Liver-related mortality and morbidity of lean NAFLD is higher compared to overweight and obese NAFLD patients

Feldman, Alexandra; Denkmayr, L.; Straßer, Michael; Ruhaltinger, S.; Strebinger, Georg; Huber-Schönauer, Ursula; Niederseer, David; Stechemesser, Lars; Zandanell, Stephan; Paulweber, Bernhard; Datz, Christian; Aigner, Elmar

doi:10.1016/s0168-8278(17)30570-6

Cited by 5 publications

(3 citation statements)

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“…Although patients with lean NAFLD are not obese, they may be metabolically abnormal compared to people who are not obese and do not have NAFLD. [44][45][46][47][48][49][50][51][52][53] It is important to note that lean NAFLD encompasses a heterogeneous spectrum of diseases arising from different aetiologies including dual alcoholic and non- alcoholic fatty liver disease, congenital and acquired lipodystrophy (HIV treatment), genetic factors (polymorphisms in PNPLA3), congenital defects of metabolism (lysosomal acid lipase deficiency), endocrine disorders (polycystic ovarian syndrome, hypothyroidism, growth hormone deficiency), drug use (amiodarone, methotrexate, tamoxifen), jejunoileal bypass, starvation, or the receipt of total parental nutrition. 45,46 The prevalence of lean NAFLD in the US was reported to be 7%, whereas the prevalence of lean NAFLD in rural areas of some Asian countries ranges from 25% to 30%.…”

Section: Key Pointmentioning

confidence: 99%

Non-alcoholic fatty liver disease – A global public health perspective

Younossi

2019

Journal of Hepatology

1,645

1,169

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As the epidemics of obesity and type 2 diabetes mellitus increase worldwide, the prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing proportionately. The subtype of NAFLD which can be characterised as non-alcoholic steatohepatitis (NASH) is a potentially progressive liver disease that can lead to cirrhosis, hepatocellular carcinoma, liver transplantation, and death. NAFLD is also associated with extrahepatic manifestations such as chronic kidney disease, cardiovascular disease and sleep apnoea. NAFLD and NASH carry a large economic burden and create poor health-related quality of life. Despite this important burden, we are only beginning to understand its mechanisms of pathogenesis and the contribution of environmental and genetic factors to the risk of developing a progressive course of disease. Research is underway to identify appropriate non-invasive diagnostic methods and effective treatments. Although the risk of liver-related mortality is increased in patients with NAFLD and liver fibrosis stages F3 or F4, the leading cause of death is cardiovascular disease. Given the rapidly growing global burden of NAFLD and NASH, efforts must continue to find accurate non-invasive diagnostic and prognostic biomarkers, to develop effective treatments for individuals with advanced NASH and prevention methods for individuals at high risk of NAFLD and progressive liver disease.

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Section: Key Pointmentioning

confidence: 99%

Non-alcoholic fatty liver disease – A global public health perspective

Younossi

2019

Journal of Hepatology

1,645

1,169

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“…9 Some studies have also reported that lean NAFLD is associated with a higher risk of liver-related mortality and morbidity than overweight and obese NAFLD. 10 Presently, however, owing to the normal values of BMI, the presence of lean NAFLD is often ignored by both patients and health-care professionals. Therefore, we consider that a comprehensive evaluation of the global epidemiology of lean NAFLD and associated metabolic complications is required to inform future prevention and treatment strategies for this patient population.…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies have shown that lean NAFLD is commonly accompanied by metabolic abnormalities and even associated with metabolic complications 9 . Some studies have also reported that lean NAFLD is associated with a higher risk of liver‐related mortality and morbidity than overweight and obese NAFLD 10 . Presently, however, owing to the normal values of BMI, the presence of lean NAFLD is often ignored by both patients and health‐care professionals.…”

Section: Introductionmentioning

confidence: 99%

Global epidemiology of lean non‐alcoholic fatty liver disease: A systematic review and meta‐analysis

Zheng

Ríos

et al. 2020

J of Gastro and Hepatol

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Background and Aim: Lean non-alcoholic fatty liver disease (NAFLD) is a potentially metabolically unhealthy state that refers to NAFLD occurring in non-overweight/ nonobese subjects. Yet its global epidemiology and metabolic characteristics are not extensively elucidated. Methods: PubMed, EMBASE, Web of Science and Cochrane databases were searched for eligible studies until January 2020. Random-effects/fixed-effects models were used to estimate the global prevalence of lean NAFLD and to compare clinical characteristics among lean non-NAFLD, lean NAFLD, and overweight/obese NAFLD subjects. "Lean" NAFLD was defined by ethnic-specific body mass index measurements in the normal range. Meta-regression and subgroup analyses were performed to determine potential sources of heterogeneity. Results: A total of 33 observational studies were included with 205 307 individuals from 14 countries. The global prevalence of lean NAFLD was 4.1% (95% confidence interval [CI]: 3.4-4.8%). In lean subjects, the prevalence of NAFLD was 9.7% (95% CI: 7.7-11.8%). The prevalence of lean NAFLD with diabetes, hypertension, metabolic syndrome, dyslipidemia, or central obesity was 0.6% (95% CI: 0.4-0.9%), 1.8% (95% CI: 1.2-2.5%), 1.4% (95% CI: 1.0-1.9%), 2.8% (95% CI: 1.9-3.7%), and 2.0% (95% CI: 1.6-2.4%), respectively. The prevalence of lean NAFLD showed an upward trend between 1988 and 2017. Asian individuals had the highest prevalence of lean NAFLD (4.8%, 95% CI: 4.0-5.6%). Middle-aged people (45-59 years old) had the highest prevalence of lean NAFLD (4.4%, 95% CI: 3.2-5.5%). The prevalence of metabolic complications in lean non-NAFLD, lean NAFLD, and overweight/obese NAFLD groups increased sequentially. Conclusions: Lean NAFLD occurs with metabolic complications and is not an uncommon condition. The highest prevalence of lean NAFLD occurs in middle-aged individuals of Asian countries. the pathogenesis of NAFLD and its strong association with metabolic dysfunction, it has recently been proposed that NAFLD should be renamed as metabolic dysfunction-associated fatty liver disease, which may also in turn aid international researchers in trial recruitment. 2 It is well known that NAFLD may progress to

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Fructose-mediated effects on gene expression and epigenetic mechanisms associated with NAFLD pathogenesis

DiStefano

2019

Cell. Mol. Life Sci.

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Liver-related mortality and morbidity of lean NAFLD is higher compared to overweight and obese NAFLD patients

Cited by 5 publications

References 0 publications

Non-alcoholic fatty liver disease – A global public health perspective

Non-alcoholic fatty liver disease – A global public health perspective

Global epidemiology of lean non‐alcoholic fatty liver disease: A systematic review and meta‐analysis

Fructose-mediated effects on gene expression and epigenetic mechanisms associated with NAFLD pathogenesis

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