S3257 A Comparison of Non-Obese Non-Alcoholic Fatty Liver Disease (NAFLD) and Obese NAFLD Patients

Abstract

INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease worldwide. The relationship between NAFLD and obesity is well-established. However, it is known that NAFLD can affect the non-obese as well, and less is understood about this population of NAFLD patients. Our study aimed to further investigate possible differences between obese and non-obese NAFLD to further our understanding of non-obese NAFLD. METHODS: An EMR search of appropriately coded patients was performed. Medical records were manually searched for pertinent variables. Non-obese NAFLD was determined those with biopsy-proven NAFLD and BMI ≤30. Of the NAFLD population identified, 64 patients were found to have non-obese NAFLD. Each patient was matched with an obese (BMI >30) NAFLD patient of the same gender and age-decade. A two-tailed students t-test based and chi-squared test were performed to determine differences. RESULTS: A total of 64 non-obese NAFLD (BMI ≤30) patients were identified. Each patient was matched with a >30 BMI patient of the same gender and age-decade; total study size 128 patients (N = 128). There were 27/64 males (42%) and 37/64 females (58%). Average age and BMI of the non-obese vs obese patients was 55 years and 25, and 54 years and 37, respectively. In non-obese vs obese patients, total number affected and means were calculated for a number of pertinent variables including diabetes, dyslipidemia, hemoglobin A1c, CKD stage (mean 0.4 vs 0.7), HDL, LDL, statin usage, HTN, steatosis grade, presence of steatohepatitis, fibrosis score, LDL/HDL ratio, transferrin saturation, ceruloplasmin, ferritin, AST, ALT, platelet count, MPV, APRI score, and Fib4 score. Analysis was then performed to determine any significant differences. This showed that Fib4 was significantly (P = 0.032), even though fibrosis scores between the two groups were not significantly different. A history of dyslipidemia was nearly significant (P = 0.051) as well, but did not meet established P-value cutoffs. CONCLUSION: Our study provides further data on characteristic of and differences between non-obese NAFLD and obese NAFLD populations. It showed significantly different Fib4 score results between the two populations, even though biopsy fibrosis scores were not significantly different. If replicated on further studies, this could suggest uncertainty interpreting Fib4 scores in the non-obese NAFLD population. The study is limited by small sample size. More research is needed to broaden understanding of non-obese NAFLD.Table 1.: Demographics: number of patients in each age/gender grouping in both categories, non-obese and obese NAFLDTable 2.: Comparisons of variables between non-obese (BMI ≤30) and obese (BMI >30) patient populations; x = mean, N = number affectedTable 3.: Statistical analysis between non-obese and obese NAFLD populations showing significantly different values of Fib4 scores between the two populations