Abstract
Patients with lean NAFLD make up an increasing subset of liver disease patients. The association between lean NAFLD and feutin-A, which serves as a hepatokine and adipokine, has never been examined. Our study aimed to explore the association of serum fetuin-A among lean and non-lean patients. The study comprised 606 adults from the community, stratified into lean or non-lean (BMI </≥ 24 kg/m2) and NAFLD or non-NAFLD (scoring of ultrasonographic fatty liver indicator, US-FLI ≥ 2/< 2). Multivariate logistic regression analyses were performed to estimate the odds ratio of having NAFLD among the tertiles of fetuin-A after adjustment. The least square means were computed by general linear models to estimate marginal means of the serum fetuin-A concentrations in relation to the NAFLD groups. The odds ratio (OR) of having NAFLD for the highest versus the lowest tertile of fetuin-A was 2.62 (95% CI: 1.72–3.98; p for trend < 0.001). Stratifying by BMI, the OR of having lean NAFLD for the highest versus the lowest tertile of fetuin-A was 2.09 (95% CI: 1.09–3.98; p for trend 0.026), while non-lean NAFLD had no significant association with the fetuin-A gradient after adjustments. Fetuin-A was positively associated with lean NAFLD after adjusting for central obesity and insulin resistance.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is a growing health concern due to its increasing incidence and prevalence and its impact on associated comorbidities
A synonymous terminology is developing for diseases ranging from NAFLD to metabolicassociated fatty liver disease (MAFLD) [3]
Group shared similar metabolic factors with the non-lean, non-NAFLD group. Patients in the former group had a presentation of NAFLD and patients in the latter had a significantly higher BMI, waist circumference, and body fat percentage
Summary
Nonalcoholic fatty liver disease (NAFLD) is a growing health concern due to its increasing incidence and prevalence and its impact on associated comorbidities. It is well established that NAFLD is commonly associated with obesity, type 2 diabetes (T2DM), dyslipidemia, and metabolic syndrome (MetS) [2]. Compared with non-lean NAFLD, patients with lean NAFLD are younger and have higher hemoglobin levels [5], an elevated ALT/AST ratio [6], and less insulin resistance and MetS [7]. Lean NAFLD patients have more dyslipidemia [8] and easier central obesity and insulin resistance [9]. In terms of phenotype, patients with non-lean NAFLD share metabolic features of insulin resistance and dyslipidemia with lean NAFLD patients [7]. The limited data, conflicting results, and increasing population of lean NAFLD patients have evoked remarkable concern
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