Open AccessFatty liver without a large “belly”: Magnified review of non-alcoholic fatty liver disease in non-obese patients
Author(s) -
Mohammad S. Yousef,
Alhareth Al Juboori,
Abdulmajeed Albarrak,
Jamal A. Ibdah,
Veysel Tahan
Publication year - 2017
Publication title -
world journal of gastrointestinal pathophysiology
Language(s) - English
Resource type - Journals
ISSN - 2150-5330
DOI - 10.4291/wjgp.v8.i3.100
Subject(s) - medicine , nonalcoholic fatty liver disease , fatty liver , metabolic syndrome , steatohepatitis , insulin resistance , cirrhosis , gastroenterology , population , chronic liver disease , steatosis , obesity , disease , endocrinology , environmental health
Nonalcoholic fatty liver disease (NAFLD) is well described as a common cause of chronic liver disease, mostly in the obese population. It refers to a spectrum of chronic liver disease that starts with simple steatosis than progresses to nonalcoholic steatohepatitis and cirrhosis in patients without significant alcohol consumption. NAFLD in the non-obese population has been increasingly reported and studied recently. The pathogenesis of nonobese NAFLD is poorly understood and is related to genetic predisposition, most notably patatin-like phospholipase domain-containing 33 G allele polymorphism that leads to intrahepatic triglyceride accumulation and insulin resistance. Non-obese NAFLD is associated with components of metabolic syndrome and, especially, visceral obesity which seems to be an important etiological factor in this group. Dietary factors and, specifically, a high fructose diet seem to play a role. Cardiovascular events remain the main cause of mortality and morbidity in NAFLD, including in the non-obese population. There is not enough data regarding treatment in non-obese NAFLD patients, but similar to NAFLD in obese subjects, lifestyle changes that include dietary modification, physical activity, and weight loss remain the mainstay of treatment.