Evidence map›Paper›PMID 33150534›Full record

ReviewEating and weight disorders : EWD2021

Liver disease in obesity and underweight: the two sides of the coin. A narrative review.

Renata Risi, Dario Tuccinardi, Stefania Mariani, Carla Lubrano, Silvia Manfrini, Lorenzo Maria Donini, Mikiko Watanabe

Abstract readReview
PubMed Publisher
In one paragraph

Review in Eating and weight disorders : EWD, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 32 citations in OpenAlex.

  1. Trial
  2. Article
  3. Undernutrition-related diabetes in mice is linked to early undernutrition.American journal of physiology. Endocrinology and metabolism · 2026
    Article
  4. Article
  5. Article
  6. Shape of You: Eye-Tracking and Social Perceptions of the Human Body.Behavioral sciences (Basel, Switzerland) · 2025
    Article
  7. Observational
  8. Review
  9. Article
  10. Article
  11. Review
  12. Metabolic reprogramming of hepatocytes byJHEP reports : innovation in hepatology · 2023
    Article
  13. Article
  14. Observational
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Renata RisiDepartment of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161, Rome, Italy.
Dario TuccinardiDepartment of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 21, 00128, Rome, Italy. d.tuccinardi@unicampus.it.ORCID http://orcid.org/0000-0002-9139-7159
Stefania MarianiDepartment of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161, Rome, Italy.
Carla LubranoDepartment of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161, Rome, Italy.
Silvia ManfriniDepartment of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
Lorenzo Maria DoniniDepartment of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161, Rome, Italy.
Mikiko WatanabeDepartment of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161, Rome, Italy.
Sapienza University of Rome · ITUniversità Campus Bio-Medico · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMalnutrition, whether characterized by not enough or too much nutrient intake, is detrimental to the liver. We herein provide a narrative literature revision relative to hepatic disease occurrence in over or undernourished subjects, to shed light on the paradox where both sides of malnutrition lead to similar liver dysfunction and fat accumulation.

methodsMedline, EMBASE, and Cochrane Library were searched for publications up to July 2020. Articles discussing the association between both chronic and acute liver pathology and malnutrition were evaluated together with studies reporting the dietary intake in subjects affected by malnutrition.

resultsThe association between overnutrition and non-alcoholic fatty liver disease (NAFLD) is well recognized, as the beneficial effects of calorie restriction and very low carbohydrate diets. Conversely, the link between undernutrition and liver injury is more complex and less understood. In developing countries, early exposure to nutrient deficiency leads to marasmus and kwashiorkor, accompanied by fatty liver, whereas in developed countries anorexia nervosa is a more common form of undernutrition, associated with liver injury. Weight gain in undernutrition is associated with liver function improvement, whereas no study on the impact of macronutrient distribution is available. We hypothesized a role for very low carbohydrate diets in the management of undernutrition derived liver pathology, in addition to the established one in overnutrition-related NAFLD.

conclusionsFurther studies are warranted to update the knowledge regarding undernutrition-related liver disease, and a specific interest should be paid to macronutrient distribution both in the context of refeeding and relative to its role in the development of hepatic complications of anorexia nervosa. LEVEL OF EVIDENCE: Narrative review, Level V.

Indexed as

Non-alcoholic Fatty Liver DiseaseThinnessEnergy IntakeHumansLiverObesityAnorexia nervosaDietEating disorderLiver failureMalnutritionNAFLDTreatmentVery low carbohydrate diet

Identifiers

PMID33150534
OpenAlexW3096844254

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.