Περίληψη:
Objective 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. Design 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) 10 483 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). Conclusions 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. Lay summary 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. ©
Συγγραφείς:
Younes, R.
Govaere, O.
Petta, S.
Miele, L.
Tiniakos, D.
Burt, A.
David, E.
Vecchio, F.M.
Maggioni, M.
Cabibi, D.
McLeod, D.
Pareja, M.J.
Fracanzani, A.L.
Aller, R.
Rosso, C.
Ampuero, J.
Gallego-Durán, R.
Armandi, A.
Caviglia, G.P.
Zaki, M.Y.W.
Liguori, A.
Francione, P.
Pennisi, G.
Grieco, A.
Birolo, G.
Fariselli, P.
Eslam, M.
Valenti, L.
George, J.
Romero-Gómez, M.
Anstee, Q.M.
Bugianesi, E.
Λέξεις-κλειδιά:
adult; age; Article; Australia; body mass; body weight gain; cardiovascular disease; Caucasian; clinical feature; cohort analysis; comorbidity; controlled study; cross-sectional study; diabetes mellitus; disease course; disease exacerbation; disease severity; female; follow up; gender; gene; genetic variability; genotype; geography; histology; human; human tissue; Italy; liver biopsy; liver fibrosis; liver transplantation; longitudinal study; major clinical study; male; metabolic disorder; mortality; nonalcoholic fatty liver; nonalcoholic steatohepatitis; obesity; observational study; PNPLA3 gene; prevalence; prognosis; retrospective study; Spain; survival analysis; United Kingdom; body mass; Caucasian; complication; middle aged; nonalcoholic fatty liver; pathology; prognosis; survival rate; underweight, Adult; Body Mass Index; Cohort Studies; Female; Humans; Male; Middle Aged; Non-alcoholic Fatty Liver Disease; Prognosis; Survival Rate; Thinness; Whites
