Nonalcoholic fatty liver disease in lean subjects: is it all metabolic-associated fatty liver disease?
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.26/48449 |
Resumo: | The epidemiology of nonalcoholic fatty liver disease goes hand-in-hand with the obesity pandemic. The pathogenesis of fatty liver has shifted from an hepatocentric view to an adipocentric view, in which the overloaded adipose tissue spills out lipids that spread to ectopic tissues and organs such as the liver, elicits inflammation, and changes its adipokines profile promoting insulin resistance and the metabolic syndrome. Up to 40% of nonalcoholic fatty liver disease (NAFLD) patients are not obese and up to 20% are actually lean. Furthermore roughly 10% of lean subjects have NAFLD. In fact, adiposopathy can occur in patients with normal weight, and it is associated with expansion of metabolically active visceral fat and a qualitatively different adipose tissue that becomes overwhelmed after challenged by a mildly positive energy balance. This defines the concept of personal fat threshold that when exceeded results in metabolic dysfunction. Overweight/obese persons have higher probability of exceeding that threshold, explaining why adiposopathy/metabolic syndrome/NAFLD is more frequent in the obese. In this article, the epidemiology, pathogenesis, and management of patients with lean NAFLD are reviewed with an emphasis on reconciling the concepts of NAFLD in its relationship with adiposity and of NAFLD in lean individuals. |
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Nonalcoholic fatty liver disease in lean subjects: is it all metabolic-associated fatty liver disease?Lean nonalcoholic fatty liver diseaseMetabolically obese normal weightVisceral adipose tissueThe epidemiology of nonalcoholic fatty liver disease goes hand-in-hand with the obesity pandemic. The pathogenesis of fatty liver has shifted from an hepatocentric view to an adipocentric view, in which the overloaded adipose tissue spills out lipids that spread to ectopic tissues and organs such as the liver, elicits inflammation, and changes its adipokines profile promoting insulin resistance and the metabolic syndrome. Up to 40% of nonalcoholic fatty liver disease (NAFLD) patients are not obese and up to 20% are actually lean. Furthermore roughly 10% of lean subjects have NAFLD. In fact, adiposopathy can occur in patients with normal weight, and it is associated with expansion of metabolically active visceral fat and a qualitatively different adipose tissue that becomes overwhelmed after challenged by a mildly positive energy balance. This defines the concept of personal fat threshold that when exceeded results in metabolic dysfunction. Overweight/obese persons have higher probability of exceeding that threshold, explaining why adiposopathy/metabolic syndrome/NAFLD is more frequent in the obese. In this article, the epidemiology, pathogenesis, and management of patients with lean NAFLD are reviewed with an emphasis on reconciling the concepts of NAFLD in its relationship with adiposity and of NAFLD in lean individuals.Repositório ComumMachado, Mariana Verdelho2023-12-09T17:40:34Z20202020-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.26/48449eng10.20517/2394-5079.2020.90info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-12-15T05:00:39Zoai:comum.rcaap.pt:10400.26/48449Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T00:42:33.303266Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Nonalcoholic fatty liver disease in lean subjects: is it all metabolic-associated fatty liver disease? |
title |
Nonalcoholic fatty liver disease in lean subjects: is it all metabolic-associated fatty liver disease? |
spellingShingle |
Nonalcoholic fatty liver disease in lean subjects: is it all metabolic-associated fatty liver disease? Machado, Mariana Verdelho Lean nonalcoholic fatty liver disease Metabolically obese normal weight Visceral adipose tissue |
title_short |
Nonalcoholic fatty liver disease in lean subjects: is it all metabolic-associated fatty liver disease? |
title_full |
Nonalcoholic fatty liver disease in lean subjects: is it all metabolic-associated fatty liver disease? |
title_fullStr |
Nonalcoholic fatty liver disease in lean subjects: is it all metabolic-associated fatty liver disease? |
title_full_unstemmed |
Nonalcoholic fatty liver disease in lean subjects: is it all metabolic-associated fatty liver disease? |
title_sort |
Nonalcoholic fatty liver disease in lean subjects: is it all metabolic-associated fatty liver disease? |
author |
Machado, Mariana Verdelho |
author_facet |
Machado, Mariana Verdelho |
author_role |
author |
dc.contributor.none.fl_str_mv |
Repositório Comum |
dc.contributor.author.fl_str_mv |
Machado, Mariana Verdelho |
dc.subject.por.fl_str_mv |
Lean nonalcoholic fatty liver disease Metabolically obese normal weight Visceral adipose tissue |
topic |
Lean nonalcoholic fatty liver disease Metabolically obese normal weight Visceral adipose tissue |
description |
The epidemiology of nonalcoholic fatty liver disease goes hand-in-hand with the obesity pandemic. The pathogenesis of fatty liver has shifted from an hepatocentric view to an adipocentric view, in which the overloaded adipose tissue spills out lipids that spread to ectopic tissues and organs such as the liver, elicits inflammation, and changes its adipokines profile promoting insulin resistance and the metabolic syndrome. Up to 40% of nonalcoholic fatty liver disease (NAFLD) patients are not obese and up to 20% are actually lean. Furthermore roughly 10% of lean subjects have NAFLD. In fact, adiposopathy can occur in patients with normal weight, and it is associated with expansion of metabolically active visceral fat and a qualitatively different adipose tissue that becomes overwhelmed after challenged by a mildly positive energy balance. This defines the concept of personal fat threshold that when exceeded results in metabolic dysfunction. Overweight/obese persons have higher probability of exceeding that threshold, explaining why adiposopathy/metabolic syndrome/NAFLD is more frequent in the obese. In this article, the epidemiology, pathogenesis, and management of patients with lean NAFLD are reviewed with an emphasis on reconciling the concepts of NAFLD in its relationship with adiposity and of NAFLD in lean individuals. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020 2020-01-01T00:00:00Z 2023-12-09T17:40:34Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.26/48449 |
url |
http://hdl.handle.net/10400.26/48449 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.20517/2394-5079.2020.90 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799136326290767872 |