Cargando…

Lean Patients with Non-Alcoholic Fatty Liver Disease Have a Severe Histological Phenotype Similar to Obese Patients

A small proportion of lean patients develop non-alcoholic fatty liver disease (NAFLD). We aimed to report the histological picture of lean NAFLD in comparison to overweight and obese NAFLD patients. Biopsy and clinical data from 466 patients diagnosed with NAFLD were stratified to groups according t...

Descripción completa

Detalles Bibliográficos
Autores principales: Denkmayr, Lukas, Feldman, Alexandra, Stechemesser, Lars, Eder, Sebastian K., Zandanell, Stephan, Schranz, Michael, Strasser, Michael, Huber-Schönauer, Ursula, Buch, Stephan, Hampe, Jochen, Paulweber, Bernhard, Lackner, Carolin, Haufe, Heike, Sotlar, Karl, Datz, Christian, Aigner, Elmar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306845/
https://www.ncbi.nlm.nih.gov/pubmed/30562976
http://dx.doi.org/10.3390/jcm7120562
_version_ 1783382870496116736
author Denkmayr, Lukas
Feldman, Alexandra
Stechemesser, Lars
Eder, Sebastian K.
Zandanell, Stephan
Schranz, Michael
Strasser, Michael
Huber-Schönauer, Ursula
Buch, Stephan
Hampe, Jochen
Paulweber, Bernhard
Lackner, Carolin
Haufe, Heike
Sotlar, Karl
Datz, Christian
Aigner, Elmar
author_facet Denkmayr, Lukas
Feldman, Alexandra
Stechemesser, Lars
Eder, Sebastian K.
Zandanell, Stephan
Schranz, Michael
Strasser, Michael
Huber-Schönauer, Ursula
Buch, Stephan
Hampe, Jochen
Paulweber, Bernhard
Lackner, Carolin
Haufe, Heike
Sotlar, Karl
Datz, Christian
Aigner, Elmar
author_sort Denkmayr, Lukas
collection PubMed
description A small proportion of lean patients develop non-alcoholic fatty liver disease (NAFLD). We aimed to report the histological picture of lean NAFLD in comparison to overweight and obese NAFLD patients. Biopsy and clinical data from 466 patients diagnosed with NAFLD were stratified to groups according to body mass index (BMI): lean (BMI ≤ 25.0 kg/m², n confirmed to be appropriate = 74), overweight (BMI > 25.0 ≤ 30.0 kg/m², n = 242) and obese (BMI > 30.0 kg/m², n = 150). Lean NAFLD patients had a higher rate of lobular inflammation compared to overweight patients (12/74; 16.2% vs. 19/242; 7.9%; p = 0.011) but were similar to obese patients (25/150; 16.7%). Ballooning was observed in fewer overweight patients (38/242; 15.7%) compared to lean (19/74; 25.7%; p = 0.014) and obese patients (38/150; 25.3%; p = 0.006). Overweight patients had a lower rate of portal and periportal fibrosis (32/242; 13.2%) than lean (19/74; 25.7%; p = 0.019) and obese patients (37/150; 24.7%; p = 0.016). The rate of cirrhosis was higher in lean patients (6/74; 8.1%) compared to overweight (4/242; 1.7%; p = 0.010) and obese patients (3/150; 2.0% p = 0.027). In total, 60/466; 12.9% patients were diagnosed with non-alcoholic steatohepatitis (NASH). The rate of NASH was higher in lean (14/74; 18.9% p = 0.01) and obese (26/150; 17.3%; p = 0.007) compared to overweight patients (20/242; 8.3%)). Among lean patients, fasting glucose, INR and use of thyroid hormone replacement therapy were independent predictors of NASH in a multivariate model. Lean NAFLD patients were characterized by a severe histological picture similar to obese patients but are more progressed compared to overweight patients. Fasting glucose, international normalized ratio (INR) and the use of thyroid hormone replacement may serve as indicators for NASH in lean patients.
format Online
Article
Text
id pubmed-6306845
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-63068452019-01-02 Lean Patients with Non-Alcoholic Fatty Liver Disease Have a Severe Histological Phenotype Similar to Obese Patients Denkmayr, Lukas Feldman, Alexandra Stechemesser, Lars Eder, Sebastian K. Zandanell, Stephan Schranz, Michael Strasser, Michael Huber-Schönauer, Ursula Buch, Stephan Hampe, Jochen Paulweber, Bernhard Lackner, Carolin Haufe, Heike Sotlar, Karl Datz, Christian Aigner, Elmar J Clin Med Article A small proportion of lean patients develop non-alcoholic fatty liver disease (NAFLD). We aimed to report the histological picture of lean NAFLD in comparison to overweight and obese NAFLD patients. Biopsy and clinical data from 466 patients diagnosed with NAFLD were stratified to groups according to body mass index (BMI): lean (BMI ≤ 25.0 kg/m², n confirmed to be appropriate = 74), overweight (BMI > 25.0 ≤ 30.0 kg/m², n = 242) and obese (BMI > 30.0 kg/m², n = 150). Lean NAFLD patients had a higher rate of lobular inflammation compared to overweight patients (12/74; 16.2% vs. 19/242; 7.9%; p = 0.011) but were similar to obese patients (25/150; 16.7%). Ballooning was observed in fewer overweight patients (38/242; 15.7%) compared to lean (19/74; 25.7%; p = 0.014) and obese patients (38/150; 25.3%; p = 0.006). Overweight patients had a lower rate of portal and periportal fibrosis (32/242; 13.2%) than lean (19/74; 25.7%; p = 0.019) and obese patients (37/150; 24.7%; p = 0.016). The rate of cirrhosis was higher in lean patients (6/74; 8.1%) compared to overweight (4/242; 1.7%; p = 0.010) and obese patients (3/150; 2.0% p = 0.027). In total, 60/466; 12.9% patients were diagnosed with non-alcoholic steatohepatitis (NASH). The rate of NASH was higher in lean (14/74; 18.9% p = 0.01) and obese (26/150; 17.3%; p = 0.007) compared to overweight patients (20/242; 8.3%)). Among lean patients, fasting glucose, INR and use of thyroid hormone replacement therapy were independent predictors of NASH in a multivariate model. Lean NAFLD patients were characterized by a severe histological picture similar to obese patients but are more progressed compared to overweight patients. Fasting glucose, international normalized ratio (INR) and the use of thyroid hormone replacement may serve as indicators for NASH in lean patients. MDPI 2018-12-17 /pmc/articles/PMC6306845/ /pubmed/30562976 http://dx.doi.org/10.3390/jcm7120562 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Denkmayr, Lukas
Feldman, Alexandra
Stechemesser, Lars
Eder, Sebastian K.
Zandanell, Stephan
Schranz, Michael
Strasser, Michael
Huber-Schönauer, Ursula
Buch, Stephan
Hampe, Jochen
Paulweber, Bernhard
Lackner, Carolin
Haufe, Heike
Sotlar, Karl
Datz, Christian
Aigner, Elmar
Lean Patients with Non-Alcoholic Fatty Liver Disease Have a Severe Histological Phenotype Similar to Obese Patients
title Lean Patients with Non-Alcoholic Fatty Liver Disease Have a Severe Histological Phenotype Similar to Obese Patients
title_full Lean Patients with Non-Alcoholic Fatty Liver Disease Have a Severe Histological Phenotype Similar to Obese Patients
title_fullStr Lean Patients with Non-Alcoholic Fatty Liver Disease Have a Severe Histological Phenotype Similar to Obese Patients
title_full_unstemmed Lean Patients with Non-Alcoholic Fatty Liver Disease Have a Severe Histological Phenotype Similar to Obese Patients
title_short Lean Patients with Non-Alcoholic Fatty Liver Disease Have a Severe Histological Phenotype Similar to Obese Patients
title_sort lean patients with non-alcoholic fatty liver disease have a severe histological phenotype similar to obese patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306845/
https://www.ncbi.nlm.nih.gov/pubmed/30562976
http://dx.doi.org/10.3390/jcm7120562
work_keys_str_mv AT denkmayrlukas leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT feldmanalexandra leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT stechemesserlars leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT edersebastiank leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT zandanellstephan leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT schranzmichael leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT strassermichael leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT huberschonauerursula leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT buchstephan leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT hampejochen leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT paulweberbernhard leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT lacknercarolin leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT haufeheike leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT sotlarkarl leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT datzchristian leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients
AT aignerelmar leanpatientswithnonalcoholicfattyliverdiseasehaveaseverehistologicalphenotypesimilartoobesepatients