Similar risk factors observed in lean, non-lean patients with NAFLD
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Lean and non-lean patients with nonalcoholic fatty liver disease were similar metabolically and had common risk factors, according to findings published in the Journal of Gastroenterology and Hepatology Open.
“Age, BMI, waist circumference, blood pressure, fasting blood sugar, HbA1c, insulin resistance, uric acid, total cholesterol, HDL, LDL and triglycerides are the important risk factors of NAFLD shared equally among lean and non-lean,” Shahinul Alam, MD, from the department of hepatology, Bangabandhu Sheikh Mujib Medical University in Dhaka, Bangladesh, and colleagues wrote. “In other words, lean and non-lean NAFLD are anthropometrically different but metabolically similar entities. The findings provide a scientific basis for a further understanding of the nature of NAFLD in lean individuals and might provide a guide to determine the management strategies for lean-NAFLD.”
Alam and colleagues conducted a meta-analysis of observational studies on NAFLD and identified 1,175 articles searching through MEDLINE/PubMed, Bangladesh Journals Online and Google Scholar. Of these, investigators selected 22 for analysis. Investigators assessed data from lean (n = 6,768) and non-lean (n = 9,253) patients with NAFLD. Patients who were lean (n = 43,398) and non-lean (n = 9,619) without NAFLD served as controls.
Alam and colleagues found BMI, waist circumference, systolic BP and diastolic BP had significantly higher estimates in lean NAFLD patients compared with lean non-NAFLD controls. Lean patients with NAFLD compared with lean non-NAFLD controls had higher fasting blood glucose and insulin resistance. Apart from HDL, all components of the lipid profile increased significantly, according to researchers.
Investigators found the presence of NAFLD among lean patients correlated with an increased uric acid level. Non-lean NAFLD patients compared with the counter group had significantly different cardiometabolic profiles, whereas the magnitude of the difference of lipid and glycemic profile barely met statistical significance when patients were grouped as lean or non-lean NAFLD.
Compared with the non-NAFLD group, diastolic BP (slope: 0.19; P < .037), homeostatic model assessment for insulin resistance (slope: 0.58; P < .001) and uric acid (slope: 0.36; P = .022) were higher in patients with presence of NAFLD, according to Alam and colleagues.
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