비알콜성 지방간 초음파 영상에 GLCM과 인공신경망을 적용한 비알콜성 지방간 질환 분류

김지율,예수영 한국방사선학회 2023 한국방사선학회 논문지 Vol.17 No.5

Non-alcoholic fatty liver disease is an independent risk factor for the development of cardiovascular disease, diabetes, hypertension, and kidney disease, and the clinical importance of non-alcoholic fatty liver disease has recently been increasing. In this study, we aim to extract feature values ​​by applying GLCM, a texture analysis method, to ultrasound images of patients with non-alcoholic fatty liver disease. By applying an artificial neural network model using extracted feature values, we would like to classify the degree of fat deposition in non-alcoholic fatty liver into normal liver, mild fatty liver, moderate fatty liver, and severe fatty liver. As a result of applying the GLCM algorithm, the parameters Autocorrelation, Sum of squares, Sum average, and sum variance showed a tendency for the average value of the feature values ​​to increase as it progressed from mild fatty liver to moderate fatty liver to severe fatty liver. The four parameters of Autocorrelation, Sum of squares, Sum average, and sum variance extracted by applying the GLCM algorithm to ultrasound images of non-alcoholic fatty liver disease were applied as inputs to the artificial neural network model. The classification accuracy was evaluated by applying the GLCM algorithm to the ultrasound images of non-alcoholic fatty liver disease and applying the extracted images to an artificial neural network, showing a high accuracy of 92.5%. Through these results, we would like to present the results of this study as basic data when conducting a texture analysis GLCM study on ultrasound images of patients with non-alcoholic fatty liver disease.

비비만인에서 발견되는 비알콜성 지방간의 대사적 의미

이광은 ( Kwang Eun Lee ),김유미 ( Yoo Mee Kim ),강은석 ( Eun Seok Kang ),김혜진 ( Hae Jin Kim ),정혜원 ( Hae Won Chung ),이시훈 ( Sh Hoon Lee ),김형진 ( Hyeung Jin Kim ),김대중 ( Dae Jung Kim ),김수경 ( Soo Kyung Kim ),안철우 ( Ch 대한내과학회 2002 대한내과학회지 Vol.63 No.5

Background : It is well known that non-alcoholic fatty liver disease is associated with metabolic syndrome such as obesity, type II diabetes mellitus, dyslipidemia. Non-alcoholic fatty liver disease is frequently found in non-obese adults, but the meaning of it is unknown. So we studied the association of non-alcoholic fatty liver disease in non-obese adults and metabolic abnormalities. Methods : We examined 779 Korean adults above 30 years old (274 men, 505 women) participating in medical check-up in Health Promotion Center. Hepatitis B and C serologies were negative, and average weekly alcohol intake was .2 drinks. A standard interview, physical examination and biochemical study was conducted. An experienced operator carried out ultrasound liver studies. Results : 370 subjects had non-alcoholic fatty liver disease (47.3%). The frequency in men was higher than that in women (57.3 vs 42.2%, p<0.05). The frequency in non-obese (BMI<25 kg/m2, n=431) group was lower than that in obese (BMI.25 kg/m2, n=348) group (65.5 vs 32.3%, p<0.05). Compared with obese group, waist circumference, waist hip ratio, body fat, impaired fasting serum glucose, total cholesterol, HDL-cholesterol, total cholesterol to HDL-cholesterol ratio, fasting insulin, proinsulin, HOMA-IR and HOMA-beta were significantly different in non-obese, non-alcoholic fatty liver group. After multiple regression analysis, waist circumference was associated with non-alcoholic fatty liver disease in non-obese individuals. Odd ratios of insulin resistance in non-obese, non-alcoholic fatty liver group were 5.8 (CI: 3.1.10.9). Conclusion : The frequency of non-alcoholic fatty liver disease was very high in non-obese adults and well associated with central obesity and insulin resistance.(Korean J Med 63:488-495, 2002) Key Words : Non - alcoholic fatty liver disease, Body mass index, Metabolic syndrome, Central obesity

한국 성인에서 비알콜성 지방간의 중증도에 따른 대사이상의 특징

김형진,김대중,김수경,김세화,이유미,안철우,차봉수,송영득,임승길,김경래,이현철,허갑범 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.4

연구배경: 30세 이상의 성인 한국인에서 지방간의 중증도와 대사증후군의 여러 요소들 (특히 인슐린저항성 및 중심성비만)과의 관련성을 분석하고자 하였다. 방법: 대상자는 2001년 4월부터 6월까지 건강검진센터를 방문한 사람들 중 만성 바이러스성 간염이나 일주일에 2회 이상 음주력이 있는 사람들을 제외한 1074명 (남자 502, 여자 572)에서 문진, 신체검사, 채혈 그리고 복부초음파를 시행하였다. 결과: 1074명중 522명에서 지방간이 양성이어서 양성율은 49%였으며 남성은 여성에 비해 높은 유병률을 보였다. (57 vs 42%, p<0.05). 당뇨병, 비만 그리고 이상지질증을 가지지 않은 사람들에서 비알콜성 지방간의 유병률은 20%였다. 지방간이 양성인 522명중 218명은 경도, 273명은 중등도, 31명은 중증의 지방간 소견을 보였다. 체질량지수, 허리둘레, 체지방률, 수축기혈압, aspartate aminotransferase, alanine aminotransferase, 총콜레스테롤, 중성지방, 그리고 총콜레스테롤/고밀도지단백 비는 지방간의 중증도에 따라 의미있게 증가하는 양상을 보였다(p<0.05). 다중회귀분석을 시행하였을 때 지방간의 중증도를 잘 반영하는 인자로는 허리둘레, alanine aminotransferase, HONA_IR, 총콜레스테롤/고밀도지단백비, aspartate aminotransferase, 그리고 수축기혈압의 순서로 나타났다. 공복혈당장애, 고혈압 및 인슐린저항성은 지방간을 가진 군에서 대조군보다 의미있게 높은 빈도를 보였을 뿐만 아니라 지방간의 중증도에 따라 차이를 보였다(p<0.05). 인슐린저항성은 심한 지방간에 비교위험도가 14.7(CI; 6.8∼32.0), 중등도의 지방간에서 6.9(CI; 4.6∼10.3), 경도의 지방간에서 5.7(CI; 3.6∼8.8)이었으며 HOMA_IR의 상위 1/4을 인슐린저항성이 있는 군으로 정의하였을 때 각군에 인슐리저항성을 가진 비율은 7.6, 32.0, 36.0, 그리고 55%였다(p<0.05). 지방간의 중증도에 따른 비알콜성 지방간염의 고위험군 비율은 각각 5.0, 21.6, 27.8, 그리고 58.1%였다(p<0.05). 결론: 우리나라의 비알콜성 지방간의 빈도는 서구인에 비해 높은 것으로 나타났다. 또한 비알콜성 지방간이 있을 경우 대사증후군과 관련된 여러인자들(특히 인슐린저항성과 중심성비만)과 비알콜성 지방간염의 위험이 현저히 증가하며 초음파의 중증도 분류에 따라 비례하였다. Background: We evaluated the frequency of non-alcoholic fatty liver disease, and the associations between the metabolic abnormalities and severity of non-alcoholic fatty liver disease in Korean adults using ultrasonography. Methods: We examined 1074 Korean adults above the age of 30 years, comprising of 502 men and 572 women, participating in medical check-ups at the Health Promotion Center. Hepatitis B and C serologies were negative, and the average weekly alcohol intake was ≤ 2 standard drinks. A standard interview, physical exam and biochemical study, were conducted, and an experienced operator carried out ultrasound liver studies. Results: 522 of the subjects had non-alcoholic fatty liver disease, and the remaining 552 did not. The frequency in the men was higher than that in the women (57 vs 42%, p<0.05). The frequency of non-alcoholic fatty liver disease in the subjects without diabetes, obesity or dyslipidemia was 20%. We classified subjects into 4 groups: the controls (n=552) and those with mild (n=218), moderate (n=273) or severe fatty liver disease (n=31), according to their ultrasonographic findings. BMI, waist circumference, body fat, systolic blood pressure, aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglyceride, the total-to HDL-cholesterol ratio, impaired fasting glucose, hypertension and insulin resistance, were all significantly increase with the increased severity of non-alcoholic fatty liver disease (p<0.05). Following the multiple regression analyses, waist, alanine, aminotransferase, HOMAIR, the total- to HDL-cholesterol ratio, aspartate aminotransferase and systolic blood pressure, were all associated with the severity of non-alcoholic fatty liver disease. Odd ratios of insulin resistance in the mild, moderate and severe non-alcoholic fatty liver disease were 14.7 (CI: 6.8∼32.0), 6.9 (CI: 4.6∼10.3) and 5.7 (CI 3.6∼8.8), respectively. The percentages of subjects with insulin resistance in each group were 7.6, 32.0, 36.0 and 55.0% (p<0.05), respectively. The percentages of subjects with risk of non-alcoholic steatohepatits in each groups were 5.0, 21.6, 27.8 and 581% (p<0.05) respectively. Conclusion: The frequency of non-alcoholic fatty liver disease was relatively high in Korean adults. Proportional differences in metabolic abnormalities, relation to the severity of non-alcoholic fatty liver disease, were found by ultrasonography (J Kor Soc Endocrinol 17:514∼525, 2002).

Sex Difference in the Association between Serum Homocysteine Level and Non-Alcoholic Fatty Liver Disease

Bo-Youn Won,Kyung-Chae Park,Soo-Hyun Lee,Sung-Hwan Yun,Moon-Jong Kim,Kye-Seon Park,Young-Sang Kim,Ji-Hee Haam,Hyung-Yuk Kim,Hye-Jung Kim,Ki-Hyun Park 대한가정의학회 2016 Korean Journal of Family Medicine Vol.37 No.4

Background: The relationship between serum homocysteine levels and non-alcoholic fatty liver disease is poorly understood. This study aims to investigate the sex-specific relationship between serum homocysteine level and non-alcoholic fatty liver disease in the Korean population. Methods: This cross-sectional study included 150 men and 132 women who participated in medical examination programs in Korea from January 2014 to December 2014. Patients were screened for fatty liver by abdominal ultrasound and patient blood samples were collected to measure homocysteine levels. Patients that consumed more than 20 grams of alcohol per day were excluded from this study. Results: The homocysteine level (11.56 vs. 8.05 nmol/L) and the proportion of non-alcoholic fatty liver disease (60.7% vs. 19.7%) were significantly higher in men than in women. In men, elevated serum homocysteine levels were associated with a greater prevalence of non-alcoholic fatty liver disease (quartile 1, 43.6%; quartile 4, 80.6%; P=0.01); however, in females, there was no significant association between serum homocysteine levels and the prevalence of non-alcoholic fatty liver disease. In the logistic regression model adjusted for age and potential confounding parameters, the odds ratio for men was significantly higher in the uppermost quartile (model 3, quartile 4: odds ratio, 6.78; 95% confidential interval, 1.67 to 27.56); however, serum homocysteine levels in women were not associated with non-alcoholic fatty liver disease in the crude model or in models adjusted for confounders. Conclusion: Serum homocysteine levels were associated with the prevalence of non-alcoholic fatty liver disease in men.

건강검진 수진자에서 비알코올성 지방간의 위험인자

배재석,정희철,김덕윤,배승덕,이재욱,김남일,양청헌,이창우,서정일 東國大學校醫學硏究所 2004 東國醫學 Vol.11 No.1

배경/목적: 비알코올성 지방간은 모든 경우에서 정상으로 회복된다고 알려져 왔지만 최근 일부에서 섬유화와 더불어 간경변증으로 진행할 수 있다는 새로운 개념이 정립되면서 비알코올성 지방간에 대한 관심이 고조되고 있다. 이에 연자는 건강검진 수진자를 대상으로 음주력이 없으면서 복부 초음파에서 지방간으로 진단된 비알코올성 지방간의 위험인자를 알아보고자 하였다. 대상 및 방법: 2002년 8월부터 2003년 12월까지 동국대 경주병원에서 건강검진에서 복부 초음파검사를 받았던 2534명 가운데 HB_{s}Ag 양성 또는 anti-HCV 양성인 환자 160명을 제외한 2374명을 선택하였다. 이 가운데 초음파검사에서 지방간으로 확인된 검진자 611명 가운데 음주력이 없는 226명을 대상으로 하였고 정상소견을 보인 1421명을 대조군으로 하였다. 설문지를 이용하여 병력청취를 시행하였고 체질량 지수, 체지방률, 혈압, 간기능검사, 지질검사 및 혈당검사를 시행하였다. 지방간은 초음파 검사결과에 근거하여 3등급으로 구분하였다. 결과: 비알코올성 지방간 환자의 평균연령은 47.03 ± 10.18세로 대조군 42.24 ± 10.17세에 비해 많았고 40대에서 92명(40%)로 가장 많았다. 남자는 107명(47%), 여자가 119명(53%)이었다. 체질량지수 (BMI=25.10 ± 2.56 kg/m²), 체지방률(24.55 ± 7.53), 총콜레스테롤(204.98 ± 38.37 mg/dl), 중성지방(144.26 ± 75.61 mg/dl), 공복혈당(94.38 ± 30.66 mg/dl), 수축기 혈압(135.16 ± 67.78 mmHg), 이완기 혈일(80.73 ± 10.92 mmHg), AST(25.94 ± 12.00), ALT(32.14 ± 22.68 IU/L)는 대조군보다 유의하게 높았다. AST/ALT 비는 비알코올성 지방간 환자에서 0.95 ± 0.34로 1이하였고, 대조군에서 1.28 ± 0.44로 1이상이었다. 고밀도지단백 콜레스테롤(43.77 ± 8.24 mg/dl)은 대조군보다 유의하게 감소되어 있었다. 비알코올성 지방간 환자에서 비만이 25%, 고콜레스테롤혈증이 50%, 고중성지방혈증이 30%, 고혈압이 53%, 당뇨가 8% 동반되었으며 대조군에 비하여 유의하게 빈도가 높았다. 초음파검사에 따른 지방간 등급이 높을수록 체질량지수와 체지방률, 수축기혈압, 이완기혈압, 혈당, 총콜레스테롤, ALT, 중성지방, HLD, LDL이 높게 나타났다. 다중회귀분석에서 비알코올성 지방간의 위험인자는 ALT, 저밀도지단백, 중성지방, 총콜레스테롤, 체지방률 순으로 나타났다. 결론: 건강검진 수진자에서 비알코올성 지방간을 보인 환자들은 40대에서 가장 많았고 위험인자는 간기능검사상 ALT상승, 이상지혈증 및 비만으로 나타났다. Purpose: Non-alcoholic fatty liver has almost recovered to health state, but at present, it suggested that advanced to fibrosis and liver cirrhosis. therefore non-alcoholic hepatitis is blighted. Thus, in healthy medical check up, We are interesting to what they as non-alcoholics diagnosed as fatty liver by abdominal ultrasonography has risk factor. Methods: We selected 2374 persons, exclude 160 persons that have HBsAg, or Anti-HCV, in 2534 persons examed by abdominal ultrasonography, healthy medical check up in from August 2002 to December 2003 in Dongguk University Kyung-ju. 226 persons were selected that have not abuse alcoholics, in 611 persons confirmed as fatty liver by ultrasonography, and healthy control group of 1421 has not abnormal fin- by ultrasonography. History taking was by research panel, and body mass index, body fat ratio, blood pressure, liver function test, lipid pannel, and blood sugar test were done. Fatty liver was divided by 3 grade, based that result of abdominal ultrasonography. Results: The mean age of non alcoholic fatty liver was 47.03 ± 10.18 years. it is higher than healthy control group 42.24 ± 10.17 years, and most common age has been 40 decades (92 people (40%). mens were 107 persons (475), and women were 119 persons (53%). body mass index (BMI=25.10 ± 2.56 kg/m²), body fat ratio (24.55 ± 7.53), Total cholesterol (204.98 ± 38.37 mg/dl), triglyceride (144.26 ± 75.61 mg/dl), fasting blood sugar (94.38 ± 30.66 mg/dl), systolic blood pressure (135.16 ± 67.78 mmHg), diastolic blood pressure (80.73 ± 10.92 mmHg), AST (25.94 ± 12.00 IU/L), ALT (32.14 ± 22.68 IU/L) are higher than healthy control group significantly. AST/ALT ratio of non alcoholic fatty livers is 0.95 ± 0.34, it's below 1, health contrast peoples are 1.28±0.44, it s above 1. High density lipoprotein(43.77±8.24 mg/dl) was lower than health control group significantly. Non alcoholic fatty livers were acompanied obesity (25%), high cholesteloremia (50%), high triglycemia (30%), hypertension (53%), DM (8%), it is higher than healthy control group sigmfkantly. The risk factors of non alcoholic fatty liver were increasing ALT, Low density lipoprotein, triglyceride, total cholesterol, body fat ratio in a mulitiple regression analysis. Conclusions: The most common age of the non alcoholic fatty livers were 40 decades, and risk factors were increasing ALT, Low density lipoprotein, triglyceride total cholesterol, body fat ratio in the comprehensive medical testing persons.

성인 여성에서 비알코올성 지방간의 중증도에 따른 대사증후군 관련성

공은희 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.2

Background: The aim of this study was to elucidate the relationship between the grade of non-alcoholic fatty liver diseases diagnosed by ultrasonography and the metabolic syndrome defined by the Third Report of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) guideline. Methods: A total of 198 women who visited a health promotion center from January, 2007 to December, 2008 were selected for this study. The ultrasound scan of the liver was performed to determine the presence and the severity of non-alcoholic fatty liver disease. The relationship between non-alcoholic fatty liver and risk categories of metabolic syndrome using NCEP-ATP III guideline were analysed. Results: The prevalence of metabolic syndrome was 19.2% in women with non-alcoholic fatty livers. When odds ratios(95% CI) for metabolic syndrome in groups with moderate and severe non-alcoholic fatty livers were compared to that of group with mild non-alcoholic fatty livers, there was an increased risk of metabolic syndrome with an odds ratio of 2.24(1.31∼4.41). Conclusion: Non-alcoholic fatty liver disease was closely related to the metabolic syndrome in healthy women and the severity classification of non-alcoholic fatty liver by ultrasound scan could be useful to predict of the severity of insulin resistance and the risk of metabolic syndrome

The Impact of Weight Changes on Nonalcoholic Fatty Liver Disease in Adult Men with Normal Weight

Ji-Young Cho,Tae-Heum Chung,Kyoung-Mo Lim,Hee-Jin Park,Jung-Mi Jang 대한가정의학회 2014 Korean Journal of Family Medicine Vol.35 No.5

Background: Although it is known that losing weight has an effect on the treatment of non-alcoholic fatty liver disease, the studies that show how losing weight affects the non-alcoholic fatty liver disease for the normal weight male adults are limited so far. In this study, we set body mass index as criteria and investigated how the weight changes for 4 years makes an impact on the risk of non-alcoholic fatty liver disease for the male adults who have the normal body mass index.Methods: From January to December of 2004, among the normal weight male adults who had general check-up at the Health Promotion Center of Ulsan University Hospital, 180 people (average age, 47.4 ± 4.61 years) who were diagnosed with fatty liver through abdominal ultrasonography were included in this study and were observed according to the variety of data and ultrasonography after 4 years (2008). People who had a history of drinking more than 140 g of alcohol per week or who had a past medical history were excluded from the analysis. The weight change of subjects was calculated using the formula ‘weight change = weight of 2008 (kg) - weight of 2004 (kg)’ and classified into three groups, loss group (≤-3.0 kg), stable group (-2.9 to 2.9 kg), and gain group (≥3.0 kg). The odds for disappearance of non-alcoholic fatty liver disease in those three different groups were compared.Results: Among 180 subjects, compared with stable group (67.2%, 121 subjects), loss group (11.7%, 21 subjects) showed 18.37-fold increase in the odds of disappearance of non-alcoholic fatty liver disease (95% confidence interval [CI], 4.34 to 77.80) and gain group (21.1%, 38 subjects) showed 0.28-fold decrease in the odds of disappearance of non-alcoholic fatty liver disease (95% CI, 0.10 to 0.83).Conclusion: Even for the normal weight people, losing weight has an effect on the improvement of non-alcoholic fatty liver disease.

The Risk of Abdominal Obesity according to the Degree of Non- Alcoholic Fatty Liver Disease in Korean Men

박성근,류재홍,최중명,서민우,박정민 대한의학회 2016 Journal of Korean medical science Vol.31 No.3

Although non-alcoholic fatty liver disease has been reported as a cardiometabolic risk factor, the effect of non-alcoholic fatty liver is yet to be clarified on abdominal obesity. Therefore, this study was conducted to investigate the longitudinal relationship of nonalcoholic fatty liver on the development of abdominal obesity. The study participants were composed of 11,212 Korean men without abdominal obesity. They were followed up from 2005 to 2010 to be monitored for the development of abdominal obesity according to their degree of non-alcoholic fatty liver disease (normal, mild, and moderate to severe). Cox-proportional hazard model was used to calculate the hazard ratios for abdominal obesity according to the degree of non-alcoholic fatty liver disease. While the average incidence was 15.5%, the incidence of abdominal obesity increased according to the degree of non-alcoholic fatty liver (normal: 11.6%, mild: 25.2%, moderate to severe: 41.0%, P < 0.001). Multivariable-adjusted hazard ratios for abdominal obesity independently increased proportionally to the degree of NAFLD (mild [1.07; 0.94-1.23], moderate to severe [1.58; 1.11-2.26], P for trend < 0.001). The risk of abdominal obesity increased proportionally to the degree of non-alcoholic fatty liver disease. This finding guarantees further studies to reveal the incidental relationship of abdominal obesity with non-alcoholic fatty liver disease.

비음주 수진자들에서 지방간과 대사증후군과의 연관성

김길수,최영식,,박요한 KOSIN UNIVERSITY COLLEGE OF MEDICINE 2006 高神大學校 醫學部 論文集 Vol.21 No.1

Background: Nonalcoholic fatty liver disease (NAFLD) is liver disease characterized by diffuse fatty infilteration and inflammation. NAFLD is closely related with metabolic syndrome such as diabetes, obesity, hyperlipidemia, and hypertension. Definitive diagnosis of NAFLD still requires a liver biopsy. So, it is difficult to diagnosis of NAFLD in the health screen examinees. The aim of this was to assess the association fatty liver diagnosed by ultrasonography and components and parameters of metabolic syndrome in the non-alcoholic health screen examinees. Methods: A total of 3,829 health screen examinees (1,985 men, 1,844 women) who participated in health screening at health promotion center in Kosin Medical Center from March, 1997 to December, 2003 were enrolled in this study. All participants was no evidence of viral hepatitis and alcohol abuse. The examinees were divided two group, fatty liver and nonfatty liver group and the clinical, biochemical and metabolic parameters analyzed by multiple regression and logistic methods. Results: Almost of all variables (age, weight, blood pressure, body mass index (BMI), waist circumference (WC), total cholesterol, triglyceride, fasting blood glucose, gamma glutamyltransferase (γGTP) except high density lipoprotein (HDL) cholesterol were significantly high in the fatty liver group than nonfatty liver group (p,0.05). There was a significant positive correlation between WC and weight, blood pressure, BMI, total cholesterol, triglyceride (p<0.01). The age adjusted odds ratio between WC and fatty liver was 1.614 in men and 2.906 in women (p<0.01). As subjects were grouped according to their number of components metabolic syndrome, the development of fatty liver was increased according to the numbers of components of metabolic syndrome (p<0.05). γGTP was a significant positive correlation with WC, weight, blood pressure, BMI, total cholesterol, triglyceride (p<0.01). When subjects were grouped according to the γGTP level, group Ⅰ (≤20 U/L) and group Ⅱ (20 U/L~40 U/L) and group Ⅲ (>40 U/L). Significant differences was notice in almost of all variables (weight, blood pressure, BMI, WC, total cholesterol, triglyceride, fasting blood glucose) among each group (p<0.000). Conclusion: These results suggested that fatty liver in non alcoholic health examinees is closely associated with metabolic syndrome and number of components of metabolic syndrome. Among the metabolic parameters, the author noticed that γGTP is not a marker of alcohol induced liver disease but may also a independent and reliable marker of metabolic syndrome.

AHP 기법을 이용한 비알콜성 지방간에 인진호탕(茵蔯蒿湯) 선택과정 분석

김기태 ( Kitae Kim ),고흥 ( Heung Ko ),신선미 ( Seonmi Shin ) 대한한의진단학회 2015 大韓韓醫診斷學會誌 Vol.19 No.3

Abstract Objectives: Lately, non alcoholic fatty liver patients are increasing rapidly and the average age of patients are getting younger. Non alcoholic fatty liver often represents asymptomatic and korean pattern diagnosis is difficult to implement without symptoms. This study aimed to analyze interrelationship between non alcoholic fatty liver disease and Injinho-tang. Methods The AHP is a systematic procedure for analyzing the elements of any problem hierarchically. Based on survey of expertise, as series of pairwise comparison judgements is performed to evaluate the various elements in the hierarchy. We are expected to use the AHP analysis that would apply to oriental doctor`s diagnostic process analysis. Results and conclusion Non-alcoholic fatty liver disease induced complex causes of the metabolic syndrome. Injinho-tang has been widely used disease that causes jaundice and liver biliary disease. According to AHP analysis, LFT is the most important facor in choosing Injinho-tang on non alcoholic fatty liver disease. BMI and body composition by bioelectrical impedance analysis are the next important factors. Personal hot temper also gives a big impact on choicing Injinho-tang on non alcoholic fatty liver disease.