Fatty liver without a large "belly": Magnified review of non-alcoholic fatty liver disease in non-obese patients

• Published in: World journal of gastrointestinal pathophysiology Vol. 8; no. 3; pp. 100 - 107
• Main Authors: Yousef, Mohamad H, Al Juboori, Alhareth, Albarrak, Abdulmajeed A, Ibdah, Jamal A, Tahan, Veysel
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 15.08.2017
• Subjects: Minireviews; Genetic; Nonobese; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Hepatic steatosis
• ISSN: 2150-5330; 2150-5330
• DOI: 10.4291/wjgp.v8.i3.100

Nonalcoholic fatty liver disease (NAFLD) is well described as a common cause of chronic liver disease, mostly in the obese population. It refers to a spectrum of chronic liver disease that starts with simple steatosis than progresses to nonalcoholic steatohepatitis and cirrhosis in patients without significant alcohol consumption. NAFLD in the non-obese population has been increasingly reported and studied recently. The pathogenesis of nonobese NAFLD is poorly understood and is related to genetic predisposition, most notably patatin-like phospholipase domain-containing 33 G allele polymorphism that leads to intrahepatic triglyceride accumulation and insulin resistance. Non-obese NAFLD is associated with components of metabolic syndrome and, especially, visceral obesity which seems to be an important etiological factor in this group. Dietary factors and, specifically, a high fructose diet seem to play a role. Cardiovascular events remain the main cause of mortality and morbidity in NAFLD, including in the non-obese population. There is not enough data regarding treatment in non-obese NAFLD patients, but similar to NAFLD in obese subjects, lifestyle changes that include dietary modification, physical activity, and weight loss remain the mainstay of treatment.