ReviewJournal of gastroenterology and hepatology2023
Epidemiology and prevalence of lean nonalcoholic fatty liver disease and associated cirrhosis, hepatocellular carcinoma, and cardiovascular outcomes in the United States: a population-based study and review of literature.
Review in Journal of gastroenterology and hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Global epidemiology of diabetes and prediabetes in lean or non-obese patients with NAFLD: a systematic review and meta-analysis.Annals of medicine · 2026Pooled it
- Review
- Adiponectin as a Predictor of Metabolic Dysfunction-Associated Steatotic Liver Disease and Non-Alcoholic Fatty Liver Disease: A 17-Year Korean Cohort Study.Diabetes & metabolism journal · 2026Article
- Predictive value of liver fibrosis markers and model for end-stage liver disease score in evaluating the degree of esophageal and gastric varices in cirrhosis.American journal of translational research · 2026Article
- Clinical and Genetic Predictors of Non-Alcoholic Steatotic Liver Disease and Fibrosis in Lean Individuals.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Construction and characteristics of an adjustable biomechanical in vitro corneal stromal model simulating keratoconus pathological features.Materials today. Bio · 2025Article
- HOMA-IR, an independent predictor of advanced liver fibrosis in metabolic-dysfunction associated fatty liver disease: a cross-sectional study in Egyptian patients.Scientific reports · 2025Article
- Prevalence and Risk Factors of Liver Fibrosis Among People With HIV and Metabolic Dysfunction-Associated Steatotic Liver Disease.Open forum infectious diseases · 2025Article
- Differential risk factors of fibrosis between lean and obese MAFLD.Clinical and experimental medicine · 2025Article
- Ramadan Fasting and Complications of Metabolic Dysfunction-Associated Steatotic Liver Disease: Impacts on Liver Cirrhosis and Heart Failure.Journal of clinical medicine · 2025Review
- Impact of PNPLA3 I148M on Clinical Outcomes in Patients With MASLD.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- The global landscape of lean metabolic dysfunction-associated steatotic liver disease: insight from Asia and the West.Frontiers in gastroenterology (Lausanne, Switzerland) · 2025Review
- Long-term outcomes and risk modifiers of metabolic dysfunction-associated steatotic liver disease between lean and non-lean populations.Clinical and molecular hepatology · 2025Review
- The emerging phenotype of nonalcoholic fatty liver disease in lean individuals: what's different?Frontiers in endocrinology · 2025Review
- Steatotic liver disease among lean and non-lean individuals in Southern Lao PDR: a cross-sectional study of risk factors.Annals of medicine · 2024Article
- Ramadan Fasting in Individuals with Metabolic Dysfunction-Associated Steatotic Liver Disease, Liver Transplant, and Bariatric Surgery: A Narrative Review.Journal of clinical medicine · 2024Review
- Article
- Association of Combined PFOA, PFOS, Metals and Allostatic Load on Hepatic Disease Risk.Journal of xenobiotics · 2024Article
- Metabolic-associated fatty liver disease and sarcopenia: A double whammy.World journal of hepatology · 2024Review
- Unique Genetic Features of Lean NAFLD: A Review of Mechanisms and Clinical Implications.Journal of clinical and translational hepatology · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundsNonalcoholic fatty liver disease (NAFLD) is linked to obesity and metabolic syndrome conditions. However, a subset of NAFLD patients express a normal or low body mass index (lean NAFLD [L-NAFLD]). Our aim is to compare the prevalence of L-NAFLD to the obesity-associated NAFLD in the United States by assessing prevalence, potential risk factors, liver-related complications, and coronary artery disease outcomes. METHODOLOGY: A multicenter database (Explorys Inc.) of >70 million patients across the United States was screened. A cohort of patients with "nonalcoholic fatty liver" between 1999 and 2021 was identified. Two sub-cohorts of NAFLD patients were identified: those with a body mass index (BMI) < 25 kg/m
results68 892 260 individuals were screened. NAFLD prevalence was four per 100 000, and L-NAFLD prevalence was 0.6 per 100 000. Compared with those without, patients with L-NAFLD tended to be older (OR 2.16), females (OR 1.28), and smokers (OR 4.67) and of Asian race (OR 2.12). L-NAFLD patients were more likely to have acute coronary syndromes (OR 30.00) and metabolic syndrome (OR 2.31) despite the normal/low BMI. Esophageal varices and hepatocellular carcinoma risks were high in both cirrhosis patients.
conclusionThis is the largest study to assess L-NAFLD prevalence in the United States. L-NAFLD are at a significantly higher risk for acute coronary syndromes, esophageal varices, and hepatocellular carcinoma.
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Registered trials
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.