The metabolic profiles and body composition of lean metabolic associated fatty liver disease

Cheng, Yu‐Ming; Kao, Jia‐Horng; Wang, Chia‐Chi

doi:10.1007/s12072-021-10147-0

Cited by 28 publications

(27 citation statements)

References 46 publications

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“…Genetic variations in PNPLA3, transmembrane 6 superfamily 2 (TM6SF2), membrane-bound Oacyltransferase domain-containing 7 (MBOAT7), or other genes associated with hepatic steatosis may possibly explain the relationship between lean NAFLD and the increased future risk of developing severe liver disease or RFS in HCC. In this study, there were no significant differences in any pathologic characteristics, including microvascular invasion or histological stage, between the lean-and non-lean-MAFLD groups; however, the lean-MAFLD group was older than the non-lean-MAFLD group, which was consistent with a recent study published from Taiwan in which the prevalence of lean MAFLD was higher in elder age [33], which may explain the higher risk of HCC recurrence in the lean-MAFLD group. Another possible reason may be that lean-MAFLD (BMI < 23 kg/m 2 ) could be due to cancer-related malnutrition, which could also lead to poorer RFS in the lean-MAFLD group.…”

Section: Discussionsupporting

confidence: 92%

Impact of MAFLD on HBV-Related Stage 0/A Hepatocellular Carcinoma after Curative Resection

Lin

Wang

et al. 2021

JPM

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Backgrounds and Aim: Metabolic-associated fatty liver dis-ease (MAFLD) is a novel term proposed in 2020 to avoid the exclusion of certain subpopulations, though the application of this term in the real world is very limited. Here, we aimed to evaluate the impact of MAFLD on hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative resection. Methods: Patients with chronic hepatitis B (CHB)-related HCC who received hepatectomy between January 2010 and December 2019 were consecutively selected. The association between histologically proven concurrent MAFLD and clinical outcomes were retrospectively analyzed. Results: Among the 812 eligible patients with CHB-related HCC, 369 (45.4%) were diagnosed with concurrent MAFLD. After a mean follow-up of 65 months, 303 patients (37.3%) developed HCC recurrence, 111 (13.7%) died, and 12 (1.5%) received liver transplantation. Although no differences in the incidences of HCC recurrence (HR: 0.902, 95% CI: 0.719–1.131, p = 0.370) and death or liver transplantation (HR: 0.743, 95% CI: 0.518–1.006, p = 0.107) were observed between patients with and without MAFLD in multivariate analysis, the patients with MAFLD tended to achieve better recurrent-free survival compared to patients without MAFLD. Notably, lean MAFLD (BMI < 23 kg/m2) was a relative risk factor for tumor recurrence (HR: 2.030, 95% CI: 1.117–3.690, p = 0.020) among patients with MAFLD. Conclusions: The overall prognosis in HBV-related early-stage HCC, in terms of HCC recurrence and death or liver transplantation, was not significantly different between patients with and without MAFLD. Among patients with MALFD, lean-MAFLD was a risk factor for HCC recurrence. Further studies are warranted to validate these results.

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Section: Discussionsupporting

confidence: 92%

Impact of MAFLD on HBV-Related Stage 0/A Hepatocellular Carcinoma after Curative Resection

Lin

Wang

et al. 2021

JPM

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“…36 The prevalence of lean/normal weight MAFLD has been reported to be 16% to 18% of patients with MAFLD in the Asia-Pacific region. 40,63 Kawaguchi T et al P. 6…”

Section: Validity Of the Mafld Definition For People Who Are Lean/normal Weightmentioning

confidence: 99%

MAFLD enhances clinical practice for liver disease in the Asia-Pacific region

et al. 2022

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Fatty liver is now a major cause of liver disease in the Asia-Pacific region. Liver diseases in this region have distinctive characteristics. First, fatty liver is frequently observed in lean/normal-weight individuals. However, there is no standard definition of this unique phenotype. Second, fatty liver is often observed in patients with concomitant viral hepatitis. The exclusion of viral hepatitis from non-alcoholic fatty liver disease limits its value and detracts from the investigation and holistic management of coexisting fatty liver in patients with viral hepatitis. Third, fatty liver-associated hepatocellular carcinoma (HCC) is generally categorized as non-B non-C HCC. Fourth, the population is aging rapidly, and it is imperative to develop a practicable, low-intensity exercise program for elderly patients. Fifth, most patients and nonspecialized healthcare professionals still lack an awareness of the significance of fatty liver both in terms of intrahepatic and extrahepatic disease and cancer. Recently, an international expert panel proposed a new definition of fatty liver: metabolic dysfunction-associated fatty liver disease (MAFLD). One feature of MAFLD is that metabolic dysfunction is a prerequisite for diagnosis. Pertinent to regional issues, MAFLD also provides its diagnostic criteria in lean/normal-weight individuals. Furthermore, MAFLD is independent of any concomitant liver disease, including viral hepatitis. Therefore, MAFLD may be a more suitable definition for fatty liver in the Asia-Pacific region. In this review, we introduce the regional characteristics of fatty liver and discuss the advantages of MAFLD for improving clinical practice for liver disease in the region.

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“…Furthermore, our database included information on various risk factors for reflux esophagitis, such as hiatal hernia and lifestyle habits, including eating and exercise habits, 5,6 and was therefore suitable for evaluating the impact of MAFLD on the development of reflux esophagitis. Although the number of lean/normal‐weight MAFLD was fewer and the patients were older than in other groups, previous studies had similar issues, which cannot solve at present 14,18,30 …”

Section: Discussionmentioning

confidence: 81%

“…Although the number of lean/normal-weight MAFLD was fewer and the patients were older than in other groups, previous studies had similar issues, which cannot solve at present. 14,18,30 There is no documented evidence of an association between NAFLD and reflux esophagitis in clinical guidelines. 31 Furthermore, Min et al reported that NAFLD is not an independent risk factor for reflux esophagitis, but rather, reflux esophagitis is primarily a consequence of obesity.…”

Section: Discussionmentioning

confidence: 99%

Lean/normal‐weight metabolic dysfunction‐associated fatty liver disease is a risk factor for reflux esophagitis

Fukunaga

Nakano

Tsutsumi

et al. 2022

Hepatology Research

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Aim: Reflux esophagitis is associated with metabolic dysfunction. Recently, fatty liver has been redefined as metabolic dysfunction-associated fatty liver disease (MAFLD). We investigated the impact of MAFLD and its subtypes on the incidence of reflux esophagitis. Methods:This multicenter, observational cohort study enrolled 9100 consecutive health-check examinees who underwent esophagogastroduodenoscopy and ultrasonography. All patients were classified into the MAFLD or non-MAFLD group.Based on the Asian cut-off value for body mass index (BMI), the MAFLD group was further classified into the lean/normal-weight (BMI <23 kg/m 2 ) and overweight/ obese (BMI ≥23 kg/m 2 ) subgroups. The impact of MAFLD and its subtypes on the cumulative incidence of reflux esophagitis was evaluated using multivariable Cox proportional hazards regression analysis.Results: MAFLD was diagnosed in 26.5% (2416/9100) of patients. Multivariable Cox proportional hazards regression analysis indicated that MAFLD (hazard ratio[HR] 1.2183; 95% confidence interval [CI] 1.0954-1.3550; p = 0.0003), hiatal hernia, and aging were independent risk factors for reflux esophagitis. Stratification analysis indicated that cumulative incidence of reflux esophagitis among patients with MAFLD was significantly higher in the lean/normal-weight than in the overweight/obese group (HR 1.3274; 95% CI 1.0043-1.7547; p = 0.0466). Among various metabolic factors, visceral adiposity was the only independent metabolic risk factor for reflux esophagitis (HR 2.8331; 95% CI 1.0201-7.8691; p = 0.0457) in the lean/normal-weight MAFLD group.Conclusions: MAFLD, in particular lean/normal-weight MAFLD, is independent risk factor for reflux esophagitis. Furthermore, visceral adiposity was identified as the most strong metabolic risk factor for reflux esophagitis in lean/normal-weight patients with MAFLD.

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The metabolic profiles and body composition of lean metabolic associated fatty liver disease

Cited by 28 publications

References 46 publications

Impact of MAFLD on HBV-Related Stage 0/A Hepatocellular Carcinoma after Curative Resection

Impact of MAFLD on HBV-Related Stage 0/A Hepatocellular Carcinoma after Curative Resection

MAFLD enhances clinical practice for liver disease in the Asia-Pacific region

Lean/normal‐weight metabolic dysfunction‐associated fatty liver disease is a risk factor for reflux esophagitis

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