Lean nonalcoholic fatty liver disease and risk of incident type 2 diabetes mellitus: A literature review and meta-analysis

Gao, Yuting; Zhao, Tianyi; Song, Shen; Duo, Yanbei; Gao, Jun; Yuan, Ting; Zhao, Weigang

doi:10.1016/j.diabres.2023.110699

Cited by 6 publications

(3 citation statements)

References 40 publications

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“…We observed the presence of steatosis in lean individuals (BMI < 23 kg/m2) with HBV infection in this study was approximately 10%, similar with the overall prevalence of steatosis in lean individuals according to literature [ 15 ]. There were 420 lean HBV-infected subjects totally, and liver histology was compared in the NAFLD and non-NAFLD group (Subgroup 2).…”

Section: Resultssupporting

confidence: 89%

Fatty liver is associated with significant liver inflammation and increases the burden of advanced fibrosis in chronic HBV infection

Dai,

Xu,

Pan

et al. 2023

BMC Infect Dis

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Background Concurrent non-alcoholic fatty liver disease (NAFLD) is common in patients with chronic HBV infection. But the impact of fatty liver on the histologic progression of HBV infection remains controversial. Methods Consecutive HBV-infected patients who underwent liver biopsy between 2016 and 2021 were included. Alcohol consumption and other types of viral hepatitis were excluded. All biopsies were scored for grading and staging by Scheuer’s score, and the steatosis was scored as an estimate of the percentage of liver parenchyma replaced by fat. Logistic regression analyses were applied to assess the associated factors for significant liver inflammation (G ≥ 2), significant fibrosis (S ≥ 2) and advanced fibrosis (S ≥ 3). Results Among the 871 HBV-infected patients, hepatic steatosis was prevalent in 255 patients (29.28%). Significant liver inflammation was present in 461 patients (52.93%). Significant fibrosis was observed in 527 patients (60.51%), while advanced liver fibrosis was observed in 171 patients (19.63%). Patients with concomitant NAFLD were more likely to have significant liver inflammation and advanced fibrosis. Fatty liver was an independent risk factor for significant liver inflammation (OR: 2.117, 95% CI: 1.500-2.988), but it could not predict the development of fibrosis. Especially, in HBV-infected patients with persistent normal ALT (immune tolerant and inactive carrier phase), the presence of significant liver inflammation was higher in NAFLD than those without NAFLD. The prevalence of advanced liver fibrosis was higher in NAFLD than non-NAFLD only in the immune tolerant phase, while NAFLD did not increase fibrosis burden in other stages of HBV infection. We developed a predictive model for significant liver inflammation with the area under receiver operating characteristic curve (AUROC) of 0.825, and a model for significant fibrosis with the AUROC of 0.760. Conclusions NAFLD is independently associated with significant liver inflammation, and increases the burden of advanced liver fibrosis in HBV-infected patients. The influence of NAFLD on the degree of liver inflammation and fibrosis is different in distinct clinical phases of chronic HBV infection.

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Section: Resultssupporting

confidence: 89%

Fatty liver is associated with significant liver inflammation and increases the burden of advanced fibrosis in chronic HBV infection

Dai,

Xu,

Pan

et al. 2023

BMC Infect Dis

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show abstract

“…The above results were independent of age, gender, adiposity measures and other metabolic parameters. Indeed, another recent meta-analysis, involving 16 observational studies (304,975 adults with almost 1,300 cases of new-onset T2DM) followed-up for a median of 5 years, reported that the incidence of T2DM was significantly higher in patients with lean NAFLD vs. without NAFLD (HR = 2.72, 95% CI: 1.56–4.74) [ 58 ]. Furthermore, HR of incident T2DM in overweight/obese patients without NAFLD and in overweight/obese patients with NAFLD was 1.32 (95% CI: 0.99–1.77) and 2.98 (1.66–5.32) compared with lean patients without NAFLD [ 58 ].…”

Section: T2dm and Liver Dysfunctionmentioning

confidence: 99%

“…Indeed, another recent meta-analysis, involving 16 observational studies (304,975 adults with almost 1,300 cases of new-onset T2DM) followed-up for a median of 5 years, reported that the incidence of T2DM was significantly higher in patients with lean NAFLD vs. without NAFLD (HR = 2.72, 95% CI: 1.56–4.74) [ 58 ]. Furthermore, HR of incident T2DM in overweight/obese patients without NAFLD and in overweight/obese patients with NAFLD was 1.32 (95% CI: 0.99–1.77) and 2.98 (1.66–5.32) compared with lean patients without NAFLD [ 58 ]. Underlying pathophysiological mechanisms include insulin resistance, hyperglycemia, hyperinsulinemia, oxidative stress, inflammation, endothelial dysfunction, dysregulation of adipose tissue function and lipid dysmetabolism (lipotoxicity) [ 59 , 60 ].…”

Section: T2dm and Liver Dysfunctionmentioning

confidence: 99%

The Cardiac-Kidney-Liver (CKL) syndrome: the “real entity” of type 2 diabetes mellitus

Katsiki,

Kolovou,

Melidonis

et al. 2024

Arch Med Sci

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Lean MASLD: are overweight or obese people with MASLD ‘protected’ from CVD mortality?

Lima,

Amaral,

Barbosa

et al. 2024

Current Problems in Cardiology

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Lean nonalcoholic fatty liver disease and risk of incident type 2 diabetes mellitus: A literature review and meta-analysis

Cited by 6 publications

References 40 publications

Fatty liver is associated with significant liver inflammation and increases the burden of advanced fibrosis in chronic HBV infection

Fatty liver is associated with significant liver inflammation and increases the burden of advanced fibrosis in chronic HBV infection

The Cardiac-Kidney-Liver (CKL) syndrome: the “real entity” of type 2 diabetes mellitus

Lean MASLD: are overweight or obese people with MASLD ‘protected’ from CVD mortality?

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