Metabolic Profile of Lean/Non Obese NAFLD (Non Alcoholic Fatty Liver Disease) Subjects
Correspondence Address :
Dr. Akash Jaiswal,
Quarter No 4, ILS Hospital Premises, Kunjawan, Agartala, Tripura, India.
E-mail: akashjaiswal19@gmail.com
Introduction: Non Alcoholic Fatty Liver Disease (NAFLD) in the absence of overweight and obesity has been defined as ‘lean NAFLD’. Metabolic syndrome associated diseases in low and middle income countries have variable phenotypes and clinical outcomes. Hypothetically, 'Lean NAFLD' can be a part of the spectrum of classical obesity related NAFLD or separate entity with different pathophysiology.
Aim: 1) To characterise the NAFLD in lean/non obese subjects; 2) To explore how it differs from classical 'obese phenotype' of the NAFLD; 3) To explore how these lean/non obese subjects with NAFLD are different from healthy lean/non obese subjects in terms of metabolic profile.
Materials and Methods: The present study was a crosssectional observational study conducted over a period of six months. Forty subjects were categorised into four groups (1. Lean NAFLD without Diabetes; 2. Lean NAFLD with Diabetes; 3. Obese NAFLD with Diabetes; 4. Lean healthy subjects). Clinical history, examination, anthropometry, biochemical data including insulin resistance by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) were analysed.
Results: Mean Body Mass Index (BMI), Fasting Blood Glucose (FBG) and HbA1c (Glycated haemoglobin) of group 2 and group 3 were significantly higher than that of group 1 and group 4 subjects (p<0.001). Mean HOMA-IR of the patients of group 2 and group 3 were significantly higher than that of group 1 and group 4 (p<0.001). No significant difference was seen in HOMAIR between patients of group 1 and group 4 (p>0.05) and also of group 2 and group 3 subjects (p>0.05).
Conclusion: Lean NAFLD subjects have a different metabolic profile than overweight-obese patients with NAFLD, particularly in relation to diabetes. On the basis of all metabolic parameters and insulin resistance, authors propose a spectrum of insulin resistance 'Non obese Control - Non obese NAFLD without Diabetes Mellitus (DM) - Non obese NAFLD with DM - Obese NAFLD with DM'.
Body mass index, Diabetes, Homeostatic model of insulin resistance, Insulin resistance
10.7860/JCDR/2021/51585.15600
Date of Submission: Jul 26, 2021
Date of Peer Review: Sep 07, 2021
Date of Acceptance: Sep 28, 2021
Date of Publishing: Nov 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? No
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. No
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• iThenticate Software: Oct 05, 2021 (23%)
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