ArticleLiver international : official journal of the International Association for the Study of the Liver2025
Clinical and Genetic Predictors of Non-Alcoholic Steatotic Liver Disease and Fibrosis in Lean Individuals.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Lower Allele Frequency ofJCO global oncology · 2026Article
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12 authors.
Funding
Abstract
BACKGROUND &
aimsSteatotic liver disease (SLD) is characterised by liver fat accumulation exceeding 5%. Lean body weight (BMI ≤ 25 kg/m
methodsWe used International Classification of Disease codes, radiology and pathology review to identify 177 lean non-alcoholic SLD cases (47 cryptogenic, 130 MASLD), 677 matched lean controls, and 3090 overweight/obese SLD cases in the Mayo Clinic Biobank and Tapestry databases. We performed case-control and cross-sectional comparisons of clinical and genetic factors between these groups, using univariable and multivariable analyses.
resultsLean individuals with non-alcoholic SLD exhibited metabolic and genetic profiles that were intermediate between those of lean controls without SLD and overweight/obese SLD individuals, including intermediate rates of diabetes, hypertension, hyperlipidaemia and of homozygosity for the risk allele of PNPLA3. Multivariable analysis indicated that diabetes was an independent predictor of SLD among lean individuals. Among lean individuals with non-alcoholic SLD, those with metabolic-associated SLD (MASLD), as compared to those with cryptogenic SLD (without metabolic risk factor), were more likely to be homozygous for risk alleles in GCKR. The Fib-4 score, a tool for screening advanced liver disease in SLD, accurately predicted advanced fibrosis among lean individuals with non-alcoholic SLD.
conclusionDiabetes serves as a primary predictor of non-alcoholic SLD in lean individuals. These results support the recommendation to screen for SLD in patients with diabetes, regardless of BMI. The GCKR risk allele is associated with MASLD in lean individuals, and the risk factors for cryptogenic SLD remain unclear.
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