Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease, impacting more than a quarter of people globally and in the United States.
Surprisingly, not just obese or diabetic individuals are affected. NAFLD can also be found in people with a lean body build, accounting for about 7 to 20% of NAFLD cases.
Given the lack of clear guidelines for handling NAFLD in lean individuals, a recent report was published to provide advice for doctors on diagnosing and managing this condition.
Nonalcoholic Fatty Liver Disease: A Silent Epidemic
NAFLD, where fat accumulates in the liver of those who consume little or no alcohol, is often associated with obesity and type 2 diabetes mellitus (T2DM). However, it can also affect lean individuals.
One subtype of NAFLD, nonalcoholic steatohepatitis, leads to severe health complications, including liver cirrhosis, liver failure, and liver cancer. This makes the need for effective diagnosis and treatment all the more important.
A team of researchers, led by Dr. Michelle T. Long, an associate professor of gastroenterology at Boston University School of Medicine, has compiled a clinical practice update to aid in the management of NAFLD in lean individuals.
This report, approved by the American Gastroenterological Association (AGA), provides up-to-date advice on a topic of great clinical importance.
The AGA conducted an internal and external peer review of this document to ensure its relevance and accuracy.
Key Recommendations
The update includes 15 best practice advice statements. Here are some of the highlights:
- Lean NAFLD should be diagnosed in individuals with a body mass index (BMI) of less than 25 kg/m2 (for non-Asians) or less than 23 kg/m2 (for Asians).
- Lean NAFLD patients should be evaluated for other health conditions, such as T2DM, high cholesterol, and high blood pressure.
- Doctors should assess lean NAFLD patients for hepatic fibrosis, a condition characterized by excessive connective tissue in the liver, to identify those with severe fibrosis or cirrhosis.
- Routine screening for NAFLD in lean individuals is not recommended. However, individuals over 40 with T2DM should consider screening.
Dr. Long points out the challenge of diagnosing NAFLD, particularly in lean individuals, as the disease often goes unnoticed.
She states, “About 10 percent of those with NAFLD are lean and traditionally this group has been even more difficult to diagnose.”
These findings, published in the journal Gastroenterology, represent a step forward in addressing NAFLD among lean individuals.
This report offers doctors clear guidelines on diagnosis and management, enhancing the care provided to these patients.
If you care about liver health, please read studies about a diet that can treat fatty liver disease and obesity, and coffee drinkers may halve their risk of liver cancer.
For more information about liver health, please see recent studies that anti-inflammatory diet could help prevent fatty liver disease, and results showing vitamin D could help prevent non-alcoholic fatty liver disease.
The study was published in Gastroenterology.
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