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18.09.2019 | Original Article—Liver, Pancreas, and Biliary Tract

Association between body size-metabolic phenotype and nonalcoholic steatohepatitis and significant fibrosis

verfasst von: Donghee Kim, Won Kim, Sae Kyung Joo, Jimin Han, Jung Ho Kim, Stephen A. Harrison, Zobair M. Younossi, Aijaz Ahmed

Erschienen in: Journal of Gastroenterology | Ausgabe 3/2020

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Abstract

Background and aims

Body size-metabolic phenotype may help predict whether or not individuals with nonalcoholic fatty liver disease (NAFLD) develop advanced liver disease. We studied the association of body size-metabolic phenotype with nonalcoholic steatohepatitis (NASH) and significant fibrosis.

Methods

Our cross-sectional study included 559 subjects (mean age of 53 years; women 51%) with biopsy-proven NAFLD. Clinical, genetic, and histological characteristic features of NAFLD were evaluated. The metabolically unhealthy phenotype was defined by the presence of two or more metabolic components, while body size was categorized based on body mass index: obese (≥ 25 kg/m²) or non-obese (< 25 kg/m²). Body size-metabolic phenotypes were divided into four study groups: (1) non-obese metabolic syndrome (MS)−, (2) non-obese MS+ , (3) obese MS−, and (4) obese MS+.

Results

Obese MS− and non-obese MS+ groups demonstrated comparable levels of insulin resistance, adipose tissue insulin resistance indexes, and visceral adipose tissue (VAT) areas. The VAT area was significantly higher in the obese MS+ group versus obese MS− group. However, the VAT to subcutaneous adipose tissue (SAT) ratio was highest in the non-obese MS+ group. There was no difference in histology between the non-obese MS+, obese MS−, and obese MS+ groups. Multivariate analyses adjusted for age, sex, smoking status, PNPLA3, TM6SF2, and VAT/SAT areas demonstrated an independent and dose-dependent relationship between the body size-metabolic phenotype and NASH or significant fibrosis.

Conclusion

The non-obese MS+ group displayed similar degree of hepatic histological severity compared to their obese MS− counterparts. Metabolic milieu beyond obesity may play a pathogenic role in non-obese MS+ individuals who develop NASH with significant hepatic fibrosis.

Clinical trial number

NCT 02206841.

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Titel: Association between body size-metabolic phenotype and nonalcoholic steatohepatitis and significant fibrosis
verfasst von: Donghee Kim
Won Kim
Sae Kyung Joo
Jimin Han
Jung Ho Kim
Stephen A. Harrison
Zobair M. Younossi
Aijaz Ahmed
Publikationsdatum: 18.09.2019
Verlag: Springer Singapore
Erschienen in: Journal of Gastroenterology / Ausgabe 3/2020
Print ISSN: 0944-1174
Elektronische ISSN: 1435-5922
DOI: https://doi.org/10.1007/s00535-019-01628-z

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Association between body size-metabolic phenotype and nonalcoholic steatohepatitis and significant fibrosis

Abstract

Background and aims

Methods

Results

Conclusion

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