Alice Yuxin Wang1, Jasbir Dhaliwal2, Marialena Mouzaki3. 1. Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada. 2. Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. 3. Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, OH, USA. Electronic address: Marialena.Mouzaki@cchmc.org.
Abstract
BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD), with its increasing prevalence and association with various co-morbidities, such as diabetes, cardiovascular disease and metabolic syndrome, is a growing concern. Previously thought to predominantly affect obese individuals, NAFLD has been shown to occur in non-obese subjects. This subset of individuals, known to have 'lean NAFLD' or 'non-obese NAFLD', is also growing increasingly prevalent. We summarize the clinical manifestations, pathophysiology and management of lean NAFLD in both adult and pediatric populations. METHODS: Two reviewers performed an independent, formal review and analysis of the literature (PubMed and EMBASE search until April 2018). RESULTS AND CONCLUSIONS: Patients with lean NAFLD share metabolic features of insulin resistance and dyslipidemia, similar to obese patients with NAFLD. Genetic predisposition, dietary and environmental factors may play a role in the pathogenesis of lean NAFLD. Genetic and metabolic conditions should be considered as well. Currently, there are no formal recommendations for the treatment of adult or pediatric lean NAFLD; however, lifestyle changes aimed at improving overall fitness are likely to have a favorable impact.
BACKGROUND & AIMS:Non-alcoholic fatty liver disease (NAFLD), with its increasing prevalence and association with various co-morbidities, such as diabetes, cardiovascular disease and metabolic syndrome, is a growing concern. Previously thought to predominantly affect obese individuals, NAFLD has been shown to occur in non-obese subjects. This subset of individuals, known to have 'lean NAFLD' or 'non-obese NAFLD', is also growing increasingly prevalent. We summarize the clinical manifestations, pathophysiology and management of lean NAFLD in both adult and pediatric populations. METHODS: Two reviewers performed an independent, formal review and analysis of the literature (PubMed and EMBASE search until April 2018). RESULTS AND CONCLUSIONS:Patients with lean NAFLD share metabolic features of insulin resistance and dyslipidemia, similar to obesepatients with NAFLD. Genetic predisposition, dietary and environmental factors may play a role in the pathogenesis of lean NAFLD. Genetic and metabolic conditions should be considered as well. Currently, there are no formal recommendations for the treatment of adult or pediatric lean NAFLD; however, lifestyle changes aimed at improving overall fitness are likely to have a favorable impact.
Authors: Beatrice Bissig-Choisat; Michele Alves-Bezerra; Barry Zorman; Scott A Ochsner; Mercedes Barzi; Xavier Legras; Diane Yang; Malgorzata Borowiak; Adam M Dean; Robert B York; N Thao N Galvan; John Goss; William R Lagor; David D Moore; David E Cohen; Neil J McKenna; Pavel Sumazin; Karl-Dimiter Bissig Journal: JHEP Rep Date: 2021-03-21
Authors: Oriol Juanola; Sebastián Martínez-López; Rubén Francés; Isabel Gómez-Hurtado Journal: Int J Environ Res Public Health Date: 2021-05-14 Impact factor: 3.390