Department of Gastroenterology, Buddhist Tzu Chi Medical Foundation and School of Medicine, Taipei Tzu Chi Hospital, Tzu Chi University, 289 Jianguo Rd., Xindian area, New Taipei City, Hualien, 23142, Taiwan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Hepatol Int. 2021 Apr;15(2):405-412. doi: 10.1007/s12072-021-10147-0. Epub 2021 Feb 4.
BACKGROUND/PURPOSE: Metabolic associated fatty liver disease (MAFLD) is the commonest cause of chronic liver disease, which is associated with obesity and diabetes. However, it also occurs in lean individuals especially in Asian populations.
The participants of Tzu Chi MAFLD cohort (TCMC) including health controls or MAFLD patients were enrolled. MAFLD was defined as fatty liver in imaging without hepatitis B virus, hepatitis C virus infection, drug, alcohol or other known causes of chronic liver disease. Lean MAFLD was defined as MAFLD in lean subjects (BMI < 23 kg/m).
A total of 880 subjects were included for final analysis. Of 394 MAFLD patients, 65 (16.5%) patients were diagnosed as lean MAFLD. Lean MAFLD patients were elder, higher percentage of female gender, lower ALT, diastolic blood pressure, triglyceride, and waist circumference but higher HDL than non-lean MAFLD patients. Using binary regression analysis, elder age and lower waist circumference were associated with lean MAFLD. Compared with lean healthy controls, lean MAFLD patients had higher BMI, waist circumference, and percentage of hypertension. In body composition, fatty tissue index (FTI), lean tissue index (LTI) ,and total body water (TBW) were lower in lean MAFLD than non-lean MAFLD patients; but they were comparable with lean healthy controls.
The prevalence of lean MAFLD was 16.5% in this study population and it was higher in elder age, especially of female subjects. Lean MAFLD patients had different metabolic profiles compared with lean healthy controls, but different body composition compared with non-lean MAFLD patients.
背景/目的：代谢相关脂肪性肝病（MAFLD）是最常见的慢性肝病病因，与肥胖和糖尿病相关。然而，它也发生在瘦人身上，尤其是在亚洲人群中。
本研究纳入了慈济 MAFLD 队列（TCMC）的参与者，包括健康对照或 MAFLD 患者。MAFLD 的定义为影像学检查有脂肪肝，无乙型肝炎病毒、丙型肝炎病毒感染、药物、酒精或其他已知的慢性肝病病因。瘦型 MAFLD 的定义为 BMI<23kg/m2 的 MAFLD 患者。
共纳入 880 例患者进行最终分析。在 394 例 MAFLD 患者中，有 65 例（16.5%）患者被诊断为瘦型 MAFLD。与非瘦型 MAFLD 患者相比，瘦型 MAFLD 患者年龄更大，女性比例更高，ALT、舒张压、甘油三酯和腰围较低，但 HDL 较高。使用二元回归分析，年龄较大和腰围较小与瘦型 MAFLD 相关。与瘦型健康对照相比，瘦型 MAFLD 患者的 BMI、腰围和高血压比例更高。在身体成分方面，与非瘦型 MAFLD 患者相比，瘦型 MAFLD 患者的脂肪组织指数（FTI）、瘦组织指数（LTI）和总体水（TBW）较低；但与瘦型健康对照相比，无显著差异。
在本研究人群中，瘦型 MAFLD 的患病率为 16.5%，且在年龄较大的患者中更为常见，尤其是女性。与瘦型健康对照相比，瘦型 MAFLD 患者的代谢特征不同，但与非瘦型 MAFLD 患者相比，身体成分不同。
