Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Non peer reviewed
Title Clinical and anthropometric characteristics of non-obese non-alcoholic fatty liver disease subjects in Japan.
Journal Formal name:Hepatology research : the official journal of the Japan Society of Hepatology
Abbreviation:Hepatol Res
ISSN code:13866346/13866346
Domestic / ForeginDomestic
Volume, Issue, Page 50(9),pp.1032-1046
Author and coauthor Shida Takashi, Oshida Natsumi, Suzuki Hideo, Okada Kosuke, Watahiki Takahisa, Oh Sechang, Kim Taeho, Isobe Tomonori, Okamoto Yoshikazu, Ariizumi Shun-Ichi, Yamamoto Masakazu, Shoda Junichi
Publication date 2020/09
Summary AIM:The underlying mechanism of non-obese non-alcoholic fatty liver disease (NAFLD) has not been fully elucidated. We classified patients with NAFLD by sex and body mass index and compared their clinical features to clarify the background pathophysiology of non-obese NAFLD.METHODS:A total of 404 patients with NAFLD were divided according to their body mass index (<25 [non-obese], 25 to <30 [obese], and ≥30 [severe obese]), and were further compared with 253 patients without obesity and NAFLD (non-NAFLD).RESULTS:The proportion of the individuals with non-obese NAFLD was 25.7% in men and 27.6% in women. The male and female non-obese NAFLD groups had lower skeletal muscle mass and muscle strength than the obese NAFLD groups. The visceral fat area, although low, was ≥100 cm2 in 59.3% of men and 43.8% of women. An increase in liver fat accumulation, hepatic fibrosis, homeostasis model assessment of insulin resistance, and leptin levels was modest in the non-obese NAFLD group compared with a marked increase in the obese NAFLD groups. The muscle mass of the non-obese NAFLD group was similar to that of the non-NAFLD group, but muscle steatosis was particularly common among women. Multivariate analysis revealed that the factors contributing to increased liver fat accumulation in the non-obese NAFLD group were visceral fat area, HbA1c, myostatin, and leptin.CONCLUSIONS:In patients with non-obese NAFLD, a sex difference was observed in the clinical features. In addition to increased visceral fat, decreased muscle mass and muscle strength, muscle atrophy (presarcopenia), and impaired glucose tolerance were considered to be important pathophysiological factors.
DOI 10.1111/hepr.13543
PMID 32602214