Presence of sarcopenia identifies a special group of lean NAFLD in middle-aged and older people

Zhu, Xiaopeng; Huang, Qingzhong; Ma, Shuai; Chen, Lingyan; Wu, Qi; Wu, Li; Ma, Hui; Li, Xiaoming; Li, Qian; Aleteng, Qiqige; Yu, Huimei; He, Wenzhuan; Gao, Xin; Lin, Hung-Ching; Tang, Huiru; Gao, Xiuren; Xia, Mingfeng

doi:10.1007/s12072-022-10439-z

Cited by 11 publications

(10 citation statements)

References 34 publications

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“…Zhu et al. examined 1305 patients with NAFLD and demonstrated that, in the middle‐aged and older population, 68.1% of patients with sarcopenia and NAFLD were non‐obese 39 . Seo et al.…”

Section: Discussionmentioning

confidence: 99%

Impact of non‐obese metabolic dysfunction‐associated fatty liver disease on risk factors for the recurrence of esophageal squamous cell carcinoma treated with endoscopic submucosal dissection: A multicenter study

Fukunaga,

Mukasa,

Nakane

et al. 2023

Hepatology Research

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AimMetabolic dysfunction is a risk factor for esophageal squamous cell carcinoma (ESCC). We investigated the impact of the recently proposed metabolic dysfunction‐associated fatty liver disease (MAFLD) and its subtypes on ESCC recurrence after endoscopic treatment.MethodsThis multicenter observational cohort study enrolled consecutive patients newly diagnosed with ESCC after endoscopic treatment. Patients were classified into MAFLD or non‐MAFLD groups. The MAFLD group was further classified into non‐obese and obese MAFLD groups with a body mass index cutoff value of 25 kg/m2. The impact of MAFLD on the recurrence of ESCC was evaluated using a decision tree algorithm and random forest analysis.ResultsA total of 147 patients (average age, 69 years; male: female, 127:20; observational period, 2.4 years) were enrolled. The 1‐, 3‐, and 5‐year recurrence rates were 2.0%, 21.1%, and 33.7%, respectively. Independent risk factors for the recurrence of ESCC were MAFLD (HR, 2.2812; 95% CI, 1.0497–4.9571; p=0.0373), drinking status, and smoking status. MAFLD was identified as the second most important classifier for recurrence followed by drinking status. The cumulative incidence of ESCC recurrence was higher in the MAFLD group than in the non‐MAFLD group. In a sub‐analysis, the cumulative incidence of recurrence was significantly higher in the non‐obese than in the obese MAFLD group among abstainers/non‐drinkers. Directed acyclic graphs revealed that MAFLD directly contributes to ESCC recurrence.ConclusionsMAFLD was independently and directly associated with ESCC recurrence after endoscopic treatment; a high recurrence rate was observed in patients with non‐obese MAFLD. MAFLD may identify patients at high risk for ESCC recurrence.This article is protected by copyright. All rights reserved.

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“…Zhu et al. examined 1305 patients with NAFLD and demonstrated that, in the middle‐aged and older population, 68.1% of patients with sarcopenia and NAFLD were non‐obese 39 . Seo et al.…”

Section: Discussionmentioning

confidence: 99%

Impact of non‐obese metabolic dysfunction‐associated fatty liver disease on risk factors for the recurrence of esophageal squamous cell carcinoma treated with endoscopic submucosal dissection: A multicenter study

Fukunaga,

Mukasa,

Nakane

et al. 2023

Hepatology Research

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“…Lean individuals with MASLD have a “more favorable” metabolic risk profile than their non-lean counterparts. Despite having a BMI below the overweight cut-off, lean individuals with MASLD had a higher BMI and WC than lean individuals without MASLD [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Further, visceral adiposity is higher in lean individuals with MASLD than in lean individuals without MASLD, though visceral adiposity is still lower in lean MASLD than in high-BMI MASLD [ 12 , 29 , 40 , 43 ].…”

Section: Pathogenesis Of Masld In Lean Individualmentioning

confidence: 99%

“…In contrast, both TG and HDL are the highest and lowest in high-BMI patients with MASLD, respectively. The difference in TC and LDL levels between all groups was still inconclusive [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. In contrast, TG and HDL levels increased stepwise from lean individuals without MASLD to those with MASLD and overweight/obese individuals without MASLD to those with MASLD [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ].…”

Section: Pathogenesis Of Masld In Lean Individualmentioning

confidence: 99%

“…The difference in TC and LDL levels between all groups was still inconclusive [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. In contrast, TG and HDL levels increased stepwise from lean individuals without MASLD to those with MASLD and overweight/obese individuals without MASLD to those with MASLD [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Collectively, visceral obesity, as evaluated by increased WC, could contribute to the pathogenesis of MASLD in lean individuals.…”

Section: Pathogenesis Of Masld In Lean Individualmentioning

confidence: 99%

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What Is New in Metabolic Dysfunction-Associated Steatotic Liver Disease in Lean Individuals: From Bench to Bedside

Danpanichkul,

Suparan,

Kim

et al. 2024

JCM

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Metabolic dysfunction-associated steatotic liver disease (MASLD) affects more than 30% of the world’s adult population. While it is associated with obesity and metabolic syndrome, emerging evidence has shown that a substantial number of MASLD patients have a normal body mass index (“lean individuals with MASLD”). In this article, we provide an overview of the definition, epidemiology, pathogenesis, and clinical outcomes associated with lean individuals with MASLD and updates on current management.

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“…The causes of secondary sarcopenia can include physical inactivity and malnutrition, among others [52,53]. The presence of sarcopenia could clinically identify a subgroup of lean NAFLD patients with an increased risk of cardiovascular disease and liver fibrosis, because sarcopenia appears to be indicative of a dysregulated metabolic condition and histological alterations, and may contribute to the development and progression of various liver diseases [54,55].…”

Section: The Role Of the Muscle Microenvironment In Non-alcoholic Fat...mentioning

confidence: 99%

Mechanisms of non-alcoholic fatty liver disease development in normal-weight individuals

Muriel

Cardoso-Lezama

Vargas-Pozada

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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While non-alcoholic fatty liver disease (NAFLD) without inflammation or fibrosis is considered a relatively ‘benign’ disease, non-alcoholic steatohepatitis (NASH), by contrast, is characterized by marked inflammation in addition to lipid accumulation, and may include fibrosis, progression to cirrhosis and hepatocellular carcinoma. Obesity and type II diabetes are frequently associated with NAFLD/NASH; however, a significant number of lean individuals may develop these diseases. Little attention has been paid to the causes and mechanisms contributing to NAFLD development in normal-weight individuals. One of the main causes of NAFLD in normal-weight individuals is the accumulation of visceral and muscular fat and its interaction with the liver. Myosteatosis (triglyceride accumulation in the muscle) induces a loss of muscle by reducing blood flow and insulin diffusion, contributing to NAFLD. Normal-weight patients with NAFLD exhibit higher serum markers of liver damage and C-reactive protein levels, as well as more pronounced insulin resistance, compared to healthy controls. Notably, increased levels of C-reactive protein and insulin resistance are strongly correlated with the risk of developing NAFLD/NASH. Gut dysbiosis has also been associated with NAFLD/NASH progression in normal-weight individuals. More investigation is required to elucidate the mechanisms leading to NAFLD in normal-weight individuals.

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Presence of sarcopenia identifies a special group of lean NAFLD in middle-aged and older people

Cited by 11 publications

References 34 publications

Impact of non‐obese metabolic dysfunction‐associated fatty liver disease on risk factors for the recurrence of esophageal squamous cell carcinoma treated with endoscopic submucosal dissection: A multicenter study

Impact of non‐obese metabolic dysfunction‐associated fatty liver disease on risk factors for the recurrence of esophageal squamous cell carcinoma treated with endoscopic submucosal dissection: A multicenter study

What Is New in Metabolic Dysfunction-Associated Steatotic Liver Disease in Lean Individuals: From Bench to Bedside

Mechanisms of non-alcoholic fatty liver disease development in normal-weight individuals

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