Caucasian lean subjects with non-alcoholic fatty liver disease share long-term prognosis of non-lean: time for reappraisal of BMI-driven approach?
OBJECTIVE: The full phenotypic expression of non-alcoholic fatty liver disease (NAFLD) in lean subjects is incompletely characterised. We aimed to investigate prevalence, characteristics and long-term prognosis of Caucasian lean subjects with NAFLD. DESIGN: The study cohort comprises 1339 biopsy-pro...
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| Veröffentlicht in: | GUT 2021-02, Vol.71 (2), p.382-390 |
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| creator | Younes, Ramy Govaere, Olivier Petta, Salvatore Miele, Luca Tiniakos, Dina Burt, Alastair David, Ezio Vecchio, Fabio Maria Maggioni, Marco Cabibi, Daniela McLeod, Duncan Pareja, Maria Jesus Fracanzani, Anna Ludovica Aller, Rocio Rosso, Chiara Ampuero, Javier Gallego-Duran, Rocio Armandi, Angelo Caviglia, Gian Paolo Zaki, Marco Y.W Liguori, Antonio Francione, Paolo Pennisi, Grazia Grieco, Antonio Birolo, Giovanni Fariselli, Piero Eslam, Mohammed Valenti, Luca George, Jacob Romero-Gomez, Manuel Anstee, Quentin Mark Bugianesi, Elisabetta |
| description | OBJECTIVE: The full phenotypic expression of non-alcoholic fatty liver disease (NAFLD) in lean subjects is incompletely characterised. We aimed to investigate prevalence, characteristics and long-term prognosis of Caucasian lean subjects with NAFLD. DESIGN: The study cohort comprises 1339 biopsy-proven NAFLD subjects from four countries (Italy, UK, Spain and Australia), stratified into lean and non-lean (body mass index (BMI) |
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| fullrecord | <record><control><sourceid>kuleuven</sourceid><recordid>TN_cdi_kuleuven_dspace_20_500_12942_709031</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>20_500_12942_709031</sourcerecordid><originalsourceid>FETCH-kuleuven_dspace_20_500_12942_7090313</originalsourceid><addsrcrecordid>eNqVjE1OwzAQhb0AqQV6h1kjGU2SVmnYIFGBYMGOvTU4k8bFtSOPw881ODEJ4gCweU96-t53opaIRa039bpZqDORAyJut02xVF87Gi2JowCep5Dx5cA2C7y73EOIQZO3sY_eWego50_w7o0TtE6YhEF6Sgw-hr3OnI4wpLgPUZxA7H7us_UasjsydDFBYhqGRE7Iz8Tt06Nu02QMMO-RbH9zoU478sKr3z5Xl_d3z7sH_Tp6HifUtDKQZVOi2SCaomzWpamxwaqo_glf_Rk2-SNX30dkZ_I</addsrcrecordid><sourcetype>Institutional Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Caucasian lean subjects with non-alcoholic fatty liver disease share long-term prognosis of non-lean: time for reappraisal of BMI-driven approach?</title><source>Lirias (KU Leuven Association)</source><source>PubMed Central</source><creator>Younes, Ramy ; Govaere, Olivier ; Petta, Salvatore ; Miele, Luca ; Tiniakos, Dina ; Burt, Alastair ; David, Ezio ; Vecchio, Fabio Maria ; Maggioni, Marco ; Cabibi, Daniela ; McLeod, Duncan ; Pareja, Maria Jesus ; Fracanzani, Anna Ludovica ; Aller, Rocio ; Rosso, Chiara ; Ampuero, Javier ; Gallego-Duran, Rocio ; Armandi, Angelo ; Caviglia, Gian Paolo ; Zaki, Marco Y.W ; Liguori, Antonio ; Francione, Paolo ; Pennisi, Grazia ; Grieco, Antonio ; Birolo, Giovanni ; Fariselli, Piero ; Eslam, Mohammed ; Valenti, Luca ; George, Jacob ; Romero-Gomez, Manuel ; Anstee, Quentin Mark ; Bugianesi, Elisabetta</creator><creatorcontrib>Younes, Ramy ; Govaere, Olivier ; Petta, Salvatore ; Miele, Luca ; Tiniakos, Dina ; Burt, Alastair ; David, Ezio ; Vecchio, Fabio Maria ; Maggioni, Marco ; Cabibi, Daniela ; McLeod, Duncan ; Pareja, Maria Jesus ; Fracanzani, Anna Ludovica ; Aller, Rocio ; Rosso, Chiara ; Ampuero, Javier ; Gallego-Duran, Rocio ; Armandi, Angelo ; Caviglia, Gian Paolo ; Zaki, Marco Y.W ; Liguori, Antonio ; Francione, Paolo ; Pennisi, Grazia ; Grieco, Antonio ; Birolo, Giovanni ; Fariselli, Piero ; Eslam, Mohammed ; Valenti, Luca ; George, Jacob ; Romero-Gomez, Manuel ; Anstee, Quentin Mark ; Bugianesi, Elisabetta</creatorcontrib><description>OBJECTIVE: The full phenotypic expression of non-alcoholic fatty liver disease (NAFLD) in lean subjects is incompletely characterised. We aimed to investigate prevalence, characteristics and long-term prognosis of Caucasian lean subjects with NAFLD. DESIGN: The study cohort comprises 1339 biopsy-proven NAFLD subjects from four countries (Italy, UK, Spain and Australia), stratified into lean and non-lean (body mass index (BMI) </≥25 kg/m2). Liver/non-liver-related events and survival free of transplantation were recorded during the follow-up, compared by log-rank testing and reported by adjusted HR. RESULTS: Lean patients represented 14.4% of the cohort and were predominantly of Italian origin (89%). They had less severe histological disease (lean vs non-lean: non-alcoholic steatohepatitis 54.1% vs 71.2% p<0.001; advanced fibrosis 10.1% vs 25.2% p<0.001), lower prevalence of diabetes (9.2% vs 31.4%, p<0.001), but no significant differences in the prevalence of the PNPLA3 I148M variant (p=0.57). During a median follow-up of 94 months (>10 483 person-years), 4.7% of lean vs 7.7% of non-lean patients reported liver-related events (p=0.37). No difference in survival was observed compared with non-lean NAFLD (p=0.069). CONCLUSIONS: Caucasian lean subjects with NAFLD may progress to advanced liver disease, develop metabolic comorbidities and experience cardiovascular disease (CVD) as well as liver-related mortality, independent of longitudinal progression to obesity and PNPLA3 genotype. These patients represent one end of a wide spectrum of phenotypic expression of NAFLD where the disease manifests at lower overall BMI thresholds. LAY SUMMARY: NAFLD may affect and progress in both obese and lean individuals. Lean subjects are predominantly males, have a younger age at diagnosis and are more prevalent in some geographic areas. During the follow-up, lean subjects can develop hepatic and extrahepatic disease, including metabolic comorbidities, in the absence of weight gain. These patients represent one end of a wide spectrum of phenotypic expression of NAFLD.</description><identifier>ISSN: 0017-5749</identifier><language>eng</language><publisher>BMJ PUBLISHING GROUP</publisher><ispartof>GUT, 2021-02, Vol.71 (2), p.382-390</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,315,780,784,27860</link.rule.ids></links><search><creatorcontrib>Younes, Ramy</creatorcontrib><creatorcontrib>Govaere, Olivier</creatorcontrib><creatorcontrib>Petta, Salvatore</creatorcontrib><creatorcontrib>Miele, Luca</creatorcontrib><creatorcontrib>Tiniakos, Dina</creatorcontrib><creatorcontrib>Burt, Alastair</creatorcontrib><creatorcontrib>David, Ezio</creatorcontrib><creatorcontrib>Vecchio, Fabio Maria</creatorcontrib><creatorcontrib>Maggioni, Marco</creatorcontrib><creatorcontrib>Cabibi, Daniela</creatorcontrib><creatorcontrib>McLeod, Duncan</creatorcontrib><creatorcontrib>Pareja, Maria Jesus</creatorcontrib><creatorcontrib>Fracanzani, Anna Ludovica</creatorcontrib><creatorcontrib>Aller, Rocio</creatorcontrib><creatorcontrib>Rosso, Chiara</creatorcontrib><creatorcontrib>Ampuero, Javier</creatorcontrib><creatorcontrib>Gallego-Duran, Rocio</creatorcontrib><creatorcontrib>Armandi, Angelo</creatorcontrib><creatorcontrib>Caviglia, Gian Paolo</creatorcontrib><creatorcontrib>Zaki, Marco Y.W</creatorcontrib><creatorcontrib>Liguori, Antonio</creatorcontrib><creatorcontrib>Francione, Paolo</creatorcontrib><creatorcontrib>Pennisi, Grazia</creatorcontrib><creatorcontrib>Grieco, Antonio</creatorcontrib><creatorcontrib>Birolo, Giovanni</creatorcontrib><creatorcontrib>Fariselli, Piero</creatorcontrib><creatorcontrib>Eslam, Mohammed</creatorcontrib><creatorcontrib>Valenti, Luca</creatorcontrib><creatorcontrib>George, Jacob</creatorcontrib><creatorcontrib>Romero-Gomez, Manuel</creatorcontrib><creatorcontrib>Anstee, Quentin Mark</creatorcontrib><creatorcontrib>Bugianesi, Elisabetta</creatorcontrib><title>Caucasian lean subjects with non-alcoholic fatty liver disease share long-term prognosis of non-lean: time for reappraisal of BMI-driven approach?</title><title>GUT</title><description>OBJECTIVE: The full phenotypic expression of non-alcoholic fatty liver disease (NAFLD) in lean subjects is incompletely characterised. We aimed to investigate prevalence, characteristics and long-term prognosis of Caucasian lean subjects with NAFLD. DESIGN: The study cohort comprises 1339 biopsy-proven NAFLD subjects from four countries (Italy, UK, Spain and Australia), stratified into lean and non-lean (body mass index (BMI) </≥25 kg/m2). Liver/non-liver-related events and survival free of transplantation were recorded during the follow-up, compared by log-rank testing and reported by adjusted HR. RESULTS: Lean patients represented 14.4% of the cohort and were predominantly of Italian origin (89%). They had less severe histological disease (lean vs non-lean: non-alcoholic steatohepatitis 54.1% vs 71.2% p<0.001; advanced fibrosis 10.1% vs 25.2% p<0.001), lower prevalence of diabetes (9.2% vs 31.4%, p<0.001), but no significant differences in the prevalence of the PNPLA3 I148M variant (p=0.57). During a median follow-up of 94 months (>10 483 person-years), 4.7% of lean vs 7.7% of non-lean patients reported liver-related events (p=0.37). No difference in survival was observed compared with non-lean NAFLD (p=0.069). CONCLUSIONS: Caucasian lean subjects with NAFLD may progress to advanced liver disease, develop metabolic comorbidities and experience cardiovascular disease (CVD) as well as liver-related mortality, independent of longitudinal progression to obesity and PNPLA3 genotype. These patients represent one end of a wide spectrum of phenotypic expression of NAFLD where the disease manifests at lower overall BMI thresholds. LAY SUMMARY: NAFLD may affect and progress in both obese and lean individuals. Lean subjects are predominantly males, have a younger age at diagnosis and are more prevalent in some geographic areas. During the follow-up, lean subjects can develop hepatic and extrahepatic disease, including metabolic comorbidities, in the absence of weight gain. These patients represent one end of a wide spectrum of phenotypic expression of NAFLD.</description><issn>0017-5749</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>FZOIL</sourceid><recordid>eNqVjE1OwzAQhb0AqQV6h1kjGU2SVmnYIFGBYMGOvTU4k8bFtSOPw881ODEJ4gCweU96-t53opaIRa039bpZqDORAyJut02xVF87Gi2JowCep5Dx5cA2C7y73EOIQZO3sY_eWego50_w7o0TtE6YhEF6Sgw-hr3OnI4wpLgPUZxA7H7us_UasjsydDFBYhqGRE7Iz8Tt06Nu02QMMO-RbH9zoU478sKr3z5Xl_d3z7sH_Tp6HifUtDKQZVOi2SCaomzWpamxwaqo_glf_Rk2-SNX30dkZ_I</recordid><startdate>20210204</startdate><enddate>20210204</enddate><creator>Younes, Ramy</creator><creator>Govaere, Olivier</creator><creator>Petta, Salvatore</creator><creator>Miele, Luca</creator><creator>Tiniakos, Dina</creator><creator>Burt, Alastair</creator><creator>David, Ezio</creator><creator>Vecchio, Fabio Maria</creator><creator>Maggioni, Marco</creator><creator>Cabibi, Daniela</creator><creator>McLeod, Duncan</creator><creator>Pareja, Maria Jesus</creator><creator>Fracanzani, Anna Ludovica</creator><creator>Aller, Rocio</creator><creator>Rosso, Chiara</creator><creator>Ampuero, Javier</creator><creator>Gallego-Duran, Rocio</creator><creator>Armandi, Angelo</creator><creator>Caviglia, Gian Paolo</creator><creator>Zaki, Marco Y.W</creator><creator>Liguori, Antonio</creator><creator>Francione, Paolo</creator><creator>Pennisi, Grazia</creator><creator>Grieco, Antonio</creator><creator>Birolo, Giovanni</creator><creator>Fariselli, Piero</creator><creator>Eslam, Mohammed</creator><creator>Valenti, Luca</creator><creator>George, Jacob</creator><creator>Romero-Gomez, Manuel</creator><creator>Anstee, Quentin Mark</creator><creator>Bugianesi, Elisabetta</creator><general>BMJ PUBLISHING GROUP</general><scope>FZOIL</scope></search><sort><creationdate>20210204</creationdate><title>Caucasian lean subjects with non-alcoholic fatty liver disease share long-term prognosis of non-lean: time for reappraisal of BMI-driven approach?</title><author>Younes, Ramy ; Govaere, Olivier ; Petta, Salvatore ; Miele, Luca ; Tiniakos, Dina ; Burt, Alastair ; David, Ezio ; Vecchio, Fabio Maria ; Maggioni, Marco ; Cabibi, Daniela ; McLeod, Duncan ; Pareja, Maria Jesus ; Fracanzani, Anna Ludovica ; Aller, Rocio ; Rosso, Chiara ; Ampuero, Javier ; Gallego-Duran, Rocio ; Armandi, Angelo ; Caviglia, Gian Paolo ; Zaki, Marco Y.W ; Liguori, Antonio ; Francione, Paolo ; Pennisi, Grazia ; Grieco, Antonio ; Birolo, Giovanni ; Fariselli, Piero ; Eslam, Mohammed ; Valenti, Luca ; George, Jacob ; Romero-Gomez, Manuel ; Anstee, Quentin Mark ; Bugianesi, Elisabetta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-kuleuven_dspace_20_500_12942_7090313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Younes, Ramy</creatorcontrib><creatorcontrib>Govaere, Olivier</creatorcontrib><creatorcontrib>Petta, Salvatore</creatorcontrib><creatorcontrib>Miele, Luca</creatorcontrib><creatorcontrib>Tiniakos, Dina</creatorcontrib><creatorcontrib>Burt, Alastair</creatorcontrib><creatorcontrib>David, Ezio</creatorcontrib><creatorcontrib>Vecchio, Fabio Maria</creatorcontrib><creatorcontrib>Maggioni, Marco</creatorcontrib><creatorcontrib>Cabibi, Daniela</creatorcontrib><creatorcontrib>McLeod, Duncan</creatorcontrib><creatorcontrib>Pareja, Maria Jesus</creatorcontrib><creatorcontrib>Fracanzani, Anna Ludovica</creatorcontrib><creatorcontrib>Aller, Rocio</creatorcontrib><creatorcontrib>Rosso, Chiara</creatorcontrib><creatorcontrib>Ampuero, Javier</creatorcontrib><creatorcontrib>Gallego-Duran, Rocio</creatorcontrib><creatorcontrib>Armandi, Angelo</creatorcontrib><creatorcontrib>Caviglia, Gian Paolo</creatorcontrib><creatorcontrib>Zaki, Marco Y.W</creatorcontrib><creatorcontrib>Liguori, Antonio</creatorcontrib><creatorcontrib>Francione, Paolo</creatorcontrib><creatorcontrib>Pennisi, Grazia</creatorcontrib><creatorcontrib>Grieco, Antonio</creatorcontrib><creatorcontrib>Birolo, Giovanni</creatorcontrib><creatorcontrib>Fariselli, Piero</creatorcontrib><creatorcontrib>Eslam, Mohammed</creatorcontrib><creatorcontrib>Valenti, Luca</creatorcontrib><creatorcontrib>George, Jacob</creatorcontrib><creatorcontrib>Romero-Gomez, Manuel</creatorcontrib><creatorcontrib>Anstee, Quentin Mark</creatorcontrib><creatorcontrib>Bugianesi, Elisabetta</creatorcontrib><collection>Lirias (KU Leuven Association)</collection><jtitle>GUT</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Younes, Ramy</au><au>Govaere, Olivier</au><au>Petta, Salvatore</au><au>Miele, Luca</au><au>Tiniakos, Dina</au><au>Burt, Alastair</au><au>David, Ezio</au><au>Vecchio, Fabio Maria</au><au>Maggioni, Marco</au><au>Cabibi, Daniela</au><au>McLeod, Duncan</au><au>Pareja, Maria Jesus</au><au>Fracanzani, Anna Ludovica</au><au>Aller, Rocio</au><au>Rosso, Chiara</au><au>Ampuero, Javier</au><au>Gallego-Duran, Rocio</au><au>Armandi, Angelo</au><au>Caviglia, Gian Paolo</au><au>Zaki, Marco Y.W</au><au>Liguori, Antonio</au><au>Francione, Paolo</au><au>Pennisi, Grazia</au><au>Grieco, Antonio</au><au>Birolo, Giovanni</au><au>Fariselli, Piero</au><au>Eslam, Mohammed</au><au>Valenti, Luca</au><au>George, Jacob</au><au>Romero-Gomez, Manuel</au><au>Anstee, Quentin Mark</au><au>Bugianesi, Elisabetta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Caucasian lean subjects with non-alcoholic fatty liver disease share long-term prognosis of non-lean: time for reappraisal of BMI-driven approach?</atitle><jtitle>GUT</jtitle><date>2021-02-04</date><risdate>2021</risdate><volume>71</volume><issue>2</issue><spage>382</spage><epage>390</epage><pages>382-390</pages><issn>0017-5749</issn><abstract>OBJECTIVE: The full phenotypic expression of non-alcoholic fatty liver disease (NAFLD) in lean subjects is incompletely characterised. We aimed to investigate prevalence, characteristics and long-term prognosis of Caucasian lean subjects with NAFLD. DESIGN: The study cohort comprises 1339 biopsy-proven NAFLD subjects from four countries (Italy, UK, Spain and Australia), stratified into lean and non-lean (body mass index (BMI) </≥25 kg/m2). Liver/non-liver-related events and survival free of transplantation were recorded during the follow-up, compared by log-rank testing and reported by adjusted HR. RESULTS: Lean patients represented 14.4% of the cohort and were predominantly of Italian origin (89%). They had less severe histological disease (lean vs non-lean: non-alcoholic steatohepatitis 54.1% vs 71.2% p<0.001; advanced fibrosis 10.1% vs 25.2% p<0.001), lower prevalence of diabetes (9.2% vs 31.4%, p<0.001), but no significant differences in the prevalence of the PNPLA3 I148M variant (p=0.57). During a median follow-up of 94 months (>10 483 person-years), 4.7% of lean vs 7.7% of non-lean patients reported liver-related events (p=0.37). No difference in survival was observed compared with non-lean NAFLD (p=0.069). CONCLUSIONS: Caucasian lean subjects with NAFLD may progress to advanced liver disease, develop metabolic comorbidities and experience cardiovascular disease (CVD) as well as liver-related mortality, independent of longitudinal progression to obesity and PNPLA3 genotype. These patients represent one end of a wide spectrum of phenotypic expression of NAFLD where the disease manifests at lower overall BMI thresholds. LAY SUMMARY: NAFLD may affect and progress in both obese and lean individuals. Lean subjects are predominantly males, have a younger age at diagnosis and are more prevalent in some geographic areas. During the follow-up, lean subjects can develop hepatic and extrahepatic disease, including metabolic comorbidities, in the absence of weight gain. These patients represent one end of a wide spectrum of phenotypic expression of NAFLD.</abstract><pub>BMJ PUBLISHING GROUP</pub></addata></record> |
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| source | Lirias (KU Leuven Association); PubMed Central |
| title | Caucasian lean subjects with non-alcoholic fatty liver disease share long-term prognosis of non-lean: time for reappraisal of BMI-driven approach? |
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