The risk of cardiometabolic disorders in lean non-alcoholic fatty liver disease: A longitudinal study - PubMed (original) (raw)

The risk of cardiometabolic disorders in lean non-alcoholic fatty liver disease: A longitudinal study

Ehimen C Aneni et al. Am J Prev Cardiol. 2020.

Abstract

Background: Recent studies suggest that non-alcoholic fatty liver disease (NAFLD) in lean (BMI<25 ​kg/m2) individuals presents a distinct phenotype. We sought to determine the cardiometabolic consequences of lean NAFLD in a population cohort of relatively young asymptomatic individuals who participated in a voluntary routine health promotion evaluation in Brazil.

Methods: We analyzed data in our population collected from 2004 to 2016. Medical and demographic history, anthropometric measures, and fasting blood samples were obtained. Participants had ultrasonography to assess for fatty liver. We defined NAFLD as fatty liver in individuals scoring below 8 on the alcohol use disorders identification test (AUDIT). We included data from 9137 individuals who had complete data at baseline and at follow-up.

Results: The prevalence of lean NAFLD in our cohort was 3.8%. Over the median follow-up period of 2.4 years (range 0.5-9.9 years), lean individuals had 74% (HR: 1.74 (1.39-2.18)) and 67% (1.67 (1.29-2.15)) greater risk of developing elevated BP and elevated glucose, and nearly 3 times the risk of atherogenic dyslipidemia (HR: 2.98 (2.10-4.24)) compared to lean individuals without NAFLD. Lean NAFLD individuals also had higher risk of developing elevated glucose (HR: 1.37 (1.07-1.75)) and atherogenic dyslipidemia (1.46 (1.05-2.01)) compared to non-lean individuals without NAFLD. However, there was no significant difference in the risk of elevated BP, elevated glucose or atherogenic dyslipidemia between lean NAFLD and non-lean individuals with NAFLD in fully adjusted models.

Conclusion: Lean NAFLD is not metabolically benign. Further cardiovascular risk stratification and appropriate preventive measures should be considered in lean individuals who present with NAFLD.

Keywords: Cardiometabolic disease; Inflammation; Lean individuals; Non-alcoholic fatty liver disease; Triglycerides.

© 2020 The Authors.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: RDS has received honoraria related to consulting, speaking, and research activities from Ache, Amgen, AstraZeneca, Esperion, Kowa, Merck, Novo-Nordisk, Pfizer, PTC, and Sanofi/Regeneron. MSB has received honoraria related to consulting, speaking and research activities from Boston Scientific, Sanofi, GE HealthCare, EMS and Novo-Nordisk.

Figures

Fig. 1

Fig. 1

Participant selection into the study.

Fig. 2

Fig. 2

The incidence of cardiometabolic abnormalities (per 100 person-years) across BMI-NAFLD groups.

References

    1. Younossi Z., Anstee Q.M., Marietti M. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat. Rev. Gastroenterol. Hepatol. 2018;15:11–20. - PubMed
    1. Santos R.D., Valenti L., Romeo S. Does nonalcoholic fatty liver disease cause cardiovascular disease? Current knowledge and gaps. Atherosclerosis. 2019;282:110–120. - PubMed
    1. Targher G., Byrne C.D., Lonardo A., Zoppini G., Barbui C. Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: a meta-analysis. J. Hepatol. 2016;65:589–600. - PubMed
    1. Stahl E.P., Dhindsa D.S., Lee S.K., Sandesara P.B., Chalasani N.P., Sperling L.S. Nonalcoholic fatty liver disease and the heart: JACC state-of-the-art review. J. Am. Coll. Cardiol. 2019;73:948–963. - PubMed
    1. Cotter T.G., Rinella M. Nonalcoholic fatty liver disease 2020: the state of the disease. Gastroenterology. 2020;158(7):1851–1864. - PubMed

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