Circulating lipidomic alterations in obese and non‐obese subjects with non‐alcoholic fatty liver disease

Summary Background Non‐alcoholic fatty liver disease (NAFLD) affects obese and non‐obese individuals. However, mechanisms underlying non‐obese non‐alcoholic steatohepatitis (NASH) remain unclear. Aims To attempt to identify metabolic perturbations associated with non‐obese and obese NAFLD using a lipidomics approach. Methods A cross‐sectional analysis of 361 subjects with biopsy‐proven NAFLD (157 NAFL and 138 NASH) and healthy controls (n = 66) was performed. Individuals were categorised as obese or non‐obese based on the Asian cut‐off for body mass index. Circulating lipidomic profiling of sera was performed based on the histological severity of NAFLD. Circulating lipidomic alterations were validated with an independent validation set (154 NAFLD subjects [93 NAFL and 61 NASH] and 21 healthy controls). Results Saturated sphingomyelin (SM) species were significantly associated with visceral adiposity in non‐obese NAFLD (SM d38:0; P