- Presence and severity of nonalcoholic fatty liver disease in normal-weight adults (lean NAFLD) are independently associated with increased risk for diabetes mellitus (DM).
Why this matters
- Although NAFLD phenotype is classically an obese/overweight individual with features of metabolic syndrome, about 8%-19% of cases occur in patients with BMI 2.
- Individuals with lean NAFLD have higher diabetes risk than non-NAFLD overweight/obese individuals.
- Careful monitoring for metabolic abnormalities is warranted.
- Korean cohort study of 51,463 adults (mean age, 48.7±9.1 years) without diabetes, liver disease, hepatitis, or cancer, undergoing regular health screening.
- Normal weight: BMI between 18.5 and 22.9 kg/m2.
- 10.3% had lean NAFLD; 46.1% had overweight/obese NAFLD.
- Funding: None.
- 5370 participants developed diabetes over median 4-year follow-up.
- 10-year was almost double in lean patients with vs without NAFLD (27.3% vs 14.1%).
- In fully adjusted models using lean non-NAFLD as a reference, risk for diabetes was higher with:
- Lean NAFLD (HR=1.18; 95% CI, 1.03-1.35).
- Overweight/obese individuals with NAFLD (HR=1.45; 95% CI, 1.34-1.57), but not those without NAFLD.
- Risk with lean NAFLD was higher (P<.001 with intermediate-high hr="2.73;" ci vs low nafld fibrosis score>
- Association was stronger among patients aged
- Retrospective design.
- Asian population.