Non-alcoholic fatty liver disease in non-obese individuals: the impact of metabolic health

Excessive calorie consumption relative to expenditure, intake of unhealthy diets, and lack of physical activity are globally 1 Inoue Y Qin B Poti J Sokol R Gordon-Larsen P Epidemiology of obesity in adults: latest trends. Curr Obes Rep. 2018; 7: 276-288 Crossref PubMed Scopus (69) Google Scholar fuelling an increase in the prevalence of poor metabolic health, even in individuals of normal weight. 2 Stefan N Schick F Haring HU Causes, characteristics, and consequences of metabolically unhealthy normal weight in humans. Cell Metab. 2017; 26: 292-300 Summary Full Text Full Text PDF PubMed Scopus (178) Google Scholar Consequently, this trend entails increased risk of various metabolic disorders, including non-alcoholic fatty liver disease (NAFLD), recently re-named metabolic associated fatty liver disease (MAFLD), which affects about a quarter of the global population. 3 Younossi Z Anstee QM Marietti M et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018; 15: 11-20 Crossref PubMed Scopus (1264) Google Scholar , 4 Eslam M Sanyal AJ George J MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease. Gastroenterology. 2020; (published online Feb 7.)DOI:10.1053/j.gastro.2019.11.312 Summary Full Text Full Text PDF PubMed Scopus (368) Google Scholar Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: a systematic review and meta-analysisOverall, around 40% of the global NAFLD population was classified as non-obese and almost a fifth was lean. Both non-obese and lean groups had substantial long-term liver and non-liver comorbidities. These findings suggest that obesity should not be the sole criterion for NAFLD screening. Moreover, clinical trials of treatments for NAFLD should include participants across all body-mass index ranges. Full-Text PDF