Clinical and Laboratory Characteristics of Normal Weight and Obese Individuals with Non-Alcoholic Fatty Liver Disease

• Published in: Diagnostics (Basel) 2022-03, Vol.12 (4), p.801
• Main Authors: Trifan, Anca, Rotaru, Adrian, Stafie, Remus, Stratina, Ermina, Zenovia, Sebastian, Nastasa, Robert, Huiban, Laura, Cuciureanu, Tudor, Muzîca, Cristina, Chiriac, Stefan, Gîrleanu, Irina, Sîngeap, Ana-Maria, Sfarti, Catalin, Cojocariu, Camelia, Stanciu, Carol
• Format: Article
• Language: English
• Subjects: Alcohol; Body mass index; Hepatitis; High density lipoprotein; Hypertension; lean; Liver cirrhosis; Liver diseases; liver steatosis; liver stiffness; Metabolism; obese; Obesity; Overweight; Patients; Regression analysis; Variance analysis; VCTE; Womens health
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics12040801

Non-alcoholic fatty liver disease (NAFLD) has had, over the past few decades, a progressively growing prevalence among the general population all over the world, in parallel with metabolic conditions such as type 2 diabetes mellitus (T2DM), dyslipidemia, and obesity. However, NAFLD is also detected in 10−13% of subjects with a body mass index (BMI) ≤ 25 kg/m² (lean-NAFLD), whose major risk factors remain unknown. In this study, we aimed to characterize the clinical features and associated risk factors of lean-NAFLD in comparison with obese-NAFLD patients. Consecutive patients diagnosed with NAFLD by vibration-controlled transient elastography and controlled attenuation parameter were prospectively enrolled. Biological and clinical data obtained from the participants were stratified according to their BMI in two groups: lean-NAFLD and obese-NAFLD. In total, 331 patients (56.8% males) were included in the final analysis. Most of the subjects were obese-NAFLD (n = 258, 77.9%) and had a higher prevalence of T2DM, dyslipidemia, and components of the metabolic syndrome, together with abnormal biological parameters. Regarding liver stiffness measurements, the proportion of subjects with at least significant fibrosis (≥F2) was approximately twofold higher among obese-NAFLD (43.81%) in comparison with lean-NAFLD patients (23.29%). Moreover, obese individuals had a higher risk for liver fibrosis (OR = 2.6, 95%, CI 1.5−4.42, p < 0.001) than lean individuals. Although associated metabolic conditions and at least significant liver fibrosis were present in approximately one-quarter of the patients, these were more frequent among obese-NAFLD patients. Therefore, individualized screening strategies for NAFLD should be established according to BMI.