مورد إلكتروني
Caucasian lean subjects with non-alcoholic fatty liver disease share long-term prognosis of non-lean: time for reappraisal of BMI-driven approach?
| العنوان: | Caucasian lean subjects with non-alcoholic fatty liver disease share long-term prognosis of non-lean: time for reappraisal of BMI-driven approach? |
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| بيانات النشر: | BMJ Publishing Group 2022-01-11 |
| تفاصيل مُضافة: | European Commission NIHR Biomedical Research Centre (UK) Ministero della Salute Sydney Medical Foundation University of Sydney National Health and Medical Research Council (Australia) Younes, Ramy Govaere, Olivier Petta, Salvatore Miele, Luca Tiniakos, Dina Burt, Alastair Davis, Ezio Vecchio, Fabio Maria Maggioni, Marco Cabibi, Daniela McLeod, Duncan Pareja, María Jesús Fracanzani, Anna Ludovica Aller, Rocío Rosso, Chiara Ampuero, Javier Gallego-Durán, Rocío Armandi, Angelo Caviglia, Gian Paolo Zaki, Marco Y. W. Liguori, Antonio Francione, Paolo Pennisi, Grazia Grieco, Antonio Birolo, Giovanni Fariselli, Piero Eslam, Mohammed Valenti, Luca George, Jacob Romero-Gómez, Manuel Anstee, Quentin M. Bugianesi, Elisabetta |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | [Objective] The full phenotypic expression of non-alcoholic fatty liver disease (NAFLD) in lean subjects is incompletely characterised. We aimed to investigate prevalence, characteristics and long-term prognosis of Caucasian lean subjects with NAFLD. [Design] The study cohort comprises 1339 biopsy-proven NAFLD subjects from four countries (Italy, UK, Spain and Australia), stratified into lean and non-lean (body mass index (BMI) [Results] Lean patients represented 14.4% of the cohort and were predominantly of Italian origin (89%). They had less severe histological disease (lean vs non-lean: non-alcoholic steatohepatitis 54.1% vs 71.2% p<0.001; advanced fibrosis 10.1% vs 25.2% p<0.001), lower prevalence of diabetes (9.2% vs 31.4%, p<0.001), but no significant differences in the prevalence of the PNPLA3 I148M variant (p=0.57). During a median follow-up of 94 months (>10 483 person-years), 4.7% of lean vs 7.7% of non-lean patients reported liver-related events (p=0.37). No difference in survival was observed compared with non-lean NAFLD (p=0.069). [Conclusions] Caucasian lean subjects with NAFLD may progress to advanced liver disease, develop metabolic comorbidities and experience cardiovascular disease (CVD) as well as liver-related mortality, independent of longitudinal progression to obesity and PNPLA3 genotype. These patients represent one end of a wide spectrum of phenotypic expression of NAFLD where the disease manifests at lower overall BMI thresholds. [Lay summary] NAFLD may affect and progress in both obese and lean individuals. Lean subjects are predominantly males, have a younger age at diagnosis and are more prevalent in some geographic areas. During the follow-up, lean subjects can develop hepatic and extrahepatic disease, including metabolic comorbidities, in the absence of weight gain. These patients represent one end of a wide spectrum of phenotypic expression of NAFLD. |
| مصطلحات الفهرس: | NAFLD, NASH, Lean-NASH, Lean-Outcomes, PNPLA3, artículo |
| URL: | Postprint Sí info:eu-repo/grantAgreement/EC/H2020/634413 |
| الإتاحة: | Open access content. Open access content openAccess |
| أرقام أخرى: | CTK oai:digital.csic.es:10261/270112 Gut 71(2): 382-390 (2022) 10.1136/gutjnl-2020-322564 1333186169 |
| المصدر المساهم: | CSIC From OAIster®, provided by the OCLC Cooperative. |
| رقم الأكسشن: | edsoai.on1333186169 |
| قاعدة البيانات: | OAIster |
| الوصف غير متاح. |