The Severity of Histologic Liver Lesions Is Independent of Body Mass Index in Patients With Nonalcoholic Fatty Liver Disease

Margariti, Apostolia; Deutsch, Melanie; Manolakopoulos, Spilios; Tiniakos, Dina; Papatheodoridis, George V.

doi:10.1097/mcg.0b013e31826be328

Cited by 43 publications

(44 citation statements)

References 53 publications

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“…Also, a significant percentage of patients (about 25%) had normal weight confirming that, even if positive energy balance and increased BMI substantially increase the risk of NAFLD, this latter may develop in individuals with normal BMI as well[41] e.g ., as a consequence of an uncorrected lifestyle.…”

Section: Discussionmentioning

confidence: 99%

Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

Gelli

Tarocchi

Abenavoli

et al. 2017

WJG

110

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AIMTo determine the clinical effectiveness of nutritional counseling on reduction of non-alcoholic fatty liver disease (NAFLD) severity, weight loss, metabolic and anthropometric indexes and liver enzymes.METHODSForty-six adults with NAFLD received a 6-mo clinical and a dietary intervention (based on Mediterranean diet) carried out respectively by a gastroenterologist and a nutritionist with counseling license. The counseling process consisted of monthly meeting (about 45 min each). The effect of the treatment was evaluated monitoring liver enzymes, metabolic parameters, cardiovascular risk indexes, NAFLD severity [assessed by ultrasound (US)] and related indexes. All parameters were assessed at baseline. Biochemistry was also assessed at mid- and end-interventions and US was repeated at end-intervention.RESULTSThe percentage of patients with steatosis grade equal or higher than 2 was reduced from 93% to 48% and steatosis regressed in 9 patients (20%). At the end of the treatment the end-point concerning the weight (i.e., a 7% weight reduction or achievement/maintenance of normal weight) was accomplished by 25 out of 46 patients (i.e., 54.3%). As far as the liver enzymes is concerned, all three liver enzymes significantly decrease during the treatment the normalization was particularly evident for the ALT enzyme (altered values reduced from 67% down to 11%). Several parameters, i.e., BMI, waist circumference, waist-to-hip ratio, AST, ALT, GGT, HDL, serum glucose, Tot-Chol/HDL, LDL/HDL, TG/HDL, AIP, HOMA, FLI, Kotronen index, VAI, NAFLD liver fat score and LAP, showed a significant improvement (P < 0.01) between baseline and end-treatment.CONCLUSIONOutcomes of this study further strengthen the hypothesis that MedDiet and more active lifestyle can be considered a safe therapeutic approach for reducing risk and severity of NAFLD and related disease states. The proposed approach may be proposed as a valid and recommended approach for improving the clinical profile of NAFLD patients.

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Section: Discussionmentioning

confidence: 99%

Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

Gelli

Tarocchi

Abenavoli

et al. 2017

WJG

110

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“…[8] The prevalence of CD among patients with NAFLD has been reported as 2.2-7.9%[29, 30] and among these patients BMI was often in the normal range. [29] Conversely, little is known of the risks of NAFLD in those already diagnosed with CD.…”

Section: Discussionmentioning

confidence: 99%

“…[8] A high-fat diet and sedentary lifestyle are alterable risks, modifications here can yield improvements in NAFLD [9], and recovery after weight loss may be related to reduced insulin resistance. [10] Many adults and children with CD are overweight or obese at diagnosis, or become overweight after treatment [11, 12], increasing risks for NAFLD.…”

Section: Introductionmentioning

confidence: 99%

Increased risk of non-alcoholic fatty liver disease after diagnosis of celiac disease

Reilly

Lebwohl

Hultcrantz

et al. 2015

Journal of Hepatology

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Background and Aims Nonalcoholic fatty liver disease is a common cause of chronic liver disease. Celiac disease alters intestinal permeability and treatment with a gluten-free diet often causes weight gain, but so far there are few reports of nonalcoholic fatty liver disease in patients with celiac disease. Methods Population-based cohort study. We compared the risk of nonalcoholic fatty liver disease diagnosed from 1997-2009 in individuals with celiac disease (n=26,816) to matched reference individuals (n=130,051). Patients with any liver disease prior to celiac disease were excluded, as were individuals with a lifetime diagnosis of alcohol-related disorder to minimize misclassification of nonalcoholic fatty liver disease. Cox regression estimated hazard ratios for nonalcoholic fatty liver disease were determined. Results During 246,559 person-years of follow-up, 53 individuals with celiac disease had a diagnosis of nonalcoholic fatty liver disease (21/100,000 person-years). In comparison, we identified 85 reference individuals diagnosed with nonalcoholic fatty liver disease during 1,488,413 person-years (6/100,000 person-years). This corresponded to a hazard ratio of 2.8 (95%CI=2.0-3.8), with the highest risk estimates seen in children (HR=4.6; 95%CI=2.3-9.1). The risk increase in the first year after celiac disease diagnosis was 13.3 (95%CI=3.5-50.3) but remained significantly elevated even beyond 15 years after the diagnosis of celiac disease (HR=2.5; 95% CI 1.0-5.9). Conclusion Individuals with celiac disease are at increased risk of nonalcoholic fatty liver disease compared to the general population. Excess risks were highest in the first year after celiac disease diagnosis, but persisted through 15 years beyond diagnosis with celiac disease.

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“…Pancreatic β‐cell dysfunction preceded glucose intolerance in patients with NASH but without obesity ( n = 20) compared to both insulin‐sensitive ( n = 30) and ‐insensitive ( n = 15) controls (matched for age, sex, and BMI) and could contribute to the development of type 2 diabetes in these patients . From a metabolic point of view, several studies reported that NALFD without obesity may be comparable with NAFLD with obesity (Table ) ( , ). In contrast, other authors have found the metabolic profile of NAFLD without obesity to be less severe when compared with NAFLD with obesity .…”

Section: Nafld and Its Comorbiditiesmentioning

confidence: 99%

Normal weight dyslipidemia: Is it all about the liver?

Ipsen

Tveden‐Nyborg

Lykkesfeldt

2016

Obesity

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Objective: The liver coordinates lipid metabolism and may play a vital role in the development of dyslipidemia, even in the absence of obesity. Normal weight dyslipidemia (NWD) and patients with nonalcoholic fatty liver disease (NAFLD) who do not have obesity constitute a unique subset of individuals characterized by dyslipidemia and metabolic deterioration. This review examined the available literature on the role of the liver in dyslipidemia and the metabolic characteristics of patients with NAFLD who do not have obesity. Methods: PubMed was searched using the following keywords: nonobese, dyslipidemia, NAFLD, NWD, liver, and metabolically obese/unhealthy normal weight. Additionally, article bibliographies were screened, and relevant citations were retrieved. Studies were excluded if they had not measured relevant biomarkers of dyslipidemia. Results: NWD and NAFLD without obesity share a similar abnormal metabolic profile. When compared with patients with NAFLD who have obesity, the metabolic abnormalities of NAFLD without obesity are similar or less severe. Furthermore, hepatic lesions develop independent of obesity, and the extent of dyslipidemia seems comparable. Conclusions: NAFLD may impair hepatic lipid handling, causing faulty lipid homeostasis, and serves as a likely starting point for initiation and propagation of dyslipidemia along with associated comorbidities in patients without obesity.

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The Severity of Histologic Liver Lesions Is Independent of Body Mass Index in Patients With Nonalcoholic Fatty Liver Disease

Abstract: Approximately 1 of 8 NAFLD patients coming to a Greek tertiary liver center has normal BMI. On liver biopsy, normal BMI patients often have nonalcoholic steatohepatitis and histologic liver lesions of similar severity to the overweight or obese patients.

Cited by 43 publications

References 53 publications

Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

Increased risk of non-alcoholic fatty liver disease after diagnosis of celiac disease

Normal weight dyslipidemia: Is it all about the liver?

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