Comparative Burden of Metabolic Dysfunction in Lean NAFLD vs Non-lean NAFLD - A Systematic Review and Meta-analysis

Tang, Ansel Shao Pin; Ng, Cheng Han; Phang, Poh Hui; Chan, Kai En; Chin, Yip Han; Fu, Clarissa Elysia; Zeng, Rebecca Wenling; Xiao, Jieling; Tan, Darren Jun Hao; Quek, Jingxuan; Lim, Wen Hui; Mak, Lung‐Yi; Wang, Jiong‐Wei; Chew, Nicholas; Syn, Nicholas; Huang, Daniel Q.; Siddiqui, Mohammad Shadab; Sanyal, Arun J.; Muthiah, Mark; Noureddin, Mazen

doi:10.1016/j.cgh.2022.06.029

Cited by 57 publications

(49 citation statements)

References 110 publications

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“…Both obesity and type 2 diabetes rates have continued to increasing prevalence of NAFLD ( 25 ). However, there is a subtype of NAFLD, defined as lean NAFLD, which occurs in lean population without obesity with different histological features from those of obese NAFLD ( 26 ). A clinical study observed that patients with lean NAFLD had a significantly higher visceral adiposity index than obese NAFLD ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Role of aerobic exercise in ameliorating NASH: Insights into the hepatic thyroid hormone signaling and circulating thyroid hormones

Liu

Li²,

He³

et al. 2022

Front. Endocrinol.

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AimTriiodothyronine (T3) administration significantly eliminates hepatic steatosis and also has a therapeutic effect on non-alcoholic steatohepatitis (NASH). However, the potential mechanism by which T3-mediated exercise improves NASH is unknow. This study aimed to explore the effect of aerobic exercise on liver injury in NASH.MethodsAerobic exercise was conducted to explore the effects of exercise on liver injury in NASH model induced by Atherosclerotic (Ath) diet. Biochemical evaluations, histological staining and real-time PCR were first applied to confirm the amelioration effects of exercise on NASH. RNA-sequencing (RNA-seq) analysis for livers of each group were further used to identify the underlying mechanisms of aerobic exercise. Bioinformatics methods were used to explore the key functional pathways involved in the improvement of liver tissue in NASH mice by aerobic exercise.ResultsAerobic exercise improved hepatic steatosis, lobular inflammation and fibrosis in NASH mice. multiple inflammation-related pathways were significantly enriched in the liver of NASH group and improved by aerobic exercise. The results of gene set variation analysis (GSVA) showed a higher enrichment score of T3 response signature in NASH mice with exercise. Increased Dio1 expression in the liver of NASH with exercise mice and increased circulating FT3 and FT4 levels upon aerobic exercise were confirmed.ConclusionsWe found that aerobic exercise could significantly reduce hepatic lipid accumulation, inflammatory infiltration and fibrosis progression in the liver of NASH mice. Hepatic thyroid hormone signaling activation and circulating thyroid hormones is potentially involved in the amelioration effect of aerobatic exercise on NASH progression.

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Section: Discussionmentioning

confidence: 99%

Role of aerobic exercise in ameliorating NASH: Insights into the hepatic thyroid hormone signaling and circulating thyroid hormones

Liu

Li²,

He³

et al. 2022

Front. Endocrinol.

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“…Importantly, the marginal effect of ectopic fat distributions on the predictive probability of having NAFLD were more significant in non-obese NAFLD relative to obese NAFLD. The importance of weight remains key in the management principle for NAFLD [ 31 , 32 ]. However, there should also be a wholesome reduction in fat mass beyond visceral fats which are most commonly associated with NAFLD.…”

Section: Discussionmentioning

confidence: 99%

DEXA Scan Body Fat Mass Distribution in Obese and Non-Obese Individuals and Risk of NAFLD—Analysis of 10,865 Individuals

Tan

Chan

et al. 2022

JCM

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Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide yet predicting non-obese NAFLD is challenging. Thus, this study investigates the potential of regional fat percentages obtained by dual-energy X-ray absorptiometry (DXA) in accurately assessing NAFLD risk. Using the United States National Health and Nutrition Examination Survey (NHANES) 2011–2018, multivariate logistic regression and marginal analysis were conducted according to quartiles of regional fat percentages, stratified by gender. A total of 23,752 individuals were analysed. Males generally showed a larger increase in marginal probabilities of NAFLD development than females, except in head fat, which had the highest predictive probabilities of non-obese NAFLD in females (13.81%, 95%CI: 10.82–16.79) but the lowest in males (21.89%, 95%CI: 20.12–23.60). Increased percent of trunk fat was the strongest predictor of both non-obese (OR: 46.61, 95%CI: 33.55–64.76, p < 0.001) and obese NAFLD (OR: 2.93, 95%CI: 2.07–4.15, p < 0.001), whereas raised percent gynoid and leg fat were the weakest predictors. Ectopic fat deposits are increased in patients with non-obese NAFLD, with greater increases in truncal fat over gynoid fat. As increased fat deposits in all body regions can increase odds of NAFLD, therapeutic intervention to decrease ectopic fat, particularly truncal fat, may decrease NAFLD risk.

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“…When examining retrospective data comparing the two diagnoses, the majority of patients fulfil both the criteria for MAFLD and NAFLD. However, there is a small proportion who make up the non-MR NAFLD group across these studies ranging from 0.6%-16.1%, with most consistently estimating this group to make up around 5% of the fatty liver disease population [20,22,32,33,[41][42][43][44]. Whilst most risks were associated with MAFLD diagnosis, some studies did show that non-MR NAFLD patients did have increased risks of cardiovascular disease in follow up, though the majority of studies show no increase in liver-related risk compared to the control populations [40].…”

Section: Non-metabolic Risk (Mr) Nafldmentioning

confidence: 99%

MAFLD: How is it different from NAFLD?

et al. 2023

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Metabolic (dysfunction) associated fatty liver disease (MAFLD) is the term suggested in 2020 to refer to fatty liver disease related to systemic metabolic dysregulation. The name change to MAFLD comes with a simple set of criteria to enable easy diagnosis at the bedside for the general medical community, including for primary care physicians. Since the introduction of the term, there have been key areas in which the superiority of MAFLD over the traditional NAFLD terminology has been demonstrated including for the risk of liver and extrahepatic mortality, disease associations, and for identifying high risk individuals. Additionally, MAFLD has been adopted by a number of leading pannational and national societies due to its concise diagnostic criterion, removal of the requirement to exclude concomitant liver diseases, and reduction in stigma associated with this condition. This article explores the differences between MAFLD and NAFLD diagnosis, areas of benefit, some potential limitations, and how the MAFLD terminology has opened up new fields of research.

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Comparative Burden of Metabolic Dysfunction in Lean NAFLD vs Non-lean NAFLD - A Systematic Review and Meta-analysis

Cited by 57 publications

References 110 publications

Role of aerobic exercise in ameliorating NASH: Insights into the hepatic thyroid hormone signaling and circulating thyroid hormones

Role of aerobic exercise in ameliorating NASH: Insights into the hepatic thyroid hormone signaling and circulating thyroid hormones

DEXA Scan Body Fat Mass Distribution in Obese and Non-Obese Individuals and Risk of NAFLD—Analysis of 10,865 Individuals

MAFLD: How is it different from NAFLD?

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