RT Journal Article
T1 Caucasian lean subjects with non-alcoholic fatty liver disease share long-term prognosis of non-lean: time for reappraisal of BMI-driven approach?
A1 Younes, Ramy
A1 Govaere, Olivier
A1 Petta, Salvatore
A1 Miele, Luca
A1 Tiniakos, Dina
A1 Burt, Alastair
A1 David, Ezio
A1 Vecchio, Fabio Maria
A1 Maggioni, Marco
A1 Cabibi, Daniela
A1 McLeod, Duncan
A1 Pareja, Maria Jesus
A1 Fracanzani, Anna Ludovica
A1 Aller, Rocio
A1 Rosso, Chiara
A1 Ampuero, Javier
A1 Gallego-Duran, Rocio
A1 Armandi, Angelo
A1 Caviglia, Gian Paolo
A1 Zaki, Marco Y W
A1 Liguori, Antonio
A1 Francione, Paolo
A1 Pennisi, Grazia
A1 Grieco, Antonio
A1 Birolo, Giovanni
A1 Fariselli, Piero
A1 Eslam, Mohammed
A1 Valenti, Luca
A1 George, Jacob
A1 Romero-Gomez, Manuel
A1 Anstee, Quentin Mark
A1 Bugianesi, Elisabetta
K1 fatty liver
K1 nonalcoholic steatohepatitis
K1 Adult
K1 Cohort Studies
K1 Humans
K1 Middle Aged
K1 Prognosis
K1 Thinness
AB The full phenotypic expression of non-alcoholic fatty liver disease (NAFLD) in lean subjects is incompletely characterised. We aimed to investigate prevalence, characteristics and long-term prognosis of Caucasian lean subjects with NAFLD. The study cohort comprises 1339 biopsy-proven NAFLD subjects from four countries (Italy, UK, Spain and Australia), stratified into lean and non-lean (body mass index (BMI)  Lean patients represented 14.4% of the cohort and were predominantly of Italian origin (89%). They had less severe histological disease (lean vs non-lean: non-alcoholic steatohepatitis 54.1% vs 71.2% p10 483 person-years), 4.7% of lean vs 7.7% of non-lean patients reported liver-related events (p=0.37). No difference in survival was observed compared with non-lean NAFLD (p=0.069). Caucasian lean subjects with NAFLD may progress to advanced liver disease, develop metabolic comorbidities and experience cardiovascular disease (CVD) as well as liver-related mortality, independent of longitudinal progression to obesity and PNPLA3 genotype. These patients represent one end of a wide spectrum of phenotypic expression of NAFLD where the disease manifests at lower overall BMI thresholds. NAFLD may affect and progress in both obese and lean individuals. Lean subjects are predominantly males, have a younger age at diagnosis and are more prevalent in some geographic areas. During the follow-up, lean subjects can develop hepatic and extrahepatic disease, including metabolic comorbidities, in the absence of weight gain. These patients represent one end of a wide spectrum of phenotypic expression of NAFLD.
PB BMJ Group
YR 2022
FD 2022-1-11
LK http://hdl.handle.net/10668/20153
UL http://hdl.handle.net/10668/20153
LA en
NO Younes R, Govaere O, Petta S, Miele L, Tiniakos D, Burt A, et al. Caucasian lean subjects with non-alcoholic fatty liver disease share long-term prognosis of non-lean: time for reappraisal of BMI-driven approach? Gut. 2022 Feb;71(2):382-390.
DS RISalud
RD Apr 17, 2025