Systematic Reviews
Copyright ©The Author(s) 2024.
World J Hepatol. Mar 27, 2024; 16(3): 452-464
Published online Mar 27, 2024. doi: 10.4254/wjh.v16.i3.452
Table 1 Characteristics of lean non-alcoholic fatty liver disease patients
Ref.
Population
Prevalence
Characteristics
Cardiometabolic risk
Laboratory values
Anthropometric values
Younossi et al[7], 2012Compared lean with overweight/obese NAFLD patients (n = 11613)18%< 40 yr, female↓ T2DM, IR, HTN, Hypercholesterolemia↓ AST, ALT, plateletsNot reported
Wei et al[37], 2015Compared lean with overweight/obese NAFLD patients (n = 911)19.3%< 50 years: male, > 50 years: No difference between sexes↓ T2DM, HTN, MetS and liver stiffness↓ ALT, HOMA-IR, ↑ HDL↓ WC, WHR
Fracanzani et al[66], 2017Compare lean with overweight/obese NAFLD patients (n = 669)21.3%Not reported↓ T2DM, MetS, HTN↓ HOMA-IR, ↑ HDL, platelet↓ WC
Golabi et al[65], 2019Compare lean with and without NAFLD patients (n = 5375)Not reportedNot reported↑ Risk cardiovascular and all-cause of mortalityNot reportedNot reported
Shao et al[63], 2020Compare lean with obese NAFLD patients (n = 543)Not reportedNo difference between sexes or age↓ BP↓ AST, ALT, LDL, total cholesterol, FBG, HOMA-IR, ↑ HDL↓ BMI, WC, WHR
Aneni et al[40], 2020Compared lean with and without NAFLD patients (n = 9137)3.8%> 40 yr, male↑ Risk of AD, BP↑ FBG, total cholesterol, LDL, TG, AST, ALTl; Low HDL↑ WC
Rahman et al[41], 2020Compared lean with and without NAFLD patients (n = 1305)4.4%> 40 yr, male↑ MetS, T2DM↑ TG, Total cholesterol, FBG↑ Abdominal obesity, BMI
Semmler et al[46], 2021Compared lean with and without NAFLD patients (n = 3043)6.7%> 40 yr, male↑ Dyslipidemia, IR, T2DM, MetS, cardiovascular riskNot reported↑ WC
Weinberg et al[60], 2021Compared lean with overweight/obese NAFLD patients (n = 3386)Not reported> 60 yr
No difference between sexes
↓ Cirrhosis, CVD, HTN, T2DM, dyslipidemia↓ AST, ALT; ↑ AlbuminNot reported
Aneni et al[58], 2022Compared lean with overweight/obese NAFLD patients (n = 6513)Not reported< 45 yr, female↓ HTN, T2DM, hyperlipidemia, MetS, AD, ↑ risk of all-cause of mortality↓ FBG, total cholesterol, LDL, TG, AST, ALT; ↑ HDL↓ WC
Razouki et al[45], 2022Describe lean NAFLD (n = 1049)5.8%> 60 yr, male, Asian American↑ MetS, Inadequate physical activity↑ FBG, TG
Zhang et al[56], 2022Compare lean with obese NAFLD patients (n = 2708)34.1%> 40 yr↓ BP↓ HOMA-IR; ↑ HDL↓ WC
Ahmed et al[50], 2022Compared lean with overweight/obese NAFLD patients (n = 4834)8.6%Females, Asian and African American↓ HTN, T2DM, hyperlipidemiaNot reportedNot reported
Nabi et al[42], 2023Compared lean with non-lean NAFLD patients (n = 25753)5.3%< 40 yr, no difference between sexes↑ Risk of CVD, liver-related events, CKD and all-cause of death↑ AST↓ WC
De et al[52], 2023Compared lean with non-lean NAFLD patients (n = 1040)14.3%No difference between sexes and age↓ HTN, MetSNo significant difference↓ Central obesity
Wijarnpreecha et al[62], 2023Compared lean with non-lean NAFLD patients (n = 18594)11.4%Female, no difference between age↓ MetS, HTN, T2DM, CKD, cerebrovascular accident↓ AST, ALT, total cholesterol, LDL and TG, ↑ HDLNot reported
Biswas et al[59], 2023Compared lean with overweight/obese NAFLD patients (n = 1051)12.1%< 40 yr, males↓ HTNNot difference in ALT and AST↓ WC
Kawanaka et al[57], 2023Compared lean with non-lean NAFLD patients (n = 782)11%> 50 yr, no difference between sexes↓ HTN↓ AST, ALT, TG, HOMA-IR, HbA1CNot reported
Ishido et al[61], 2023Compared lean with non-lean NAFLD patients (n = 581)Not reportedMales, no difference between age↓ HTN, T2DM↓ AST, ALT, TG; ↑ HDL↓ BMI
Table 2 Non-invasive scores accuracy and histology characteristics in lean patients with non-alcoholic fatty liver disease
Ref.
Population
Results
Leung et al[73], 2017Histology (n = 307), lean vs obese NAFLD patientsLow NAS (steatosis and hepatocyte ballooning), low stiffness
Denkmayr et al[76], 2018Histology (n = 466), lean vs overweight/obese NAFLD patientsHigh lobular inflammation and hepatocellular ballooning
Li et al[82], 2019Scores (n = 898), lean vs overweight/obese NAFLD patientsWHR and FLI accurate in lean and obese patients, ZJU and HSI accurate in lean patients
Kim et al[75], 2019Histology (n = 542), lean vs obese NAFLD patientsLow grade steatosis and NAS, high stage of fibrosis
Fu et al[81], 2020Scores (n = 709), non-obese vs obese NAFLD patientsFIB-4, NFS, APRI, BARD score and AST-to-ALT ratio had similar accurate in obese and non-obese patients
Eren et al[79], 2022Scores (n = 560), lean vs overweight vs severely and morbid obese NAFLD patientsFIB-4 and NFS cannot discriminate advance fibrosis in lean patients
Park et al[80], 2023Scores (n = 1501), lean vs non-lean NAFLD patientsFIB-4 and NFS accurate in identify advance fibrosis in lean and non-lean NAFLD patients
Iwaki et al[74], 2022Histology (n = 223), lean vs obese NAFLD patientsLow grade lobular inflammation, steatosis
Rastogi et al[77], 2022Histology (n = 1273), lean vs overweight/obese NAFLD patientsHigh hepatocyte ballooning, early-stage fibrosis