Lean non‐alcoholic fatty liver disease patients had comparable total caloric, carbohydrate, protein, fat, iron, sleep duration and overtime work as obese non‐alcoholic fatty liver disease patients

Li, Chunlong; Guo, Panpan; Okekunle, Akinkunmi Paul; Ji, Xiaoning; Huang, Min; Qi, Jiayue; Jiang, Yixiang; Feng, Rennan; Li, Rui

doi:10.1111/jgh.14360

Cited by 29 publications

(23 citation statements)

References 31 publications

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“…It is worth mentioning that the prevalence of lean NAFLD showed a general upward trend in recent years, which has occurred in parallel with the increasing dietary fat and fructose consumptions both in Asia and in Western countries 11 . Similar to risk factors for overweight/obese NAFLD, lifestyle changes (e.g., decreased physical activity, sedentariness, high fat, and fructose intakes) may be also acquired risk factors for lean NAFLD 12 . Therefore, as the global burden of lean NAFLD increases, special attention should be paid to lean subjects with coexisting risk factors for the development of NAFLD.…”

Section: Discussionmentioning

confidence: 99%

“…11 Similar to risk factors for overweight/obese NAFLD, lifestyle changes (e.g., decreased physical activity, sedentariness, high fat, and fructose intakes) may be also acquired risk factors for lean NAFLD. 12 Therefore, as the global burden of lean NAFLD increases, special attention should be paid to lean subjects with coexisting risk factors for the development of NAFLD.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…Despite these limitations, in a Chinese population, no substantial qualitative differences in diet were noted between those who were lean and had NAFLD versus obese individuals with NAFLD. 26 In general, even within the lean population, those with NAFLD tend to consume greater total calories. 27 Sedentary lifestyle is known to be associated with an increased prevalence of insulin resistance, however in lean individuals the role of a sedentary lifestyle has not yet been well established.…”

Section: Diet and Other Environmental Influencesmentioning

confidence: 99%

Non-alcoholic fatty liver disease in lean individuals

Chowdhury²,

2019

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Non-alcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease, encompassing a spectrum from non-alcoholic fatty liver to non-alcoholic steatohepatitis, which can progress to cirrhosis. It has recently been recognised that NAFLD also occurs in individuals who are not obese, especially in Asian populations. In these patients, NAFLD manifests at lower overall body mass index thresholds in the presence of increased visceral adipose tissue. Currently, the principles of clinical management are similar to those in obese individuals, although, in specific regions and clinical situations, unique aetiologies of NAFLD must be treated specifically.

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“…These studies indicate that NAFLD patients consume diets that are higher in sugars, carbohydrates, saturated fatty acids, and total fat, 60 while a higher consumption rate of processed food, animal protein (red meat), trans fat, saturated fats, and simple sugars aides the development of NAFLD 61 . A recent case–control study on 351 Chinese adults also confirmed these findings in lean NAFLD patients 62 . It is also proven that NAFLD patients tend to consume less insoluble dietary fibers than their healthy counterparts, while higher intake of dietary fibers from green vegetables, nuts, soy foods, and whole grain leads to lower NAFLD rates in populations 61,63 .…”

Section: Pathogenesismentioning

confidence: 73%

A review of non‐alcoholic fatty liver disease in non‐obese and lean individuals

Ahadi

Molooghi

Masoudifar

et al. 2020

J of Gastro and Hepatol

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Non‐alcoholic fatty liver disease (NAFLD) is one of the most common causes of hepatic disorders. It represents a wide range of chronic liver diseases in patients with no history of significant alcohol consumption, starting with simple steatosis and progressing towards non‐alcoholic steatohepatitis, cirrhosis, and ultimately hepatocellular carcinoma. NAFLD is usually associated with type 2 diabetes mellitus, dyslipidemia, metabolic syndrome, and obesity. This disease has mostly been studied in obese individuals; however, it has been widely reported and studied among the lean/non‐obese population in recent years. The pathogenesis of NAFLD in non‐obese patients is associated with various genetic predispositions, particularly a patatin‐like phospholipase domain‐containing protein 3 G allele polymorphism, which results in the accumulation of triglyceride in the liver and resistance to insulin. Additionally, dietary factors such as high fructose consumption seem to play a substantial role in the pathology of non‐obese NAFLD. Although there is not enough evidence on the treatment of NAFLD in non‐obese patients, the standard approach is to advise altering one's lifestyle in order to diminish visceral adiposity. Dietary modification, weight loss, and increased physical activity are highly recommended. We aimed to review and summarize the existing information on the prevalence, pathogenesis, genetic predispositions, diagnosis, and treatment of NAFLD in non‐obese patients according to the latest literature.

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Lean non‐alcoholic fatty liver disease patients had comparable total caloric, carbohydrate, protein, fat, iron, sleep duration and overtime work as obese non‐alcoholic fatty liver disease patients

Cited by 29 publications

References 31 publications

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

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

Non-alcoholic fatty liver disease in lean individuals

A review of non‐alcoholic fatty liver disease in non‐obese and lean individuals

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