Metabolic status indicators and influencing factors in non-obese, non-centrally obese nonalcoholic fatty liver disease

Q: What are the key findings of this study?

Body mass index was the main influencing factor for NAFLD in non-obese, non-centrally obese adults, who also had higher metabolic abnormality rates.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Non-obese, non-centrally obese nonalcoholic fatty liver disease (NAFLD) (n=36). Intervention: Body mass index (BMI) in non-obese, non-centrally obese individuals vs. Non-obese, non-centrally obese healthy controls without NAFLD. Primary outcome: Presence of non-obese, non-centrally obese nonalcoholic fatty liver disease (NAFLD) (OR 1.879, 95% CI 1.233-2.863).

Q: What does this research mean for the field?

In non-obese, non-centrally obese individuals, BMI remains the primary influencing factor for NAFLD, and patients with NAFLD have significantly higher rates of metabolic abnormalities and insulin resistance. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate clinical parameters, metabolic status, and influencing factors in non-obese and non-centrally obese patients with nonalcoholic fatty liver disease.

Zhipeng Huang; Donghong Wei; Xueping Yu; Zicheng Huang; Yijie Lin; Wenji Lin; Zhijun Su; Jianjia Jiang

doi:10.1097/md.0000000000032922

February 10, 2023MedicineOpen Access

Metabolic status indicators and influencing factors in non-obese, non-centrally obese nonalcoholic fatty liver disease

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Key result

Higher BMI is linked to ~88% higher odds of NAFLD in non-obese adults.

OR 1.879
95% CI 1.233-2.863
n=36

Figures

Why the study?

Non-obese NAFLD is characterized by metabolic disorders and complications, but clinical, metabolic, and influencing factors in this specific population required an integrated description.

What are the metabolic status indicators and main influencing factors associated with NAFLD in non-obese, non-centrally obese adults (BMI < 28 kg/m2 and VAT < 100 cm2)?

Key Points

To evaluate clinical parameters, metabolic status, and influencing factors in non-obese and non-centrally obese patients with nonalcoholic fatty liver disease.
Cross-sectional evaluation of 36 participants with body mass index < 28 kg/m2 and visceral adipose tissue < 100 cm2, categorized into a control group (n = 17) and a nonalcoholic fatty liver disease group (n = 19).
Metabolic abnormality was defined by the presence of at least two criteria among impaired fasting glucose, elevated triglycerides, low high-density lipoprotein cholesterol, and elevated blood pressure.
Multivariable logistic regression was used to identify factors independently associated with nonalcoholic fatty liver disease.
The nonalcoholic fatty liver disease group exhibited a significantly higher rate of metabolic abnormalities than the control group (36.84% vs 5.88%, P = .044).
Participants with fatty liver had significantly higher fasting plasma glucose (median 5.81 vs 4.94 mmol/L, P = .009) and insulin resistance (HOMA-IR 2.71 ± 1.21 vs 1.69 ± 0.72, P = .005).
Body mass index was the primary independent factor linked to fatty liver disease (regression coefficient β = 0.631; odds ratio = 1.879; 95% CI, 1.233–2.863).

Study Design

Type

Cross-Sectional (n=36)

Multicenter

No

Structured PICO

What are the metabolic status indicators and main influencing factors associated with NAFLD in non-obese, non-centrally obese adults (BMI < 28 kg/m2 and VAT < 100 cm2)?

P

Population

36 non-obese, non-centrally obese Chinese adults (BMI < 28 kg/m2 and visceral adipose tissue < 100 cm2; 19 with NAFLD and 17 healthy controls) evaluated in a single-center cross-sectional study.

E

Exposure

Non-obese, non-centrally obese nonalcoholic fatty liver disease (NAFLD) status and metabolic/anthropometric risk factors (including BMI, VAT, insulin resistance, and fasting plasma glucose)

C

Comparator

Non-obese, non-centrally obese healthy controls without NAFLD (n=17)

O

Outcome

Presence of non-obese, non-centrally obese NAFLD (diagnosed via liver ultrasonography) and metabolic abnormality rate (defined as >2 abnormal metabolic indices among fasting plasma glucose ≥5.6 mmol/L, triglycerides ≥1.7 mmol/L, HDL-C <1.03 mmol/L in males or <1.29 mmol/L in females, and blood pressure ≥130/85 mm Hg)surrogate

Main Result

Odds Ratio: 1.879 (95% CI 1.233–2.863)

Even among strictly defined non-obese and non-centrally obese individuals (BMI < 28 kg/m2 and VAT < 100 cm2), NAFLD is associated with higher insulin resistance, fasting plasma glucose, and metabolic abnormality rates, with BMI remaining the primary influencing factor.

Limitations

Relatively small sample size of patients with non-obese and non-centrally obese NAFLD, partly due to the COVID-19 pandemic affecting data collection
Diagnosis of NAFLD was based on ultrasonography rather than pathological biopsy or nuclear magnetic resonance evidence
Relatively small sample size (n=36), partly because the COVID-19 pandemic affected data collection
NAFLD diagnosis was based on liver ultrasonography and not supported by pathological biopsy or nuclear magnetic resonance evidence
Single-center cross-sectional design

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Implication

BMI identifies NAFLD risk in non-obese adults despite normal VAT; leaves open causal mechanisms and need for prospective validation.

Abstract

Non-obese nonalcoholic fatty liver disease (NAFLD) is characterized by metabolic disorders and related complications. This study aimed to provide an integrated description of clinical, metabolic, and influencing factors for a specific category of patients with non-obese NAFLD. A total of 36 participants with body mass index (BMI) < 28 kg/m2 and visceral adipose tissue < 100 cm2 were classified into 2 groups: the non-obese, non-centrally obese control group (n = 17) and non-obese, non-centrally obese NAFLD group (n = 19). Hypertriglyceridemia, impaired fasting glucose, low high-density lipoprotein cholesterol levels, and hypertension were used to determine whether participants were metabolically abnormal. Based on a logistic regression model, odds ratios for the factors influencing NAFLD with 95% confidence intervals were calculated. Insulin resistance (IR) and fasting plasma glucose (FPG) levels were higher in the NAFLD group than in the control group (P < .05). The NAFLD group had a higher metabolic abnormality rate than the healthy control group (36.84% vs 5.88%, P = .044). Correlation analysis showed that IR was positively correlated with FPG and triglyceride (P < .05). BMI was the main influencing factor of NAFLD (regression coefficient β = 0.631; odds ratio = 1.879; 95% confidence interval, 1.233-2.863). NAFLD patients with a BMI < 28 kg/m2 and visceral adipose tissue < 100 cm2 had more apparent IR, higher FPG, and a higher metabolic abnormality rate. IR may be affected by FPG and triglyceride. Even in non-obese and non-centrally obese individuals, BMI should be controlled to avoid NAFLD.

Discussion

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Cite This Study

Huang et al. (2023) conducted a cross-sectional in Non-obese, non-centrally obese nonalcoholic fatty liver disease (NAFLD) (n=36). Body mass index (BMI) in non-obese, non-centrally obese individuals vs. Non-obese, non-centrally obese healthy controls without NAFLD was evaluated on Presence of non-obese, non-centrally obese nonalcoholic fatty liver disease (NAFLD) (OR 1.879, 95% CI 1.233-2.863). Body mass index was the main influencing factor for NAFLD in non-obese, non-centrally obese adults, who also had higher metabolic abnormality rates.

synapsesocial.com/papers/6a8c0b75d5d4290f64f496ae https://doi.org/10.1097/md.0000000000032922

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Metabolic status indicators and influencing factors in non-obese, non-centrally obese nonalcoholic fatty liver disease

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Metabolic status indicators and influencing factors in non-obese, non-centrally obese nonalcoholic fatty liver disease

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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