@article{3128121,
    title = "The Severity of histologic liver lesions is independent of body mass index in patients with nonalcoholic fatty liver disease",
    author = "Margariti, A. and Deutsch, M. and Manolakopoulos, S. and Tiniakos, D. and Papatheodoridis, G.V.",
    journal = "Journal of Clinical Gastroenterology",
    year = "2013",
    volume = "47",
    number = "3",
    pages = "280-286",
    issn = "0192-0790, 1539-2031",
    doi = "10.1097/MCG.0b013e31826be328",
    keywords = "alanine aminotransferase;  aspartate aminotransferase, adult;  article;  body mass;  disease severity;  female;  hepatitis;  histopathology;  human;  human tissue;  liver fibrosis;  liver injury;  major clinical study;  male;  metabolic syndrome X;  nonalcoholic fatty liver;  priority journal, Adult;  Alanine Transaminase;  Aspartate Aminotransferases;  Body Mass Index;  Fatty Liver;  Female;  Greece;  Humans;  Ideal Body Weight;  Inflammation;  Liver Cirrhosis;  Male;  Metabolic Syndrome X;  Middle Aged;  Obesity;  Overweight;  Prevalence;  Severity of Illness Index",
    abstract = "GOALS/BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is associated with obesity, but it may also be present in lean individuals. We evaluated the characteristics of NAFLD patients, focusing on those with normal body mass index (BMI). STUDY: One hundred and sixty-two of 185 consecutive NAFLD patients were included. Demographic, clinical, somatometric, and laboratory characteristics were recorded. BMI<25 kg/m was considered to be normal. RESULTS: Of the 162 patients, 12% had normal BMI. Patients with normal compared with those with increased BMI fulfilled more frequently no criterion of metabolic syndrome (43% vs. 2%; P<0.001) and had higher median alanine aminotransferase (92 vs. 62 IU/L; P=0.032) and aspartate aminotransferase levels (45 vs. 37 IU/L; P=0.036). Liver stiffness values by transient elastography were significantly lower in patients with normal than in those with increased BMI (5.0±1.6 vs. 9.5±8.7 kPa; P=0.003). In the 56 patients with liver biopsy, the prevalence of nonalcoholic steatohepatitis (50% vs. 68.8%; P=0.423) and the severity of inflammation and fibrosis did not significantly differ between cases with normal and those with increased BMI. CONCLUSIONS: 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. Copyright © 2013 by Lippincott Williams & Wilkins."
}