/answers/175472-100864/what-is-the-prognosis-of-fatty-liver-disease. If you have fat in your liver plus signs of inflammation and liver cell damage, the disease is called nonalcoholic steatohepatitis (NASH). Scand J Gastroenterol. It causes scarring and damage to the liver. Inherited disorders of sugar metabolism, such as galactosemia or glycogen storage disease. Underlying conditions such as hypertension and type 2 diabetes may increase your risk of liver-related complications. Overall, 11 patients developed cirrhosis during follow-up period, four patients in the NAFLD group and seven patients in the AFLD group. PubMed Often, cirrhosis shows no signs or symptoms until liver damage is extensive. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Ong JP, Pitts A, Younossi ZM: Increased overall mortality and liver-related mortality in non-alcoholic fatty liver disease. Cirrhosis of the liver - British Liver Trust The symptoms, diagnosis and treatment. Bruha R, et al. 1992, 117: 646-654. In addition a connective tissue stain, Weigert van Gieson or most commonly Masson Trichrome stain was performed. Tonon M, et al. PubMedGoogle Scholar. fatigue. It is quite common with up to 25% of people in the world having this condition. 1997, 25: 108-111. NASH Tendencies. Besides, you will experience severe problems, which include-. Overall, 58 (62%) of the patients in the AFLD group had undergone alcohol addiction therapy according to computerized database of patients in the National Centre of Addiction Medicine, whereas 2 (1%) in the NAFLD group had undergone an addiction therapy, not due to alcohol but due to abuse of sedatives and due to a gambling addiction. Patients with simple fatty liver at baseline seem to have a good prognosis in terms of liver disease. Compensated cirrhosis: People with compensated cirrhosis do not show symptoms, while life expectancy is . 2009, 44: 1236-1243. If you have NASH, its important to control any conditions that may contribute to fatty liver disease. People who drink too much alcohol may also have fat in their liver, but that condition is different from fatty liver disease. Can diet help improve depression symptoms? Median follow-up time for the non-alcoholic group was 9.9years (range 0.2-26 years) and 9.2years (0.2-25 years) for the alcoholic group. You may opt-out of email communications at any time by clicking on Bambha K, et al. Haflidadottir, S., Jonasson, J.G., Norland, H. et al. It's during stage 3 that a liver transplant may be recommended. Long term follow-up and liver-related death rate in patients with non-alcoholic and alcoholic related fatty liver disease, http://www.hagstofan.is/Hagtolur/Mannfjoldi/faeddir-og-danir, http://www.biomedcentral.com/1471-230X/14/166/prepub, https://creativecommons.org/licenses/by/4.0/, https://creativecommons.org/publicdomain/zero/1.0/. CAS the unsubscribe link in the e-mail. Learn more about cirrhosis from transplant hepatologist Sumera Ilyas, M.B.B.S. Continue with Recommended Cookies, Nonalcoholic fatty liver refers to the accumulation of fat in the liver of a person. Ekstedt M, Franzn LE, Mathiesen UL, Thorelius L, Holmqvist M, Bodemar G, Kechagias S: Long-term follow-up of patients with NAFLD and elevated liver enzymes. Whats the difference between NASH and NAFLD? Information was available to calculate BMI in 56% of the total study cohort. Dam-Larsen S, Becker U, Franzmann MB, Larsen K, Christoffersen P, Bendtsen F: Final results of long-term, clinical follow-up in fatty liver patients. According to the NAS score overall 31/151 (21%) patients in the NAFLD group had NASH compared to 35/94 (37%) with ASH in the AFLD group (p=0.007). In a study on prognosis and life expectancy in chronic liver disease the five year survival was 38% for the alcoholic group and 68% for the non-alcoholic group but only 87% of . health information, we will treat all of that information as protected health This can move them higher up the list of those waiting for a liver transplant. Non-alcohol related fatty liver disease (NAFLD) is a type of steatosis that's caused by factors other than excessive alcohol use. Adams LA, Lymp JF, St. Sauver J, Sanderson SO, Lindor KD, Feldstein A, Angulo P: The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Life expectancy by stage. Lose weight. The proportion of men was higher in the AFLD group, that is 67% (63/94) whereas the proportion of women was 31/94 (33%). Once the liver stops functioning, an organ transplant may be an option. A reasonable explanation for this difference in our study could be that our patients had in general mild changes in the liver biopsy at baseline. It's usually seen in people who are overweight or obese. All rights reserved. The average life expectancy for those with decompensated liver failure is about two years. A recent study from the US also found a higher proportion of women in the NAFLD group [22] which is in line with our results. NASH symptoms are often silent or nonspecific, making it difficult to diagnose. National Institute of Diabetes and Digestive and Kidney Diseases. Is there anything that can increase life expectancy? Accordingly, the problem is common and even spreads consistently in the following types of people-. The last follow-up date was the 30th of November 2011. And when this happens, scar tissue forms. Child-pugh versus MELD score for the assessment of prognosis in liver cirrhosis. Medications, including methotrexate or isoniazid. If your NASH worsens, you may begin to experience symptoms that are indicative of the inflammation and damage done to your liver cells. The absence of HCC among the NAFLD group differs from previous cohort studies showing that 3/129 (2%) [7] and 2/420 (0.5%) [6] of NAFLD patients developed HCC [7]. (2016). One of the main findings in this study was that patients with fatty liver disease showed a markedly higher risk of developing liver-related death compared to the general population. Further still, there is no single test that can diagnose NASH. But the likelihood of both is much higher in those with ASH0.5% compared to 3% to 10%, respectively. Despite its severity, the condition is not rare. If you have been diagnosed with NASH, here are some important things you should do to avoid further liver damage: Nonalcoholic steatohepatitis (NASH) is a form of nonalcoholic fatty liver disease in which there is inflammation and destruction of liver cells. Cirrhosis of the liver life expectancy: Stages, prognosis, and more The two main types of NAFLD are nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). Learn more about the stages, signs, treatments and more here. Most people are asymptomatic for a long time, and their daily life is unaffected, leading to difficulty in identifying and managing people who slowly progress to non-alcoholic . The main limitation of the study was its retrospective design and data was not systematically registrered and was therefore sometimes missing or unavailable. The liver. include protected health information. But the disease doesn't always get worse. If you have cirrhosis, there are several tools your doctor can use to give you a better understanding of your outlook. A total of 67 patients died during the follow-up period; 41 women (61%) and 26 men (39%). Some imaging tests, including special ultrasound and MRI scans can help diagnose the disease and spot scar tissue in the liver. In addition, non-alcoholic steatohepatitis has recently emerged as a relevant disease etiology . Antiviral drugs can prevent additional liver damage due to viral hepatitis. Alcohol liver disease. All members of the cohort were linked through their unique personal identification number to the centralized Hospital Discharge Register at the Directorate of Health and the Registry of Causes of Death (RCD) at Statistics Iceland. 26th ed. Health professionals learn more and more every day about the conditions and diseases that damage our livers. Learn about the causes of cirrhosis, diagnosis, prevention, and how to, Liver fibrosis occurs when chronic injury or inflammation causes a buildup of scar tissue. Cirrhosis And Ascites Life Expectancy | Fatty Liver Disease Non-alcoholic fatty liver disease is a very common medical condition, driven by a combination of genetic and lifestyle factors, ultimately producing a severe chronic liver disease and increased cardiovascular risk. Cirrhosis - NHS In this retrospective study, all patients who underwent a liver biopsy 19842009 at the National University Hospital of Iceland were identified through a computerized pathological database with the code for fatty liver. CAS While theres no way to reverse cirrhosis, there are several things you can do to try to help slow down its progression and avoid additional liver damage. These are the leading causes of liver disease. Learn about metabolism and what to eat for a healthy liver. See additional information. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, for video What is cirrhosis? 2016;17(5):774. doi:10.3390/ijms17050774, Haflidadottir S, Jonasson JG, Norland H, et al. The MELD system helps to determine the risk of death in people with end-stage liver disease. Is the ketogenic diet right for autoimmune conditions? Treating the cause of the cirrhosis is also crucial. Nonalcoholic Fatty Liver Disease | Johns Hopkins Medicine NASH doesnt have to dominate your life. Healthline Media does not provide medical advice, diagnosis, or treatment. Statistics Iceland: 2013, Available from: http://www.hagstofan.is/Hagtolur/Mannfjoldi/faeddir-og-danir. Only patients with NAFLD and AFLD were included and medical records reviewed. Multiple types and stages of liver disease can lead to liver failure. They were paraffin embedded and cut in 45 micrometer thick sections. To conclude, we should say that no one of us can say the number of years, for which an individual with nonalcoholic fatty liver disease will survive or experience complications. Reduced anxiety. The Child-Turcotte-Pugh (CTP) system awards points based on whether an individual has: With the CTP system, a persons score increases according to the number and severity of their symptoms. information is beneficial, we may combine your email and website usage information with Those who were misclassified and did not have fatty liver on review were excluded (Figure1). Who is at risk for developing NAFLD and NASH? Second review to examine inter-observer variability was not undertaken. sudden death from cirrhosis of the liver - athletepro.com.au NASH definition and prevalence. fibrosis. The natural course of non-alcoholic fatty liver disease. Alcohol consumption can lead to mood swings and depression, but quitting alcohol can improve mood and overall well-being. Alcoholic cirrhosis has the worst prognosis, when compared to primary biliary cirrhosis or cirrhosis induced by hepatitis. Thank you, {{form.email}}, for signing up. The most common cause of death in the NAFLD group was of cardiovascular disease 20/42 (48%), followed by malignancy 6/42 (14%) and other chronic medical conditions 4/42 (9.5%). About 10% to 20% of Americans have NAFLD. People with cirrhosis need to regularly see their medical team to review how their condition is progressing. A total of 10/151 (7%) patients developed cirrhosis in the NAFLD group and 19/94 (20%) in AFLD group (p=0.03). In fact, one study found that most people with NASH have a similar life expectancy to those without it, especially if theirliver function tests are stable over time. Few studies have determined the natural history of biopsy-proven fatty liver disease and compared the long-term prognosis of these two major groups of fatty liver disease due to alcoholic and non-alcoholic fatty liver disease. But the CPT and MELD scores can help to give a general idea. Liver cirrhosis is a condition characterized by liver scarring, impaired liver function, and other side effects. Of these 12 (18%) were liver related in both the NAFLD and AFLD group (Table5). Next is an inflammatory response that causes nonalcoholic steatohepatitis. JAMA Netw Open. It is more often seen in people with obesity, metabolic syndrome, insulin resistance, or type 2 diabetes. If your doctor finds something suspicious, further blood tests may be necessary. Mayo Clinic. About 2% of American adults have liver disease, and therefore are at risk of developing cirrhosis. Calzadilla BL, Adams LA. Data on drug and alcohol intake was noted in the medical records. It should be noted that baseline NAS score was different between two groups with higher baseline NAS score in the AFLD group (NAS score>5: 37% vs 21%). Allscripts EPSi. What to Eat When You Have Fatty Liver Disease, EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease, Alcoholic hepatitis versus non-alcoholic steatohepatitis: levels of expression of some proteins involved in tumorigenesis, Pathogenesis of nonalcoholic steatohepatitis and hormone-based therapeutic approaches. Learn about symptoms, diagnosis, treatment. However, if a person chooses to bring lifestyle changes early, he or she may expect to avoid liver failure or liver damage. 2014;14(1):166. doi:10.1186/1471-230x-14-166, Wong RJ, Singal AK. What is it? Article Patients developing liver cirrhosis and liver related complications are demonstrated in Table4. Accessed Jan. 6, 2023. PubMed A total of 245 patients constituted the study group, 136 (56%) women and 109 men (44%). But the worst outcomes for heart and liver disease are in those with metabolic syndromea combination of insulin resistance, obesity, and hyperlipidemia. This article does not provide medical advice. 1999, 94: 2467-2474. Control diabetes. Hum Pathol. Exp Mol Pathol. Life expectancy in NAFLD compared with the general population. . Gastroenterology 24 years experience. NAFLD is sometimes called fatty liver disease because the presence of fat in the liver cells is the only characteristic of the condition. While this helps to give doctors a better idea of someones life expectancy, it also helps to prioritize those waiting for a liver transplant. Make sure that none of your medications, herbs, and supplements are toxic to the liver. Long term follow-up and liver-related death rate in patients with non-alcoholic and alcoholic related fatty liver disease. In the AFLD group, 4 died of breast cancer and one each of renal cancer, malignant brain tumor, colon cancer, nasopharyngeal cancer and pancreas cancer. Even though a simple form of the fatty liver does not cause any problem, without proper care or preventative steps, you may develop nonalcoholic steatohepatitis. Home Remedies For Non-Alcoholic Fatty Liver Disease. Non-Alcohol Related Fatty Liver Disease. Scientists use genetic rewiring to increase lifespan of cells, Beyond amyloid and tau: New targets in developing dementia treatments, Napping longer than 30 minutes linked to higher risk of obesity and high blood pressure, Activity 'snacks' could lower blood sugar, complication risk in type 1 diabetes, In Conversation: Investigating the power of music for dementia, Everything you need to know about cirrhosis, What to know about liver failure and liver disease stages, Diet for jaundice: What to eat for a healthy liver. This is a challenging process, although one of the critical steps is avoiding alcohol of any kind. In a Danish study of 109 patients diagnosed with pure non-alcoholic simple steatosis (without inflammation or significant fibrosis) only one of the patients developed cirrhosis [8]. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. The feedback link Was this Article Helpful on this page can be used to report content that is not accurate, up-to-date or questionable in any manner. If you have fat in your liver plus signs of inflammation and liver cell damage, the disease is called nonalcoholic steatohepatitis (NASH). Chopra S. Patient education: nonalcoholic fatty liver disease (NAFLD), including nonalcoholic steatohepatitis (NASH) (beyond the basics). The patients with gallstone surgery at the time of index liver biopsy were excluded to better represent the patients who would undergo a liver biopsy in clinical practice and not just the incidental finding of fatty liver during an operation.Indications for the index biopsy in the cohort were elevated liver tests, mainly serum alanine aminotransferase (ALT) and serum aspartate aminotransferase (AST) and/or hepatomegaly or suspected alcoholic liver disease. Mayo Clinic does not endorse companies or products. Patients with NAFLD have been shown to have increased cardiovascular mortality compared to the general population [6, 7]. 1A: mild, zone 3, perisinusoidal. Patient with a reported alcohol problem or abuse or an alcohol-related diagnosis before or at the time of liver index biopsy were considered to have alcoholic fatty liver disease. Terms and Conditions, We can not find a plausible explanation for this difference, although it has been shown that diagnoses on death certificates can underestimate liver-related mortality [28] which might have been the case in the Danish study [10]. Major risk factors include infections with the hepatitis B virus (HBV) or hepatitis C virus (HCV) and alcohol-related cirrhosis. Hepatology. 2022; doi:10.3350/cmh.2022.0036. But making some lifestyle changes can control or reverse the fat buildup in your liver. Experts arent sure why some people get NASH and experience symptoms and others dont. 1981, 16: 839-844. Having high blood fat levels, either triglycerides or LDL (bad) cholesterol. You can: While there are no specific medications that treat NASH directly, taking metformin and statins to treat associated metabolic conditions like insulin resistance and high cholesterol can help these associated conditions. There are two stages in cirrhosis: compensated and decompensated. Here are some of the mental health changes that occur when you stop drinking alcohol: Improved mood. Gastroenterology. Vaccines & Boosters | Testing | Visitor Guidelines | Coronavirus. 2023 Healthline Media UK Ltd, Brighton, UK. Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ: Nonalcoholic fatty liver disease. Possible signs and symptoms of NASH and advanced scarring (cirrhosis) include: Abdominal swelling (ascites) Enlarged blood vessels just beneath the skin's surface. NAFLD is a condition when fat builds up in the liver. An example of data being processed may be a unique identifier stored in a cookie. The hazard ratio for women in the AFLD group was 1.19 compared to the NAFDL group.The survival for patients with moderate to severe fibrosis was significantly worse than for patients with mild fibrosis after adjusting for gender, calendar year of diagnosis and age at diagnosis (HR 2.09, p=0.01) (Figure3). Cirrhosis of the liver is a serious condition, causing scarring and permanent damage to the liver. This is in agreement with results from a recent study showing that advanced fibrosis in the index liver biopsy was the most important predictor of the prognosis in these patients [27]. Non-alcoholic Fatty Liver Disease (NFLD). A biopsy may also be required to identify the severity, extent and cause of liver damage. Fatty liver disease is clinically categorized into two main groups, alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). 1999, 116: 1413-1419. Lazo M, Clark JM: The epidemiology of nonalcoholic fatty liver disease: a global perspective. Not everyone with these risk factors develop cirrhosis. 1995, 40: 1805-1815. Most people with NAFLD live with fat in their liver without developing liver damage. Becker U, Deis A, Sorensen TIA, Borch-Johnsen K, Muller CF, Schnohr P, Jensen G: Prediction of risk of liver disease by alcohol intake, sex, and age: a prospective population study. It may have no symptoms unless damage progresses. The survival curves were estimated by the Kaplan-Meier estimator, using years as the time-scale and taking delayed entry into account. The most common cause of death in the NAFLD group was from cardiovascular disease, followed by malignancy which is in agreement with findings of other cohort studies (6, 7, 14, 16,). The probability of being alive three years after decompensation is only 30%. A significantly higher number of patients in the AFLD group, 13/94 (14%) developed decompensated liver disease compared with 7/151 (5%) in the NAFLD group (Table4). The slides used for pathological estimation were the original slides and recuts or restaining of slides was not done except for a few exceptional cases where the original slides were unavailable or when a Masson-Trichrome stain had not been performed originally. In Iceland, the prevalence of liver cirrhosis due to alcohol is very low, only 3.3/100.000 inhabitants which was 4 times lower than in Sweden [21]. The biochemical markers AST, ALT, bilirubin, prothrombin time and MCV were higher and platelets lower in the AFLD group compared to the NAFLD group at the time of index liver biopsy whereas other biochemical markers were similar in the two groups (Table1 Goldman L, et al., eds. Nguyen L, Masouminia M, Mendoza A, et al. Progression of NAFLD has been found to be slow and seems to depend a great deal on the initial fibrosis stage [8, 14]. Antiviral Therapy in Patients with Viral Hepatitis and Hepatocellular As cirrhosis gets worse, more and more scar tissue forms, making it difficult for the liver to do its job. Inflammation can damage liver cells, causing fibrosis (scarring) of the liver. Ann Intern Med. The Comfort of Home for Chronic Liver Disease, uptodate.com/contents/model-for-end-stage-liver-disease-meld, How to Follow a Liver Cirrhosis Diet: All You Need to Know. How non-fatty liver disease develops is still being studied. Wilson's disease, a condition in which copper accumulates in the liver. Only one patient died from hepatocellular cancer (HCC) in the total cohort and as mentioned above, from the AFLD group. This number could be even higher, as many people do not receive a diagnosis until they develop advanced symptoms. Only one patient in the AFLD group developed HCC but none of the NAFLD patients developed HCC (Table4). Heres how your health care providermakes the diagnosis: If you have fat but no inflammation or tissue damage, the diagnosis is NAFLD. https://www.uptodate.com/contents/search. A wide range of other conditions and diseases can cause cirrhosis as well. Furthermore, approximately 10percent to 25percent of nonalcoholic steatohepatitis develop the problem of cirrhosis within only 10years. Hemochromatosis, a condition that causes iron buildup in the body. The main complication of fatty liver disease is the progression of NASH to cirrhosis. Risks and causes for liver cancer | Cancer Research UK Even if you do not experience any symptoms associated with liver scarring (further stage of the nonalcoholic fatty liver), you should start following a healthy lifestyle. Cookies policy. Class C patients have a worst prognosis with a cirrhosis life span . information and will only use or disclose that information as set forth in our notice of The MannWhitney U-test was used to test for differences between groups. In the nonalcoholic group 47 (31%) patients had borderline NASH and 68 patients (45%) did not have steatohepatitis. 1C: Portal/periportal. In a study from Denmark, a significantly higher BMI was seen in NAFLD than in AFLD patients. A wide range of diseases and conditions can damage the liver and lead to cirrhosis. Can Nonalcoholic Fatty Liver Disease Go Away On Its Own & What Are Its Natural Remedies? Fibrosis stage were defined as follow: 0: none. A total of 420 patients met the inclusion criteria and were divided into two groups, non-alcoholic and alcoholic group respectively (Figure1). Since many medications can harm your liver, always let all your health care providers know about any medications you are taking. It refers to . How Common Is Non-Alcoholic Fatty Liver Disease Or Is It A Rare Disease? A total of 12 patients (18%) died of malignancy. Dr. Brett Kalmowitz answered. Hepatology. Clinics for Nonalcoholic Steatohepatitis (NASH) GI Nutrition Services 650-736-5555; Liver Transplant Program 650-498-7878; DOI: What do the scores mean for life expectancy? In the alcoholic group 35 (37%) patients had borderline ASH (NS) and 22 (23%) did not have ASH (NS).

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