TY - JOUR
T1 - Nonalcoholic Fatty Liver Disease in Lean Subjects: Associations With Metabolic Dysregulation and Cardiovascular Risk-A Single-Center Cross-Sectional Study.
AU - Semmler, Georg
AU - Wernly, Sarah
AU - Bachmayer, Sebastian
AU - Wernly, Bernhard
AU - Schwenoha, Lena
AU - Huber-Schönauer, Ursula
AU - Stickel, Felix
AU - Niederseer, David
AU - Aigner, Elmar
AU - Datz, Christian
N1 - Wernly: Second Department of Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria; Aigner: First Department of Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria; Lehr-KH: Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, Oberndorf, Salzburg, Austria;
PY - 2021/4/5
Y1 - 2021/4/5
N2 - IntroductionAlthough a milder metabolic phenotype of nonalcoholic fatty liver disease (NAFLD) in lean patients (body mass index [BMI] MethodsIn total, 3,043 subjects (cohort I) and 1,048 subjects (cohort II) undergoing screening colonoscopy between 2010 and 2020 without chronic liver disease other than NAFLD were assigned to one of the following groups: lean patients without NAFLD, lean NAFLD, overweight NAFLD (BMI 25-30 kg/m2), and obese NAFLD (BMI >30 kg/m2). Diagnosis of NAFLD was established using ultrasound (cohort I) and controlled attenuation parameter (cohort II).ResultsThe prevalence of lean patients with NAFLD was 6.7%/16.1% in the overall cohort I/II and 19.7%/40.0% in lean subjects of cohort I/II. Compared with lean subjects without NAFLD, lean patients with NAFLD had a higher prevalence of dyslipidemia, dysglycemia, and the metabolic syndrome, together with a higher median Framingham risk score in both cohorts (all P < 0.001). On multivariable analyses, NAFLD in lean subjects was associated with higher odds of metabolic syndrome (adjusted odds ratio cohort I: 4.27 [95% confidence interval (CI): 2.80-6.51], P < 0.001; cohort II: 2.97 [95% CI: 1.40-6.33], P < 0.001), and higher Framingham risk score (regression coefficient B cohort I: 1.93 [95% CI: 0.95-2.92], P < 0.003; cohort II: 1.09 [95% CI: 0.81-2.10], P = 0.034), among others. Only 69.8% of lean patients with NALFD in cohort I and 52.1% in cohort II fulfilled the novel criteria for metabolic associated fatty liver disease.DiscussionNAFLD in lean patients is associated with the metabolic syndrome and increased cardiovascular risk. Novel metabolic associated fatty liver disease criteria leave a considerable proportion of patients unclassified.
AB - IntroductionAlthough a milder metabolic phenotype of nonalcoholic fatty liver disease (NAFLD) in lean patients (body mass index [BMI] MethodsIn total, 3,043 subjects (cohort I) and 1,048 subjects (cohort II) undergoing screening colonoscopy between 2010 and 2020 without chronic liver disease other than NAFLD were assigned to one of the following groups: lean patients without NAFLD, lean NAFLD, overweight NAFLD (BMI 25-30 kg/m2), and obese NAFLD (BMI >30 kg/m2). Diagnosis of NAFLD was established using ultrasound (cohort I) and controlled attenuation parameter (cohort II).ResultsThe prevalence of lean patients with NAFLD was 6.7%/16.1% in the overall cohort I/II and 19.7%/40.0% in lean subjects of cohort I/II. Compared with lean subjects without NAFLD, lean patients with NAFLD had a higher prevalence of dyslipidemia, dysglycemia, and the metabolic syndrome, together with a higher median Framingham risk score in both cohorts (all P < 0.001). On multivariable analyses, NAFLD in lean subjects was associated with higher odds of metabolic syndrome (adjusted odds ratio cohort I: 4.27 [95% confidence interval (CI): 2.80-6.51], P < 0.001; cohort II: 2.97 [95% CI: 1.40-6.33], P < 0.001), and higher Framingham risk score (regression coefficient B cohort I: 1.93 [95% CI: 0.95-2.92], P < 0.003; cohort II: 1.09 [95% CI: 0.81-2.10], P = 0.034), among others. Only 69.8% of lean patients with NALFD in cohort I and 52.1% in cohort II fulfilled the novel criteria for metabolic associated fatty liver disease.DiscussionNAFLD in lean patients is associated with the metabolic syndrome and increased cardiovascular risk. Novel metabolic associated fatty liver disease criteria leave a considerable proportion of patients unclassified.
KW - INSULIN-RESISTANCE
KW - NORMAL-WEIGHT
KW - NONOBESE
KW - PREVALENCE
KW - INDIVIDUALS
KW - POPULATION
KW - STEATOSIS
KW - SEVERITY
KW - NAFLD
UR - https://europepmc.org/articles/PMC8345908
U2 - 10.14309/ctg.0000000000000326
DO - 10.14309/ctg.0000000000000326
M3 - Original Article
C2 - 33821832
SN - 2155-384X
VL - 12
SP - e00326
JO - CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY
JF - CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY
IS - 4
ER -