Clinical profile of non‐alcoholic fatty liver disease in nonobese patients

Lum, Johnathan Huey Ming; Cheah, Mark; Leow, Wei Qiang; Wan, Wei Keat; Lim, Tony Kiat Hon; Chow, Wan Cheng; Chang, Jaerak; Goh, George Boon-Bee

doi:10.1111/jgh.15154

Cited by 9 publications

(6 citation statements)

References 29 publications

(57 reference statements)

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“…However, this can be explained as most of the reported investigations did not adjust obesity impact for its comorbidities, which can result in bias since, as stated before, those patients more frequently have other risk factors such as dyslipidemia and T2DM. Supporting our findings is an investigation published in 2020 by Lum et al [ 36 ]. From a population of 263 adults with biopsy-proven MAFLD, the development of SH and the presence of significant fibrosis was not significantly different between obese and nonobese patients.…”

Section: Discussion/conclusionsupporting

confidence: 91%

The New FibroScan-AST (FAST) Score: Enhancing Diabetes Mellitus Impact on Metabolic-Associated Fatty Liver Disease

Silva

Freitas²,

Xavier³

et al. 2022

GE Port J Gastroenterol

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Background: Metabolic-associated fatty liver disease (MAFLD) is an increasingly prevalent cause of chronic liver disease. In 2020, the FibroScan-AST (FAST) score was internationally validated as a new tool able to identify patients with steatohepatitis who benefit the most from further therapies, based on liver transient elastography (LTE) findings and serum levels of aspartate aminotransferase (AST). We aimed to identify, in MAFLD patients, which metabolic features may predict a higher FAST score. Methods: Retrospective study of consecutive patients with MAFLD submitted to LTE for two consecutive years. Patients without an AST sample collected within 6 months of the LTE were excluded. FAST score was calculated, stratifying the patient’s risk as low (<0.35), medium (0.35–0.67), or high (>0.67). Results: The sample included 117 patients, 53.0% of the female gender, with a mean age of 53 years. On multivariate analysis, patients with type 2 diabetes (T2DM) (p < 0.001), dyslipidemia (p = 0.046), and smoking habits (p = 0.037) presented with significantly higher FAST score values. Furthermore, diabetic patients did not only present significantly higher FAST scores but were also more frequently assigned to the high-risk group according to FAST score criteria (OR = 9.2; 95% CI = 1.8–45.5; p = 0.007). Conclusions: Calculating the FAST score, patients with T2DM presented a significantly higher risk of having significant fibrosis and steatohepatitis. Physicians may rely on this validated instrument to more easily identify which patients with T2DM and MAFLD benefit the most from a specialized follow-up.

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Section: Discussion/conclusionsupporting

confidence: 91%

The New FibroScan-AST (FAST) Score: Enhancing Diabetes Mellitus Impact on Metabolic-Associated Fatty Liver Disease

Silva

Freitas²,

Xavier³

et al. 2022

GE Port J Gastroenterol

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“…Detailed characteristics of the studies included in this meta-analysis are provided in Table 1 . 13 - 48 A total of 14,992 patients were analyzed, with a mean age of 48.57±6.13. Studies were conducted in various countries in the world (Asia 16, Europe 8, America 9, two or more continents 2, and Australia 1).…”

Section: Resultsmentioning

confidence: 99%

Accuracy of Noninvasive Scoring Systems in Assessing Liver Fibrosis in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

et al. 2022

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Background/Aims: Several noninvasive scoring systems have been developed to determine the risk of advanced fibrosis in nonalcoholic fatty liver disease (NAFLD). We examined the diagnostic accuracy of the fibrosis-4 (FIB-4) score and NAFLD fibrosis score (NFS) in patients with biopsy-proven NAFLD.Methods: For this meta-analysis, various databases including PubMed (MEDLINE), EMBASE, OVID Medline and the Cochrane Library were systematically searched. After the acquired abstracts were reviewed by two investigators, manuscripts were chosen for a full-text examination.Results: Thirty-six studies evaluating biopsy-proven NAFLD were selected for meta-analysis. A total of 14,992 patients were analyzed. The lower cutoff sensitivity of the FIB-4 score predicting histological fibrosis stage 3 or more (≥F3) was 69%, with specificity of 64%, positive likelihood ratio (LR+) of 1.96, and negative likelihood ratio (LR-) of 0.47. The low baseline sensitivity of the NFS score predicting ≥F3 was 70%, with a specificity of 61%, LR+ of 1.83, and LR-of 0.48. The area under the receiver operating characteristic curve (AUC) values of the FIB-4 score predicting ≥F3 and ≥F2 were 76% and 68%, respectively. The AUC values of the NFS score predicting ≥F3 and ≥F2 were 74% and 60%, respectively. Conclusions:The FIB-4 or NFS test can be used to predict the degree of liver fibrosis in NAFLD, and the diagnostic accuracy resulted as relatively high in fibrosis stages of F3 or higher.

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“…NAFLD is frequently observed in obese individuals with MS. Nevertheless, NAFLD can also manifest in nonobese individuals, especially in the Asian population 6 , 29 , 30 . However, predicting its occurrence in such cases proves challenging, and it often goes unnoticed in routine clinical practice.…”

Section: Discussionmentioning

confidence: 99%

The association between platelet-related parameters and nonalcoholic fatty liver disease in a metabolically healthy nonobese population

Choe,

Kang

2024

Sci Rep

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Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease characterized by subclinical inflammation and is related to obesity and metabolic syndrome (MS), but it is also frequently observed in nonobese populations. We aimed to evaluate the relationship between the white blood cell count-to-mean platelet volume ratio (WBC/MPV), platelet-to-lymphocyte count ratio (PLR) and lymphocyte-monocyte ratio (LMR) in association with NAFLD, considering the presence of obesity and MS. Additionally, we aimed to investigate whether these parameters exhibited similar correlations in metabolic dysfunction-associated steatotic liver disease (MASLD) as observed in NAFLD. This cross-sectional study included subjects who underwent a comprehensive health evaluation, including blood tests and abdominal ultrasonography. Subgroup analyses were conducted based on obesity and MS. Out of a total 5929 subjects (3271 males, mean age 49.7 ± 10.6 years), 2253 (38.0%) had NAFLD. WBC/MPV was significantly higher, and PLR was significantly lower in subjects with NAFLD. In the analysis restricted to the nonobese (BMI < 25 kg/m2) population without MS, both WBC/MPV and PLR were independently associated with NAFLD: WBC/MPV (adjusted OR 3.366; 95% CI 2.238–5.066) and PLR (adjusted OR 0.997; 95% CI 0.996–0.999). When assessing the risk of NAFLD based on the WBC/MPV and PLR quartiles, the adjusted OR and 95% CI for the lowest quartile compared to the highest were 2.055 (95% CI 1.626–2.602) for WBC/MPV and 0.660 (95% CI 0.523–0.832) for PLR in the nonobese, metabolically healthy group. The levels of WBC/MPV and PLR were independently associated with NAFLD. Furthermore, in MASLD, an association with WBC/MPV, PLR and LMR was identified, similar to the results observed in NAFLD, even after adjusting for confounding variables. In conclusion, the present study demonstrated a significant association between NAFLD and platelet-related parameters, especially in nonobese, metabolically healthy subjects.

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Clinical profile of non‐alcoholic fatty liver disease in nonobese patients

Cited by 9 publications

References 29 publications

The New FibroScan-AST (FAST) Score: Enhancing Diabetes Mellitus Impact on Metabolic-Associated Fatty Liver Disease

The New FibroScan-AST (FAST) Score: Enhancing Diabetes Mellitus Impact on Metabolic-Associated Fatty Liver Disease

Accuracy of Noninvasive Scoring Systems in Assessing Liver Fibrosis in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

The association between platelet-related parameters and nonalcoholic fatty liver disease in a metabolically healthy nonobese population

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