Editorial: lean and obese <scp>NAFLD</scp>—similar siblings

Mellor, Thomas; Torres, Dawn M.

doi:10.1111/apt.14196

Cited by 5 publications

(4 citation statements)

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“…Unfortunately, being slim (nonobese) does not necessarily mean one is healthy; in fact, being lean does not always lead to a lower risk of diabetes, CVD, or even NAFLD, as recently suggested . In a large recent meta‐analysis, we demonstrated that lean and obese patients with NAFLD share a common altered metabolic and cardiovascular profile .…”

Section: Introductionmentioning

confidence: 62%

Systematic review with meta‐analysis: the significance of histological disease severity in lean patients with nonalcoholic fatty liver disease

Sookoian

Pirola

2017

Aliment Pharmacol Ther

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Section: Introductionmentioning

confidence: 62%

Systematic review with meta‐analysis: the significance of histological disease severity in lean patients with nonalcoholic fatty liver disease

Sookoian

Pirola

2017

Aliment Pharmacol Ther

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“…However, NAFLD has recently become more common in non-obese people, especially in China [6]. Studies have shown that non-obese people with NAFLD have altered metabolic states, similar to that of obese people with NAFLD [16,17], as well as being more likely to develop metabolic syndrome than obese NAFLD [18]. Additionally, a retrospective cohort study showed that approximately 1 in 5 non-obese NAFLD patients also developed carotid atherosclerosis [19].…”

Section: Discussionmentioning

confidence: 99%

Higher serum uric acid to HDL-cholesterol ratio is associated with onset of non-alcoholic fatty liver disease in a non-obese Chinese population with normal blood lipid levels

et al. 2022

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Background Recent studies have demonstrated the presence of associations between metabolic syndrome and the onset of nonalcoholic fatty liver disease (NAFLD). Metabolic syndrome, in turn, has been found to be linked to high serum uric acid to HDL-cholesterol ratios (UHR). However, the relationship between UHR values and the occurrence of NAFLD in non-obese individuals remains unknown. The present study aimed to examine the possible correlation between UHR values and NAFLD onset among a non-obese Chinese population without dyslipidemia, as well as comparing the predictive value of UHR versus other NAFLD onset predictors. Methods A total of 9837 non-obese patients, with normal blood lipid levels, were included in a 5-year retrospective cohort study, and the onset of NAFLD in these patients was diagnosed by liver ultrasound. Results Out of the 9837 patients, 855 were diagnosed with NAFLD during the 5-year follow-up period, for an overall total prevalence of 8.7% at the end of the study period. Across quintiles 1, 2, 3, 4 and 5 of UHR (respectively, ratios of ≤ 120.88, 120.89–154.01, 154.02–189.91, 189.92–240.46, and ≥ 240.47), the prevalence of NAFLD among the patients increased from 2.4%, 5%, 7.9%, 10.3%, and 17.8%, respectively. After adjustments for age, gender, liver and kidney functional markers, as well as metabolic indicators, multivariate Cox proportional hazard regression analysis demonstrated that the hazard ratio (HR) was the highest in quintile 5, at 1.76 (1.12–2.75), and the lowest in quintile 1. The area under the curve (AUC) for UHR (0.690) was higher than that for serum uric acid (UA, 0.666) and HDL-C (0.636), suggesting the predictive ability of UHR for NAFLD onset was better than either alone. This finding was further supported by the presence of an independent association between UHR and NAFLD, even within the normal range of UA and HDL-C; the HR (95% confidence interval, CI) for NAFLD was 1.002 (1.000–1.004). Compared with other significant predictors, AUC for UHR (0.67) was similar to that of low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C, 0.68), non-high-density lipoprotein cholesterol (NHDL-C)/HDL-C (0.68) and alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratios (0.7), and was higher than that of LDL-C (0.63), remnant cholesterol (RC,0.59), and albumin (ALB)/alkaline phosphatase (ALP) ratio (0.61). The sensitivity of UHR (71%) was the highest among all indicators. In the subgroup with ALT < 40U/L, the AUC for UHR was 0.70, which was the highest among all predictors; among ALT > 40U/L, UHR was able to predict the occurrence of NAFLD (AUC = 0.61, p = 0.007), which was not the case for RC (P = 0.441), ALB/ALP (P = 0.419), and ALT/AST (P = 0.159). Conclusions UHR serve as an inexpensive and reliable predictor of NAFLD onset in non-obese Chinese people with normal blood lipid levels, allowing for identification of individuals at high risk for NAFLD.

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“…NAFLD was connected with metabolic diseases (21) and even considered as a metabolic manifestation in the liver (22). It is now widely accepted that, like obese NAFLD, subjects with lean NAFLD also had altered glucolipid metabolism and metabolic profile (23,24). A retrospective cohort study showed that approximately one-fifth of the lean NAFLD patients had carotid atherosclerosis (25).…”

Section: Introductionmentioning

confidence: 99%

The presence of NAFLD in nonobese subjects increased the risk of metabolic abnormalities than obese subjects without NAFLD: a population-based cross-sectional study

Hu¹,

Zeng²,

Zou³

et al. 2021

Hepatobiliary Surg Nutr

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Background: With lifestyle modification and over-nutrition, the prevalence of nonalcoholic fatty liver disease (NAFLD) has been increasing annually. Here we aimed to assess the updated prevalence of NAFLD, and to evaluate the association of NAFLD with metabolic abnormalities according to gender, body mass index and age.Methods: A population-based cross-sectional study was conducted in Shanghai from December 2016 to July 2017. With a three-stage stratified sampling strategy, 3,717 eligible participants were enrolled for the analysis.Results: In total, 1,217 subjects (32.7%) had NAFLD. Among them, 400 (16.3%) of the nonobese and 817 (65.0%) of the obese subjects had NAFLD. The prevalence of NAFLD was increased according to the quartiles of age and waist circumference (WC) in the nonobese subjects. Females with nonobese NAFLD had 1.6-, 2.6-, 2.0-, 2.3-and 3.3-fold higher risks for metabolic syndrome, diabetes mellitus, hyperglycemia, hypertriglycerdemia (high TG) and low high-density lipoprotein cholesterol than obese subjects without NAFLD, respectively. Males had comparable metabolic profiles in both groups, except for a 2.0-fold higher risk of high TG in nonobese NAFLD subjects compared with obese subjects without NAFLD. More impressively, the homeostasis metabolic assessment insulin resistance index was comparable between the two groups.Conclusions: The increase of age and WC had significant impact on the risk of NAFLD in nonobese subjects. The presence of NAFLD in nonobese subjects increased the risk of metabolic diseases than obese subjects without NAFLD, especially in female.

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Editorial: lean and obese NAFLD—similar siblings

Abstract: Linked ContentThis article is linked to Mellor and Torres paper. To view this article visit https://doi.org/10.1111/apt.14112.

Cited by 5 publications

References 4 publications

Systematic review with meta‐analysis: the significance of histological disease severity in lean patients with nonalcoholic fatty liver disease

Systematic review with meta‐analysis: the significance of histological disease severity in lean patients with nonalcoholic fatty liver disease

Higher serum uric acid to HDL-cholesterol ratio is associated with onset of non-alcoholic fatty liver disease in a non-obese Chinese population with normal blood lipid levels

The presence of NAFLD in nonobese subjects increased the risk of metabolic abnormalities than obese subjects without NAFLD: a population-based cross-sectional study

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