Nonalcoholic fatty liver disease (NAFLD) is renowned for being a prominent driver of chronic liver issues, impacting over a quarter of people both in the U.S. and globally.
A particular type of NAFLD, nonalcoholic steatohepatitis, happens when fat accumulates in the liver of individuals who consume little to no alcohol, posing severe health risks such as complications from liver cirrhosis, hepatic decompensation (the breakdown of liver function), and liver cancer.
NAFLD is notably present in those grappling with obesity or type 2 diabetes mellitus (T2DM).
Still, a surprising 7-20% of people with NAFLD are lean, posing a unique challenge for healthcare professionals, especially in the context of diagnosis and management due to limited guidance available until now.
New Guidance for Diagnosing and Managing NAFLD in Lean Individuals
In a quest to remedy this gap, researchers have assembled a clinical practice update, offering crucial advice on how to recognize and navigate NAFLD among those with a lean body build.
Under the purview of the American Gastroenterological Association (AGA) Institute Clinical Practice Updates Committee, and with the lead authorship of Dr. Michelle T. Long, an associate professor of gastroenterology at Boston University School of Medicine, these insights come as timely guidance in a field that necessitates closer scrutiny and knowledge development.
This review, comprising 15 best practice advice statements, has been internally and externally peer-reviewed, ensuring its reliability and practical application. A few pivotal pieces of advice from the research include:
Diagnosing lean NAFLD in individuals with a body mass index (BMI) below 25 kg/m2 for non-Asian races and below 23 kg/m2 for Asian races.
Ensuring lean individuals with NAFLD are assessed for comorbid conditions like T2DM, elevated cholesterol, and hypertension.
Determining the risk category for hepatic fibrosis in lean NAFLD individuals to identify cases with advanced fibrosis or cirrhosis.
Recommending against routine NAFLD screening for lean individuals in the general populace, but considering screening for those over 40 years with T2DM.
Dr. Long elucidates that pinpointing those NAFLD cases that are most at risk of disease progression is a challenging task.
Roughly 10% of those with NAFLD are lean, and traditionally, this group has been more challenging to diagnose as the condition often goes unrecognized.
The Importance of Recognizing and Addressing NAFLD in Lean Populations
These findings, accessible in the journal Gastroenterology, shine a much-needed spotlight on a facet of liver health that might often go unnoticed.
The presumption that NAFLD predominantly affects individuals with obesity and T2DM may unintentionally overshadow the struggles and risks experienced by lean individuals with the disease.
Given that an efficient identification and management strategy for NAFLD in lean individuals has remained relatively uncharted territory, this research provides a foundational step towards enhancing our understanding and handling of this condition across varied body types.
In a broader perspective, understanding and addressing NAFLD in lean individuals not only contributes to the improvement of liver health management but also challenges prevailing stereotypes and misconceptions about who is affected by such conditions, promoting a more inclusive and comprehensive approach to healthcare.
If you care about liver health, please read studies about simple habit that could give you a healthy liver, and common diabetes drug that may reverse liver inflammation.
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 research findings can be found in Gastroenterology.
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