ArticleAlimentary pharmacology & therapeutics2023
Higher mortality among lean patients with non-alcoholic fatty liver disease despite fewer metabolic comorbidities.
Article in Alimentary pharmacology & therapeutics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 5 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Global epidemiology of diabetes and prediabetes in lean or non-obese patients with NAFLD: a systematic review and meta-analysis.Annals of medicine · 2026Pooled it
- Meta-Analysis: Effects of Steatotic Liver Disease-Associated Genetic Risk Alleles on Longitudinal Outcomes.Alimentary pharmacology & therapeutics · 2025Pooled it
- Association of metabolic dysfunction-associated steatotic liver disease with bone health in adults: a systematic review and meta-analysis of observational studies.Frontiers in endocrinology · 2025Pooled it
- Liver and cardiovascular outcomes in lean non-alcoholic fatty liver disease: an updated systematic review and meta-analysis of about 1 million individuals.Hepatology international · 2024Pooled it
- EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Obesity facts · 2024Guideline
- Clinical outcomes of lean metabolic dysfunction-associated steatotic liver disease by phenotypic subtypes.Journal of gastroenterology · 2026Article
- PNPLA3 polymorphisms and risk of hepatic and extrahepatic outcomes in MASLD: A meta-analysis of observational studies.JHEP reports : innovation in hepatology · 2026Article
- Differential Effects of Cardiometabolic Risk Factors on All-Cause Mortality in United States Adults With Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Interrelationships Between Key Cardiovascular Risk Factors, Chronic Kidney Disease and Metabolic Dysfunction-Associated Steatotic Liver Disease.Current cardiology reports · 2026Review
- Article
- [Research progress on clinical characteristics and pathological mechanisms of lean metabolic-associated fatty liver disease].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Review
- Increased Mortality Among Lean Versus Non-Lean Adults With MASLD: A Multicenter Study.Journal of gastroenterology and hepatology · 2025Article
- Clinical characteristics and risk factors of metabolic dysfunction-associated steatotic liver disease in lean patients: results of the Polish Gallstone Surgery Registry.Clinical and experimental hepatology · 2025Article
- Effect of lean status on the mortality of patients with non-alcoholic fatty liver disease (NAFLD): A systematic review and meta-analysis.Pakistan journal of medical sciences · 2025Review
- Rurality and Neighborhood Socioeconomic Status are Associated With Overall and Cause-Specific Mortality and Hepatic Decompensation in Type 2 Diabetes.The American journal of medicine · 2025Article
- Physical activity, diet, and social determinants of health associate with health related quality of life and fibrosis in MASLD.Scientific reports · 2025Article
- Lean MASLD and IBD: Exploring the Intersection of Metabolic Dysfunction and the Gut-Liver Axis.Life (Basel, Switzerland) · 2025Article
- Long-term outcomes and risk modifiers of metabolic dysfunction-associated steatotic liver disease between lean and non-lean populations.Clinical and molecular hepatology · 2025Review
- The potential of insulin resistance indices to predict non-alcoholic fatty liver disease in patients with type 2 diabetes.BMC endocrine disorders · 2024Article
- Overview of Lean MASH and MASLD.Gastroenterology & hepatology · 2024Article
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsNon-alcoholic fatty liver disease (NAFLD) can develop in individuals who are not overweight. Whether lean persons with NAFLD have lower mortality and lower incidence of cirrhosis, cardiovascular diseases (CVD), diabetes mellitus (DM) and cancer than overweight/obese persons with NAFLD remains inconclusive. We compared mortality and incidence of cirrhosis, CVD, DM and cancer between lean versus non-lean persons with NAFLD.
methodsThis is a retrospective study of adults with NAFLD in a single centre from 2012 to 2021. Primary outcomes were mortality and new diagnosis of cirrhosis, CVD, DM and cancer. Outcomes were modelled using competing risk analysis and Cox proportional hazards regression analysis.
resultsA total of 18,594 and 13,420 patients were identified for cross-sectional and longitudinal analysis respectively: approximately 11% lean, 25% overweight, 28% class 1 obesity and 35% class 2-3 obesity. The median age was 51.0 years, 54.6% were women. The median follow-up was 49.3 months. Lean patients had lower prevalence of metabolic diseases at baseline and lower incidence of cirrhosis and DM than non-lean patients and no difference in CVD, any cancer or obesity-related cancer during follow-up. However, lean patients had significantly higher mortality with incidence per 1000 person-years of 16.67, 10.11, 7.37 and 8.99, respectively, in lean, overweight, obesity class 1 and obesity class 2-3 groups respectively.
conclusionsLean patients with NAFLD had higher mortality despite lower incidence of cirrhosis and DM, and similar incidence of CVD and cancer and merit similar if not more attention as non-lean patients with NAFLD.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.