Zi-Yuan Zou1,2, Vincent Wai-Sun Wong3,4, Jian-Gao Fan1,5. 1. Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai. 2. Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China. 3. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China. 4. State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, SAR, China. 5. Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China.
Abstract
AIMS: As a subpopulation of nonalcoholic fatty liver disease (NAFLD), non-obese NAFLD may also have increased risk of adverse hepatic and metabolic outcomes. We estimated the prevalence and incidence of non-obese NAFLD and described its clinical characteristics. METHODS: We performed a systematic search of 1235 citations up to Mar 2020. Meta-analyses, stratified analyses and meta-regression were all performed. RESULTS: Of the 48 studies included, 29 cross-sectional/longitudinal studies comprising 157904 non-obese subjects reported a pooled NAFLD prevalence of 14.8% (95% CI 12.5%-17.4%). Multivariable meta-regression showed that the prevalence rates varied by mean age of the sample, geographic region and population source. Further stratified analyses revealed that NAFLD was more prevalent among persons aged ≥45years (16.2%; 95% CI, 10.8-23.4) and in North America (19.3%; 95% CI, 13.9-26.2). The PNPLA3 rs738409 gene polymorphism was more frequent in non-obese NAFLD than in both obese NAFLD and non-obese controls, while the metabolic profiles of non-obese NAFLD were less severe than those of obese NAFLD. Patients with non-obese NAFLD had 5.29-fold and 5.43-fold higher risks for diabetes mellitus and metabolic syndrome than non-obese controls, respectively. Although non-obese patients had less severe liver histology, the pooled proportion of nonalcoholic steatohepatitis (NASH) and advanced fibrosis in non-obese NAFLD was 42.9% (95% CI 29.9%-56.9%) and 20.6% (95% CI 14.0%-29.2%), respectively. CONCLUSIONS: Non-obese NAFLD is common, particularly in North America and among persons aged ≥45years. Metabolic diseases and PNPLA3 rs738409 gene polymorphism are more frequent in non-obese NAFLD than in non-obese controls. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
AIMS: As a subpopulation of nonalcoholic fatty liver disease (NAFLD), non-obese NAFLD may also have increased risk of adverse hepatic and metabolic outcomes. We estimated the prevalence and incidence of non-obese NAFLD and described its clinical characteristics. METHODS: We performed a systematic search of 1235 citations up to Mar 2020. Meta-analyses, stratified analyses and meta-regression were all performed. RESULTS: Of the 48 studies included, 29 cross-sectional/longitudinal studies comprising 157904 non-obese subjects reported a pooled NAFLD prevalence of 14.8% (95% CI 12.5%-17.4%). Multivariable meta-regression showed that the prevalence rates varied by mean age of the sample, geographic region and population source. Further stratified analyses revealed that NAFLD was more prevalent among persons aged ≥45years (16.2%; 95% CI, 10.8-23.4) and in North America (19.3%; 95% CI, 13.9-26.2). The PNPLA3rs738409 gene polymorphism was more frequent in non-obese NAFLD than in both obese NAFLD and non-obese controls, while the metabolic profiles of non-obese NAFLD were less severe than those of obese NAFLD. Patients with non-obese NAFLD had 5.29-fold and 5.43-fold higher risks for diabetes mellitus and metabolic syndrome than non-obese controls, respectively. Although non-obesepatients had less severe liver histology, the pooled proportion of nonalcoholic steatohepatitis (NASH) and advanced fibrosis in non-obese NAFLD was 42.9% (95% CI 29.9%-56.9%) and 20.6% (95% CI 14.0%-29.2%), respectively. CONCLUSIONS:Non-obese NAFLD is common, particularly in North America and among persons aged ≥45years. Metabolic diseases and PNPLA3rs738409 gene polymorphism are more frequent in non-obese NAFLD than in non-obese controls. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Entities:
Keywords:
Body mass index; prevalence; single-nucleotide polymorphism; steatohepatitis
Authors: Diego García-Compeán; Emanuela Orsi; Ramesh Kumar; Felix Gundling; Tsutomu Nishida; Jesús Zacarías Villarreal-Pérez; Ángel N Del Cueto-Aguilera; José A González-González; Giuseppe Pugliese Journal: World J Gastroenterol Date: 2022-02-28 Impact factor: 5.742