Predictors of nonalcoholic steatohepatitis and significant fibrosis in non‐obese nonalcoholic fatty liver disease

Kim, Dong‐Hee; Kim, Won; Joo, Seung Ki; Kim, Jung Ho; Harrison, Stephen A.; Younossi, Zobair M.; Ahmed, Aijaz

doi:10.1111/liv.13983

Cited by 50 publications

(51 citation statements)

References 39 publications

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“…Although obesity has been considered as the main pathophysiological factor leading to metabolic syndrome, including NAFLD, non-obese individuals may also develop NAFLD. 32 Skeletal muscle is the primary target organ of insulin-mediated glucose disposal, and therefore, sarcopenia itself, independent of obesity, may aggravate IR. 33 In the current study, the significant association between LMS and Fibrosis FIB4 lost its statistical significance after adjustment for IR, implicating that IR plays an important role in the relationship between LMS and advanced fibrosis in NAFLD.…”

Section: Discussionmentioning

confidence: 99%

Association between muscle strength and advanced fibrosis in non‐alcoholic fatty liver disease: a Korean nationwide survey

Kang

Moon

Kim

et al. 2020

J cachexia sarcopenia muscle

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Background We investigated the association between muscle strength and the prevalence of advanced fibrosis among individuals with non-alcoholic fatty liver disease (NAFLD) using a nationwide cross-sectional survey. Methods Individuals, 20 to 79 years of age, from the Korean National Health and Nutrition Examination Surveys (KNHANES) from 2014 to 2016 were selected (N = 14 861), with sample weights applied. Muscle strength was quantified as the handgrip strength divided by the body mass index (BMI); low muscle strength (LMS) was defined as the lowest quartile (Q 1) of the handgrip strength/BMI for our sample population. NAFLD was defined as hepatic steatosis index >36. Advanced fibrosis was defined as a fibrosis-4 index score ≥1.30 (Fibrosis FIB4). Results The mean age of the study population was 45.6 ± 0.2 years, and 42.4% were male. As muscle strength increased, the mean BMI and age decreased accordingly, and the proportions of diabetes, dyslipidaemia, hypertension, and obesity decreased significantly (P < 0.001 for all). In a crude analysis, the LMS was associated with an increased prevalence of NAFLD (odds ratio [OR] 3.62, 95% confidence interval [CI] 3.25-4.03, P < 0.001), which remained significant even after adjustment for age, sex, obesity, insulin resistance, diabetes, hypertension, dyslipidaemia, and high-sensitivity C-reactive protein (OR 1.66, 95% CI 1.28-2.16, P < 0.001). In this logistic regression model, the prevalence of NAFLD decreased by 24% with each quartile increment in muscle strength (OR 0.76, 95% CI 0.68-0.85, P < 0.001). Among individuals with NAFLD (n = 2092), LMS was significantly associated with the presence of advanced fibrosis (Fibrosis FIB4) independently of age, sex, obesity, diabetes, hypertension, dyslipidaemia, and high-sensitivity C-reactive protein (OR 1.66, 95% CI 1.01-2.49, P = 0.015), which lost its statistical significance after additional adjustment for insulin resistance. Conclusions Low muscle strength is independently associated with NAFLD. The significant association between LMS and advanced fibrosis in NAFLD may be mediated through insulin resistance.

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Section: Discussionmentioning

confidence: 99%

Association between muscle strength and advanced fibrosis in non‐alcoholic fatty liver disease: a Korean nationwide survey

Kang

Moon

Kim

et al. 2020

J cachexia sarcopenia muscle

Self Cite

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“…Many research have shown that HFD-induced lipid metabolism disorder could lead to metabolic disorder, which is an important factor of hyperlipidemia and obesity (Kim et al, 2018;Lu et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Effect of banana pulp dietary fibers on metabolic syndrome and gut microbiota diversity in high‐fat diet mice

Wei

Yan

et al. 2020

J Food Biochem

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Banana (Musa nana Lour.) have the effect of anti‐obesity and lipid modulating properties. However, the influences of banana pulp dietary fibers (BP‐DF) on metabolic syndrome (MetS) and gut microbiota (GM) are unknown. In this research, we explore a novel strategy for dietary BP‐DF on attenuation of lipid metabolic disease, GM disorder, and associated mechanisms in high‐fat diet (HFD) mice. BP‐DF can strongly suppress on HFD caused body weight and epididymal fat mass gain, and significantly improved serum lipid profiles, liver lipid profiles, and intestinal function. BP‐DF also significantly improved fecal short‐chain fatty acids formation and fecal ammonia content. BP‐DF impacted the intestinal microorganism at all kinds of taxonomic levels by increasing the proportions of beneficial Lactobacillus, Bacteroidales _S24_7_group, and Alloprevotella and decreasing the disease or obesity associated Sutterella, Streptococcaceae, and Erysipelotrichaceae. The experiments show that BP‐DF may use as a functional ingredient for preventing obesity, MetS, and intestinal microorganism imbalance. Practical applications Obesity result in many metabolic complications, and it poses a great threat to people's health. Nowadays, the introduction of DF may lead to the development of a new strategy in the treatment of obesity and its metabolic syndrome. Our experiments findings show that BP‐DF may use as a functional ingredient for preventing obesity, MetS, and intestinal microorganism imbalance. Therefore, BP‐DF can be applied to the development and production of functional food, and can also be used as an important food functional ingredient, which can be added to various food, such as bread, noodles, baked goods, cakes, etc., to improve its nutritional value.

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“…Such speculation is supported by a recent study with 664 biopsy-proven NAFLD Asian patients showing that the severity of hepatic histology in nonobese NAFLD is comparable to that in obese NAFLD. [33] Consistently, a study of 466 Caucasian subjects with biopsy-proven NAFLD demonstrated that lean NAFLD is characterized by a severe histological picture similar to that of obese NAFLD and the former cases are more progressed compared to overweight cases. [34] In our study, we attempted to evaluate the association between lean NAFLD severity and future diabetes risk.…”

Section: Discussionmentioning

confidence: 85%

Lean Nonalcoholic Fatty Liver Disease and Risk of Incident Diabetes in a Euglycemic Population Receiving Health Checkups: A Cohort Study

Wei

Cheng

Luo

et al. 2020

Preprint

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Background: Although recent evidence suggests that nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance and an increased risk of diabetes, the association between lean NAFLD and incident diabetes is unclear. This study aimed to investigate whether lean NAFLD and overweight/obese NAFLD have similar or dissimilar effects on the risk of new-onset diabetes.Methods: A longitudinal study was performed in 14,482 euglycemic adults who participated in a health check-up program. Fatty liver was diagnosed by abdominal ultrasonography. The outcome of interest was incident diabetes.Cox proportional hazards regression models were applied to calculate HRs with 95% CIs for future diabetes risk.Results: During the median 6.0 years of follow-up, 356 cases of diabetes occurred. Despite a low probability of hepatic fibrosis indicated by the BAAT score, lean NAFLD was positively associated with an increased risk of diabetes. Moreover, after adjusting for sociodemographic and potential confounders, the fullyadjusted HRs (95% CIs) for incident diabetes between lean NAFLD and overweight/obese NAFLD to the reference (lean without NAFLD) were 2.58 (95% CI 1.68 to 3.97) and 2.52 (95% CI 1.79 to 3.55), respectively. In post hoc analysis, the HR (95% CI) for diabetes comparing lean NAFLD to obese/overweight NAFLD was 1.02 (95% CI 0.68 to 1.54, p = 0.909). The results were robust to challenges in multiple subgroup analyses and appeared to be more pronounced for female participants (p for interaction = 0.005).Conclusions: In this cohort study, lean patients with NAFLD had a risk of incident type 2 diabetes similar to that of overweight/obese ones with NAFLD. These findings suggest that lean NAFLD is not a benign condition. Further investigations are needed to gain a better understanding of the pathogenesis and natural history of NAFLD in lean subjects.

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Predictors of nonalcoholic steatohepatitis and significant fibrosis in non‐obese nonalcoholic fatty liver disease

Cited by 50 publications

References 39 publications

Association between muscle strength and advanced fibrosis in non‐alcoholic fatty liver disease: a Korean nationwide survey

Association between muscle strength and advanced fibrosis in non‐alcoholic fatty liver disease: a Korean nationwide survey

Effect of banana pulp dietary fibers on metabolic syndrome and gut microbiota diversity in high‐fat diet mice

Lean Nonalcoholic Fatty Liver Disease and Risk of Incident Diabetes in a Euglycemic Population Receiving Health Checkups: A Cohort Study

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