Cardiovascular disease more prevalent in lean vs. overweight, obese patients with NAFLD
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Lean patients with nonalcoholic fatty liver disease were at greater risk for cardiovascular and chronic kidney disease compared with overweight or obese patients, according to a researcher at the Digestive Disease Week 2022 media briefing.
“NAFLD in lean individuals is not a benign disease,” Karn Wijarnpreecha, MD, MPH, a transplant hepatology fellow at the University of Michigan, told Healio. “Attention to cardiac risk stratification and intervention is warranted for lean patients with NAFLD,”
In a retrospective study conducted from 2012 to 2021, Wijarnpreecha and colleagues identified 18,594 NAFLD patients, aged 18 years or older, at the University of Michigan Hospital and expanded the sample size with additional data from the Michigan NAFLD Cohort. Using WHO recommendations for Asian and non-Asian BMI cutoffs, they classified patients as lean (n = 2,137), overweight (n = 4,692), class 1 obese (n = 5,234) or class 2-3 obese (n = 6,531).
The prevalence of cirrhosis, cardiovascular disease, metabolic diseases and chronic kidney disease (stage 3-5) among lean compared with overweight or obese patients with NAFLD served at the primary outcome.
According to study results, lean patients had lower prevalence of cirrhosis, diabetes, hypertension and dyslipidemia but higher prevalence of peripheral vascular disease, cerebrovascular disease and any cardiovascular disease, compared with overweight or obese patients.
Further analysis revealed that lean patients with NAFLD had a significantly higher prevalence of cardiovascular disease than overweight or obese patients, independent of age, sex, race, smoking status, diabetes, hypertension and dyslipidemia.
A higher prevalence of cirrhosis was noted, however, among obese patients.
“NAFLD patients with a normal BMI are often overlooked, because we assume their risk for more serious conditions is lower than those who are overweight,” Wijarnpreecha said. “But this way of thinking may be putting these patients at risk. Physicians should pay close attention to lean patients with NAFLD, since they may be facing serious health consequences similar to NAFLD patients who are overweight or living with obesity.”
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Wijarnpreecha K, et al. Abstract 325. Presented at: Digestive Disease Week; May 21-24, 2022; San Diego (hybrid meeting).
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