Non-alcoholic fatty liver disease (NAFLD) is a term that encompasses various liver conditions affecting people who consume little to no alcohol, and it is present in approximately 25% of adults in the United States.
Astonishingly, recent research sheds light on an unexpected correlation: individuals with a normal body mass index (BMI) who have NAFLD are seemingly more prone to heart disease than their counterparts who are overweight or have obesity.
Unexpected Links to Cardiovascular Issues
Contrary to prior expectations, this link to cardiovascular issues was unearthed even though lean patients were less likely to exhibit cirrhosis, diabetes, high cholesterol, or high blood pressure – conditions commonly associated with NAFLD.
The surprise of these findings is echoed by Karn Wijarnpreecha, MD, MPH, and a transplant hepatology fellow at the University of Michigan, who stated, “Too often, we overlook NAFLD patients with a normal BMI because we assume their risk for more serious conditions is lower than those who are overweight. But this way of thinking may be putting these patients at risk.”
NAFLD, recognized by excessive fat storage in liver cells, often flies under the radar due to its typically asymptomatic nature.
However, it can act as a precursor to other perilous conditions, such as diabetes, cardiovascular disease, and cirrhosis of the liver.
While it’s notably more prevalent in those who are overweight or experiencing obesity, the presence of NAFLD in individuals with a normal BMI has been notably understudied.
Pioneering Research Revealing Unseen Perils
To delve into this, researchers embarked on a retrospective cohort study, involving over 10,000 adults diagnosed with NAFLD at the University of Michigan Hospital from 2012 to 2021.
The aim was to juxtapose the prevalence of cirrhosis, cardiovascular diseases, metabolic diseases, and chronic kidney disease among four BMI classes: lean (BMI= 18.5 to 24.9), overweight (BMI=25-29.9), class 1 obesity (BMI=30-34.9), and class 2-3 obesity (BMI=35-<40).
The results were enlightening yet perplexing: compared to non-lean patients, lean patients showcased a lower prevalence of cirrhosis, diabetes, high blood pressure, and dyslipidemia.
However, they displayed a higher prevalence of peripheral vascular disease, cerebrovascular disease, and overall cardiovascular disease.
Dr. Wijarnpreecha emphasizes that further analysis unveiled that lean patients with NAFLD also had a significantly higher prevalence of cardiovascular disease, and this was independent of variables like age, sex, race, smoking status, diabetes, hypertension, and dyslipidemia.
Re-Thinking NAFLD and Cardiovascular Disease Risk
Given these results, it’s pivotal to reassess how we perceive and manage NAFLD, especially in those with a normal BMI.
The higher prevalence of cardiovascular diseases in this demographic remains an enigma and warrants further research.
Moreover, it underscores an essential advisory for physicians to steer clear from overlooking lean NAFLD patients as they might be encountering severe health consequences that are parallel to those experienced by patients who are overweight or grappling with obesity.
The researchers are planning additional studies that will monitor patients over an extended period to ascertain whether lean patients are indeed at a heightened risk of developing cardiovascular diseases due to NAFLD.
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 health, please see recent studies about simple blood test that could detect your risk of fatty liver disease, and results showing this green diet may strongly lower non-alcoholic fatty liver disease.
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