Margariti Ekaterini, Deutsch Melanie, Manolakopoulos Spilios, Papatheodoridis George V
2 Department of Internal Medicine, Athens University Medical School, Hippokration General Hospital, Athens, Greece.
Ann Gastroenterol. 2012;25(1):45-51.
Although non-alcoholic fatty liver disease (NAFLD) is associated with obesity and metabolic syndrome (MS), it may also be present in lean individuals. We evaluated the characteristics of NAFLD patients, focusing on those with normal body mass index (BMI).
One hundred and sixty-two of 185 consecutive NAFLD patients were included (23 were excluded due to missing data). NAFLD diagnosis required elevated ALT and/or GGT, hepatic steatosis on ultrasonography and no other cause of liver disease. Demographic, clinical, somatometric and laboratory characteristics were recorded. BMI <25 kg/m2 was considered normal.
Normal BMI was present in 12% of patients. Patients with normal compared to those with increased BMI had numerically but not significantly lower prevalence of diabetes mellitus (6% vs. 15%, p=0.472), arterial hypertension (17% vs. 29%, p=0.276) and MS (20% vs. 41%, p=0.160). Normal BMI NAFLD patients met no criterion of MS more frequently (43% vs. 2%, p<0.0001) and had smaller waist circumference (94±6 vs. 108±10 cm, p<0.001), higher median levels of ALT (92 vs. 62 IU/L, p=0.032) and AST (45 vs. 37 IU/L, p=0.036) and relatively lower fasting glucose levels (98±22 vs. 106±29 mg/dL, p=0.052), but similar levels of HDL, LDL and triglycerides.
Approximately 1 of 8 NAFLD patients coming to the tertiary liver center has normal BMI. These patients do not necessarily have insulin resistance associated metabolic disorders, but they have higher levels of ALT/AST than the overweight or obese NAFLD patients.
尽管非酒精性脂肪性肝病（NAFLD）与肥胖和代谢综合征（MS）相关，但也可能存在于体型偏瘦的个体中。我们评估了NAFLD患者的特征，重点关注那些体重指数（BMI）正常的患者。
连续纳入185例NAFLD患者中的162例（23例因数据缺失被排除）。NAFLD的诊断需要ALT和/或GGT升高、超声检查显示肝脂肪变性且无其他肝病病因。记录人口统计学、临床、身体测量和实验室特征。BMI<25kg/m²被视为正常。
12%的患者BMI正常。与BMI升高的患者相比，BMI正常的患者糖尿病患病率在数值上较低但无显著差异（6%对15%，p=0.472），动脉高血压患病率（17%对29%，p=0.276）和MS患病率（20%对41%，p=0.160）。BMI正常的NAFLD患者更频繁地不符合MS的任何标准（43%对2%，p<0.0001），腰围更小（94±6对108±10cm，p<0.001），ALT中位数水平更高（92对62IU/L，p=0.032）和AST中位数水平更高（45对37IU/L，p=0.036），空腹血糖水平相对较低（98±22对106±29mg/dL，p=0.052），但HDL、LDL和甘油三酯水平相似。
前往三级肝病中心就诊的NAFLD患者中约八分之一BMI正常。这些患者不一定有与胰岛素抵抗相关的代谢紊乱，但他们的ALT/AST水平高于超重或肥胖的NAFLD患者。
