Systematic review with meta-analysis: risk factors for non-alcoholic fatty liver disease suggest a shared altered metabolic and cardiovascular profile between lean and obese patients

SOOKOIAN, S.; PIROLA, C. J.

ALIMENTARY PHARMACOLOGY & THERAPEUTICS.

WILEY-BLACKWELL PUBLISHING, INC

Año: 2017 vol. 46 p. 85 - 95

0269-2813

Background: The pathogenesis of non-alcoholic fatty liver disease (NAFLD) is closelyassociated with the co-occurrence of multiple pathological conditions characterising the metabolic syndrome (MetS), obesity in particular. However, NAFLD also develops in lean subjects, whose risk factors remain poorly defined.Methods: We performed a meta-analysis of 15 studies, along with the data pertaining to our own population (n=336 patients). Data from lean (n=1966) and obese (n=5938) patients with NAFLD were analysed; lean (n=9946) and obese (n=6027) subjects without NAFLD served as controls.Results: Relative to the lean non-NAFLD controls, lean patients with NAFLD wereolder (3.790.72 years, P=1.369106) and exhibited the entire spectrum of theMetS risk factors. Specifically, they had a significant (P=1010) increase in plasma glucose levels (6.441.12 mg/dL) and HOMA-IR (0.520.094-unit increment), blood lipids (triglycerides: 48.373.6, P=1010 and total cholesterol: 7.043.8, mg/dL, P=4.29107), systolic (5.640.7) and diastolic (3.370.9) blood pressure (mm Hg), P=10-10, and waist circumference (5.880.4 cm, P=1010); values denote difference in meansSE. Nevertheless, the overall alterations in the obese group were much more severe when compared to lean subjects, regardless of the presence of NAFLD.Meta-regression suggested that NAFLD is a modifier of the level of blood lipids.Conclusion: Lean and obese patients with NAFLD share a common altered metabolicand cardiovascular profile. The former, while having normal body weight, showed excess of abdominal adipose tissue as well as other MetS features.