Long-term Outcomes and Risk Modifiers of MASLD Between Lean and Non-Lean Populations.

IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Clinical and Molecular Hepatology Pub Date : 2024-10-23 DOI:10.3350/cmh.2024.0631
Pojsakorn Danpanichkul, Kanokphong Suparan, Vitchapong Prasitsumrit, Aijaz Ahmed, Karn Wijarnpreecha, Donghee Kim
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Abstract

One-third of adults across the globe exhibit metabolic dysfunction-associated steatotic liver disease (MASLD) - formerly known as nonalcoholic fatty liver disease (NAFLD). To date, MASLD is the fastest-growing etiology of chronic liver disease and hepatocellular carcinoma (HCC). Besides the population with obesity, MASLD can also be found in lean populations, accounting for 13% of the global population, especially Asians. Notably, individuals with lean MASLD face equal or higher overall mortality rates compared to their non-lean counterparts. Risk modifiers encompass advanced age, hepatic fibrosis, and type 2 diabetes mellitus (T2DM). Moreover, the population with lean MASLD is associated with an increased risk of HCC, while their non-lean counterparts are more prone to cardiovascular outcomes and T2DM. Existing evidence indicates a similar risk of liver-related events and extrahepatic cancer between the two groups. However, MASLD-related genetic variants, such as PNPLA3 and TM6SF2, did not significantly affect mortality between the two populations. Still, underreporting alcohol consumption and regional representation limits the study's comprehensiveness. Longitudinal studies and mechanistic explorations are needed to understand differences in lean versus non-lean MASLD populations. This review highlights the need for awareness and tailored interventions in managing MASLD, considering lean individuals' unique risks.

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精益人群与非精益人群之间 MASLD 的长期结果和风险调节因素。
全球有三分之一的成年人患有代谢功能障碍相关性脂肪性肝病(MASLD)--以前称为非酒精性脂肪肝(NAFLD)。迄今为止,MASLD 是慢性肝病和肝细胞癌(HCC)中增长最快的病因。除肥胖人群外,MASLD 也可见于瘦削人群,占全球总人口的 13%,尤其是亚洲人。值得注意的是,与非肥胖人群相比,肥胖型 MASLD 患者的总死亡率相同或更高。风险因素包括高龄、肝纤维化和 2 型糖尿病(T2DM)。此外,瘦型 MASLD 患者罹患 HCC 的风险增加,而非瘦型 MASLD 患者则更容易出现心血管疾病和 T2DM。现有证据表明,这两类人群发生肝脏相关事件和肝外癌症的风险相似。然而,与 MASLD 相关的基因变异,如 PNPLA3 和 TM6SF2,对两类人群的死亡率并无显著影响。不过,酒精消耗量报告不足和地区代表性限制了该研究的全面性。需要进行纵向研究和机理探索,以了解瘦型与非瘦型 MASLD 人群的差异。本综述强调,在管理 MASLD 时,考虑到瘦弱人群的独特风险,需要提高认识并采取有针对性的干预措施。
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来源期刊
Clinical and Molecular Hepatology
Clinical and Molecular Hepatology Medicine-Hepatology
CiteScore
15.60
自引率
9.00%
发文量
89
审稿时长
10 weeks
期刊介绍: Clinical and Molecular Hepatology is an internationally recognized, peer-reviewed, open-access journal published quarterly in English. Its mission is to disseminate cutting-edge knowledge, trends, and insights into hepatobiliary diseases, fostering an inclusive academic platform for robust debate and discussion among clinical practitioners, translational researchers, and basic scientists. With a multidisciplinary approach, the journal strives to enhance public health, particularly in the resource-limited Asia-Pacific region, which faces significant challenges such as high prevalence of B viral infection and hepatocellular carcinoma. Furthermore, Clinical and Molecular Hepatology prioritizes epidemiological studies of hepatobiliary diseases across diverse regions including East Asia, North Asia, Southeast Asia, Central Asia, South Asia, Southwest Asia, Pacific, Africa, Central Europe, Eastern Europe, Central America, and South America. The journal publishes a wide range of content, including original research papers, meta-analyses, letters to the editor, case reports, reviews, guidelines, editorials, and liver images and pathology, encompassing all facets of hepatology.
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