Karn Wijarnpreecha, MD, MPH Lead researcher of the study Transplant Hepatology Fellow University of Michigan

Lean Patients with Nonalcoholic Fatty Liver Disease May Face Serious Health Consequences

MedicalResearch.com Interview with:

Karn Wijarnpreecha, MD, MPH Lead researcher of the study Transplant Hepatology Fellow University of Michigan

Dr. Wijarnpreecha

Karn Wijarnpreecha, MD, MPH
Lead researcher of the study
Transplant Hepatology Fellow
University of Michigan

MedicalResearch.com:  What is the background for this study? 

Response: Nonalcoholic fatty liver disease (NAFLD) can develop in persons who are not overweight or obese (“lean person with NAFLD”) and approximately 10-20% of NAFLD were lean. NAFLD is a multisystem diseases that associated with cardiovascular diseases, metabolic diseases (diabetes, hypertension, and dyslipidemia), or chronic kidney disease. Whether lean persons with NAFLD have lower prevalence of cirrhosis, CVD, CKD than non-lean persons with NAFLD remains inconclusive.

MedicalResearch.com:  What are the main findings?

Response: We conducted a retrospective cohort study with cross-sectional analysis to assess for prevalence of CVD, cirrhosis, metabolic diseases, and CKD among lean and non-lean persons with NAFLD. Patients with lean NAFLD were more often female and current smokers. They had lower levels of liver enzyme, and lipid profile with lower prevalence of metabolic diseases (diabetes, hypertension, dyslipidemia) compared with non-lean patients with NAFLD. After adjusting for confounders, we found that lean persons with NAFLD had significant higher prevalence of CVD than non-lean persons with NAFLD despite lower prevalence of metabolic diseases.

We found that persons with obesity class 2-3 had higher prevalence of cirrhosis than lean persons with NAFLD. In addition, There is no difference in prevalence of CKD between lean and non-lean NAFLD after adjusting for confounders.

MedicalResearch.com: What should readers take away from your report? 

Response: Physicians should pay close attention to lean persons with NAFLD since they may be facing serious health consequences such as cardiovascular disease similar to NAFLD patients who are overweight or living with obesity. Lean (or normal BMI) persons with NAFLD has high risk that associated with cardiovascular diseases than non-lean persons with NAFLD. Thus, NAFLD in lean individuals is NOT a benign disease.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Further longitudinal study should look at incidence of cardiovascular disease diseases and explore the potential explanation for the finding in high prevalence of cardiovascular diseases in lean individuals with NAFLD which could be from genetic, diet, exercise, or gut microbiome. Moreover, future studies should also look at incidence of cancer, liver cancer, cirrhosis, chronic kidney diseases, (not only focus on cardiovascular disease since NAFLD is a multisystem disease). Since this is the single-center study which may have some bias and not represent the large population. Multicenter study for lean persons with NAFLD is needed to help us better understand the natural history of NAFLD in lean individuals with multiple ethnicities.

Nothing to disclose 


DDW abstract 325 presented, May 22, 2022


Higher prevalence of cardiovascular disease among lean versus non-lean patients with nonalcoholic fatty liver disease despite lower prevalence of atherogenic risk and metabolic diseases

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Last Updated on May 19, 2022 by Marie Benz MD FAAD