The metabolic profiles and body composition of lean metabolic associated fatty liver disease

Abstract

Background/purpose

Metabolic associated fatty liver disease (MAFLD) is the commonest cause of chronic liver disease, which is associated with obesity and diabetes. However, it also occurs in lean individuals especially in Asian populations.

Methods

The participants of Tzu Chi MAFLD cohort (TCMC) including health controls or MAFLD patients were enrolled. MAFLD was defined as fatty liver in imaging without hepatitis B virus, hepatitis C virus infection, drug, alcohol or other known causes of chronic liver disease. Lean MAFLD was defined as MAFLD in lean subjects (BMI < 23 kg/m2).

Results

A total of 880 subjects were included for final analysis. Of 394 MAFLD patients, 65 (16.5%) patients were diagnosed as lean MAFLD. Lean MAFLD patients were elder, higher percentage of female gender, lower ALT, diastolic blood pressure, triglyceride, and waist circumference but higher HDL than non-lean MAFLD patients. Using binary regression analysis, elder age and lower waist circumference were associated with lean MAFLD. Compared with lean healthy controls, lean MAFLD patients had higher BMI, waist circumference, and percentage of hypertension. In body composition, fatty tissue index (FTI), lean tissue index (LTI) ,and total body water (TBW) were lower in lean MAFLD than non-lean MAFLD patients; but they were comparable with lean healthy controls.

Conclusions

The prevalence of lean MAFLD was 16.5% in this study population and it was higher in elder age, especially of female subjects. Lean MAFLD patients had different metabolic profiles compared with lean healthy controls, but different body composition compared with non-lean MAFLD patients.

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Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Funding

This work was supported by grants (No: TCRD-TPE-108-2) from Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and the Taiwan Liver Disease Consortium (109-2321-B-002 -034), Ministry of Science and Technology, Taiwan.

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Contributions

Wang CC and Kao JH: study design, text writing and revision. Cheng YM and Kao JH: data collecting, statistical analysis and text writing. All authors approved the submission of the final version.

Corresponding author

Correspondence to Chia-Chi Wang.

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Yu-Ming Cheng, Jia-Horng Kao and Chia-Chi Wang authors declare no conflict and interest.

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The study was performed in accordance with the principles of the 1975 Declaration of Helsinki and approved by the Ethical Committee of Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation with waived informed consent.

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Cheng, YM., Kao, JH. & Wang, CC. The metabolic profiles and body composition of lean metabolic associated fatty liver disease. Hepatol Int (2021). https://doi.org/10.1007/s12072-021-10147-0

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Keywords

  • MAFLD
  • Lean
  • Metabolic profiles
  • BMI
  • Waist circumference
  • Body composition
  • Bioelectrical impedance analysis
  • Fatty tissue index
  • Lean tissue index
  • Sarcopenic obesity