中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 12
Dec.  2023
Turn off MathJax
Article Contents

Research advances in lean nonalcoholic fatty liver disease

DOI: 10.3969/j.issn.1001-5256.2023.12.024
Research funding:

Project of Administration of Traditional Chinese Medicine of Jiangsu Province of China (ZT202105)

More Information
  • Corresponding author: ZHOU Xiqiao, zhouxiqiao@njucm.edu.cn (ORCID: 0000-0003-3122-3904)
  • Received Date: 2023-03-29
  • Accepted Date: 2023-05-15
  • Published Date: 2023-12-12
  • Nonalcoholic fatty liver disease (NAFLD) is currently the main cause of chronic liver disease worldwide, and it can progress to hepatitis, liver fibrosis, liver cirrhosis, and even hepatocellular carcinoma. Although obesity plays a key role in the development of NAFLD, more and more studies have confirmed that NAFLD still exists in lean individuals, and lean NAFLD is associated with an increased risk of death and accelerated disease progression. Therefore, lean NAFLD also deserves careful evaluation and follow-up; however, we still know little about the pathophysiological mechanism of lean NAFLD. This article reviews the etiology, diagnosis, treatment, and prognosis of lean NAFLD.

     

  • loading
  • [1]
    YE Q, ZOU BY, YEO YH, et al. Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: A systematic review and meta-analysis[J]. Lancet Gastroenterol Hepatol, 2020, 5( 8): 739- 752. DOI: 10.1016/S2468-1253(20)30077-7.
    [2]
    WEINBERG EM, TRINH HN, FIRPI RJ, et al. Lean Americans with nonalcoholic fatty liver disease have lower rates of cirrhosis and comorbid diseases[J]. Clin Gastroenterol Hepatol, 2021, 19( 5): 996- 1008.e6. DOI: 10.1016/j.cgh.2020.06.066.
    [3]
    ZOU B, YEO YH, NGUYEN VH, et al. Prevalence, characteristics and mortality outcomes of obese, nonobese and lean NAFLD in the United States, 1999-2016[J]. J Intern Med, 2020, 288( 1): 139- 151. DOI: 10.1111/joim.13069.
    [4]
    NIRIELLA MA, KASTURIRATNE A, PATHMESWARAN A, et al. Lean non-alcoholic fatty liver disease(lean NAFLD): Characteristics, metabolic outcomes and risk factors from a 7-year prospective, community cohort study from Sri Lanka[J]. Hepatol Int, 2019, 13( 3): 314- 322. DOI: 10.1007/s12072-018-9916-4.
    [5]
    ZENG J, YANG RX, SUN C, et al. Prevalence, clinical characteristics, risk factors, and indicators for lean Chinese adults with nonalcoholic fatty liver disease[J]. World J Gastroenterol, 2020, 26( 15): 1792- 1804. DOI: 10.3748/wjg.v26.i15.1792.
    [6]
    NAVARROZA AMC, WONG SN. Comparison of clinical and metabolic profiles of lean versus non-lean nonalcoholic fatty liver disease[J]. Indian J Gastroenterol, 2021, 40( 4): 380- 388. DOI: 10.1007/s12664-021-01184-6.
    [7]
    NADERIAN M, KOLAHDOOZAN S, SHARIFI AS, et al. Assessment of lean patients with non-alcoholic fatty liver disease in a middle income country; prevalence and its association with metabolic disorders: A cross-sectional study[J]. Arch Iran Med, 2017, 20( 4): 211- 217.
    [8]
    YOUNES R, GOVAERE O, PETTA S, 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?[J]. Gut, 2022, 71( 2): 382- 390. DOI: 10.1136/gutjnl-2020-322564.
    [9]
    SHIDA T, OSHIDA N, SUZUKI H, et al. Clinical and anthropometric characteristics of non-obese non-alcoholic fatty liver disease subjects in Japan[J]. Hepatol Res, 2020, 50( 9): 1032- 1046. DOI: 10.1111/hepr.13543.
    [10]
    FENG RN, DU SS, WANG C, et al. Lean-non-alcoholic fatty liver disease increases risk for metabolic disorders in a normal weight Chinese population[J]. World J Gastroenterol, 2014, 20( 47): 17932- 17940. DOI: 10.3748/wjg.v20.i47.17932.
    [11]
    BYEON JH, KANG MK, KIM MC. Association of low skeletal muscle mass with the phenotype of lean non-alcoholic fatty liver disease[J]. Healthcare, 2022, 10( 5): 850. DOI: 10.3390/healthcare10050850.
    [12]
    ZHANG XX, HE ZY, SI QY, et al. The association of sarcopenia and visceral obesity with lean nonalcoholic fatty liver disease in Chinese patients with type 2 diabetes mellitus[J]. J Diabetes Res, 2022, 2022: 1- 8. DOI: 10.1155/2022/2229139.
    [13]
    ZHU X, HUANG Q, MA S, et al. Presence of sarcopenia identifies a special group of lean NAFLD in middle-aged and older people[J]. Hepatol Int, 2023, 17( 2): 313- 325. DOI: 10.1007/s12072-022-10439-z.
    [14]
    CHO Y, CHANG Y, RYU S, et al. Skeletal muscle mass to visceral fat area ratio as a predictor of NAFLD in lean and overweight men and women with effect modification by sex[J]. Hepatol Commun, 2022, 6( 9): 2238- 2252. DOI: 10.1002/hep4.1975.
    [15]
    GAO N, DENG J, WANG J, et al. The prevalence, comorbidities, influencing factors, and identifying factors of non-obese fatty liver disease[J]. Front Med(Lausanne), 2022, 9: 1038475. DOI: 10.3389/fmed.2022.1038475.
    [16]
    RASTOGI A, RATH I, VARADARAJAN A, et al. Non-alcoholic fatty liver disease(NAFLD) in lean individuals-Single centre large cohort clinicopathologic and immunophenotypic study[J]. Pathol Res Pract, 2022, 238: 154112. DOI: 10.1016/j.prp.2022.154112.
    [17]
    AKYUZ U, YESIL A, YILMAZ Y. Characterization of lean patients with nonalcoholic fatty liver disease: Potential role of high hemoglobin levels[J]. Scand J Gastroenterol, 2015, 50( 3): 341- 346. DOI: 10.3109/00365521.2014.983160.
    [18]
    CHEN F, ESMAILI S, ROGERS GB, et al. Lean NAFLD: A distinct entity shaped by differential metabolic adaptation[J]. Hepatology, 2020, 71( 4): 1213- 1227. DOI: 10.1002/hep.30908.
    [19]
    HU PF, ZENG X, ZOU ZY, et al. The presence of NAFLD in nonobese subjects increased the risk of metabolic abnormalities than obese subjects without NAFLD: A population-based cross-sectional study[J]. Hepatobiliary Surg Nutr, 2021, 10( 6): 811- 824. DOI: 10.21037/hbsn-20-263.
    [20]
    WANG QY, YOU H, OU XJ, et al. Non-obese histologically confirmed NASH patients with abnormal liver biochemistry have more advanced fibrosis[J]. Hepatol Int, 2019, 13( 6): 766- 776. DOI: 10.1007/s12072-019-09982-z.
    [21]
    LI YF, CHEN YZ, TIAN X, et al. Comparison of clinical characteristics between obese and non-obese patients with nonalcoholic fatty liver disease(NAFLD)[J]. Diabetes Metab Syndr Obes, 2021, 14: 2029- 2039. DOI: 10.2147/dmso.s304634.
    [22]
    KWAK JH, JUN DW, LEE SM, et al. Lifestyle predictors of obese and non-obese patients with nonalcoholic fatty liver disease: A cross-sectional study[J]. Clin Nutr, 2018, 37( 5): 1550- 1557. DOI: 10.1016/j.clnu.2017.08.018.
    [23]
    LI CL, GUO PP, OKEKUNLE AP, et al. Lean non-alcoholic fatty liver disease patients had comparable total caloric, carbohydrate, protein, fat, iron, sleep duration and overtime work as obese non-alcoholic fatty liver disease patients[J]. J Gastroenterol Hepatol, 2019, 34( 1): 256- 262. DOI: 10.1111/jgh.14360.
    [24]
    LIN H, WONG GL, WHATLING C, et al. Association of genetic variations with NAFLD in lean individuals[J]. Liver Int, 2022, 42( 1): 149- 160. DOI: 10.1111/liv.15078.
    [25]
    SOOKOIAN S, PIROLA CJ. Genetic predisposition in nonalcoholic fatty liver disease[J]. Clin Mol Hepatol, 2017, 23( 1): 1- 12. DOI: 10.3350/cmh.2016.0109.
    [26]
    IWAKI M, KESSOKU T, OZAKI A, et al. Gut microbiota composition associated with hepatic fibrosis in non-obese patients with non-alcoholic fatty liver disease[J]. J Gastroenterol Hepatol, 2021, 36( 8): 2275- 2284. DOI: 10.1111/jgh.15487.
    [27]
    IINO C, ENDO T, IINO K, et al. Reduced equol production and gut microbiota features in men with lean nonalcoholic fatty liver disease[J]. Am J Mens Health, 2022, 16( 4): 15579883221115598. DOI: 10.1177/15579883221115598.
    [28]
    YANG YJ, YANG EJ, PARK K, et al. Association between blood mercury levels and non-alcoholic fatty liver disease in non-obese populations: The Korean national environmental health survey(KoNEHS) 2012-2014[J]. Int J Environ Res Public Heath, 2021, 18( 12): 6412. DOI: 10.3390/ijerph18126412.
    [29]
    LONG MT, NOUREDDIN M, LIM JK. AGA clinical practice update: Diagnosis and management of nonalcoholic fatty liver disease in lean individuals: Expert review[J]. Gastroenterology, 2022, 163( 3): 764- 774.e1. DOI: 10.1053/j.gastro.2022.06.023.
    [30]
    LI K, LI J, CHENG X, et al. Association between the atherogenic index of plasma and new-onset non-alcoholic fatty liver disease in non-obese participants[J]. Front Endocrinol(Lausanne), 2022, 13: 969783. DOI: 10.3389/fendo.2022.969783.
    [31]
    ZOU Y, ZHONG L, HU C, et al. LDL/HDL cholesterol ratio is associated with new-onset NAFLD in Chinese non-obese people with normal lipids: A 5-year longitudinal cohort study[J]. Lipids Health Dis, 2021, 20( 1): 28. DOI: 10.1186/s12944-021-01457-1.
    [32]
    LI Q, HAN Y, HU H, et al. Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio has a non-linear association with non-alcoholic fatty liver disease: A secondary prospective cohort study in non-obese Chinese adults[J]. Front Med(Lausanne), 2022, 9: 995749. DOI: 10.3389/fmed.2022.995749.
    [33]
    XIE QY, LU S, KUANG MB, et al. Assessing the longitudinal association between the GGT/HDL-C ratio and NAFLD: A cohort study in a non-obese Chinese population[J]. BMC Gastroenterol, 2022, 22( 1): 500. DOI: 10.1186/s12876-022-02598-y.
    [34]
    CHAN WK. Comparison between obese and non-obese nonalcoholic fatty liver disease[J]. Clin Mol Hepatol, 2023, 29( Suppl): S58- S67. DOI: 10.3350/cmh.2022.0350.
    [35]
    LI C, GUO P, ZHANG R, et al. Both WHR and FLI as Better Algorithms for Both Lean and Overweight/Obese NAFLD in a Chinese Population. J Clin Gastroenterol. 2019; 53( 6): e253- e260. DOI: 10.1097/MCG.0000000000001089.
    [36]
    ZHANG XL, WANG TY, TARGHER G, et al. Lifestyle interventions for non-obese patients both with, and at risk, of non-alcoholic fatty liver disease[J]. Diabetes Metab J, 2022, 46( 3): 391- 401. DOI: 10.4093/dmj.2022.0048.
    [37]
    WONG VWS, WONG GLH, CHAN RSM, et al. Beneficial effects of lifestyle intervention in non-obese patients with non-alcoholic fatty liver disease[J]. J Hepatol, 2018, 69( 6): 1349- 1356. DOI: 10.1016/j.jhep.2018.08.011.
    [38]
    CIGROVSKI BERKOVIC M, BILIC-CURCIC I, MRZLJAK A, et al. NAFLD and physical exercise: Ready, steady, go![J]. Front Nutr, 2021, 8: 734859. DOI: 10.3389/fnut.2021.734859.
    [39]
    ABDELMONEIM D, EL-ADL M, EL-SAYED G, et al. Protective effect of fenofibrate against high-fat-high-fructose diet induced non-obese NAFLD in rats[J]. Fundam Clin Pharmacol, 2021, 35( 2): 379- 388. DOI: 10.1111/fcp.12597.
    [40]
    KIM Y, HAN E, LEE JS, et al. Cardiovascular risk is elevated in lean subjects with nonalcoholic fatty liver disease[J]. Gut Liver, 2022, 16( 2): 290- 299. DOI: 10.5009/gnl210084.
    [41]
    CHEN N, ZHOU JQ, WANG K, et al. Non-obese or lean non-alcoholic fatty liver disease was associated with increased risk of cancer in patients with type 2 diabetes mellitus[J]. BMJ Open Diabetes Res Care, 2023, 11( 1): e003066. DOI: 10.1136/bmjdrc-2022-003066.
    [42]
    KUMAR R, MOHAN S. Non-alcoholic fatty liver disease in lean subjects: Characteristics and implications[J]. J Clin Transl Hepatol, 2017, 5( 3): 216- 223. DOI: 10.14218/JCTH.2016.00068.
    [43]
    NABI O, LAPIDUS N, BOURSIER J, et al. Lean individuals with NAFLD have more severe liver disease and poorer clinical outcomes(NASH-CO Study)[J]. Hepatology, 2023, 78( 1): 272- 283. DOI: 10.1097/hep.0000000000000329.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(1)

    Article Metrics

    Article views (220) PDF downloads(88) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return