Background and Aims:Nonalcoholic fatty liver disease(NAFLD)is commonly associated with obesity but can de-velop in normal-weight people(lean NAFLD).We compared outcomes in lean,overweight,and obese NAFLD.Methods:This ...Background and Aims:Nonalcoholic fatty liver disease(NAFLD)is commonly associated with obesity but can de-velop in normal-weight people(lean NAFLD).We compared outcomes in lean,overweight,and obese NAFLD.Methods:This retrospective chart review included patients at Stanford University Medical Center with NAFLD confirmed by imaging between March 1995 and December 2021.Lean,overweight,and obese patients had body mass index of<25.0,>25.0 and<29.9,and 230.0 kg/m2 for non-Asian and>23.0 and≥27.5 for overweight and obese Asian patients.Results:A total of 9061 lean(10.2%),overweight(31.7%),and obese(58.1%)patients were included.Lean patients were 5 years older than obese patients(53±17.4 VS.48.7±±15.1 years),more were female(59.6%vs.55.2%),white(49.1%vs.46.5%),had NASH(29.2%VS.22.5%),cirrhosis(25.3%.Vs.19.2%),or nonliver cancer(25.3%Vs.18.3%).Fewer had diabetes(21.7%Vs.35.8%)or metabolic comorbidi-ties(all p<0.0001).Lean NAFLD patients had liver-related mortality similar to other groups but higher overall(p=0.01)and nonliver-related(p=0.02)mortality.After multivariable model adjustment for covariates,differences between lean and obese NAFLD in liver-related,nonliver-related,and over-all mortality(adjusted hazard ratios of 1.34,1.00,and 1.32;p=0.66,0.99,and 0.20,respectively)were not significant.Conclusions:Lean NAFLD had fewer metabolic comorbidi-ties but similar adverse or worse outcomes,suggesting that it is not benign.Healthcare providers should provide the same level of care and intervention as for overweight and obese NAFLD.展开更多
文摘Background and Aims:Nonalcoholic fatty liver disease(NAFLD)is commonly associated with obesity but can de-velop in normal-weight people(lean NAFLD).We compared outcomes in lean,overweight,and obese NAFLD.Methods:This retrospective chart review included patients at Stanford University Medical Center with NAFLD confirmed by imaging between March 1995 and December 2021.Lean,overweight,and obese patients had body mass index of<25.0,>25.0 and<29.9,and 230.0 kg/m2 for non-Asian and>23.0 and≥27.5 for overweight and obese Asian patients.Results:A total of 9061 lean(10.2%),overweight(31.7%),and obese(58.1%)patients were included.Lean patients were 5 years older than obese patients(53±17.4 VS.48.7±±15.1 years),more were female(59.6%vs.55.2%),white(49.1%vs.46.5%),had NASH(29.2%VS.22.5%),cirrhosis(25.3%.Vs.19.2%),or nonliver cancer(25.3%Vs.18.3%).Fewer had diabetes(21.7%Vs.35.8%)or metabolic comorbidi-ties(all p<0.0001).Lean NAFLD patients had liver-related mortality similar to other groups but higher overall(p=0.01)and nonliver-related(p=0.02)mortality.After multivariable model adjustment for covariates,differences between lean and obese NAFLD in liver-related,nonliver-related,and over-all mortality(adjusted hazard ratios of 1.34,1.00,and 1.32;p=0.66,0.99,and 0.20,respectively)were not significant.Conclusions:Lean NAFLD had fewer metabolic comorbidi-ties but similar adverse or worse outcomes,suggesting that it is not benign.Healthcare providers should provide the same level of care and intervention as for overweight and obese NAFLD.
