Current evidence suggests that lean and obese patients with nonalcoholic fatty liver disease (NAFLD) share an altered metabolic and cardiovascular profile.
However, there is an incomplete understanding of the natural history of “lean-NAFLD.”
Indeed, an unanswered question is whether lean (BMI ≤ 25 Kg/m2) NAFLD-patients are protected from severe histological outcomes.
Drs Sookoian and Pirola performed a meta-analysis with the goal of providing a quantitative estimation of the magnitude of fibrosis, as well as histological features associated with the disease severity, in lean versus overweight/obese-NAFLD patients.
Through a systematic search up to 2017, the team identified 8 studies that compared histological outcomes in lean versus overweight/obese patients.
|The overweight/obese-NAFLD patients have greater NAFLD activity|
|Alimentary Pharmacology & Therapeutics|
Relative to lean-NAFLD, overweight/obese-NAFLD patients showed significantly higher fibrosis scores.
The researchers found that the risk of having nonalcoholic steatohepatitis-NASH was significantly lower in lean-NAFLD than in overweight/obese-NAFLD.
Relative to lean-NAFLD, the research team noted that the overweight/obese-NAFLD patients also have significantly greater NAFLD activity, and steatosis scores.
Dr Sookoian's team concludes, "Lean-NAFLD patients tend to show less severe histological features as compared to overweight/obese-NAFLD patients."
"Subsequent longitudinal assessment is needed to understand the clinical impact of these findings."
"However, the significant ~ 25% increment of mean fibrosis score in overweight/obese patients suggests that obesity could predict a worse long-term prognosis."