P-40 IS THERE A DISTINCT PHENOTYPE OF NON-ALCOHOLIC FATTY LIVER DISEASE IN LEAN AND OVERWEIGHT PATIENTS?

Abstract

Introduction and Objectives: Non-alcoholic fatty liver disease (NAFLD) is not an exclusive disease of obese patients. Lean and overweight patients also deal with this disease. This study aimed to analyze if there is any different NAFLD phenotype between lean and overweight patients. Materials and Methods: This is a cross-sectional study of descriptive characteristics of lean (BMI ≤ 24.9kg/m2) and overweight (BMI 25-29.9kg/m2) patients from a NAFLD outpatient care facility at a Tertiary reference hospital in Sao Paulo, Brazil. The analysis included: gender, age, BMI, Insulin Resistance (IR), Type 2 Diabetes Mellitus (T2DM), Systemic Arterial Hypertension (SAH), Dyslipidemia (DLP), ALT, AST, GGT, ferritin, liver stiffness, CAP, Fibrosis stages and NAS score. Mann-Whitney U test, Welch two-sample t-test and Fischer's exact test were used. Results: A total of 68 (54 overweight; 14 lean) NAFLD patients were analyzed. Female majority in each group (86% lean; 67% overweight). Similar mean age: in lean 63.79yo (CI95% 59.23-68.34yo) and in overweight 63.80yo (CI95%60.91-66.68yo). The mean BMI in lean was 22.77 kg/m2 (CI95% 22.08-23.47 kg/m2) and in overweight was 27.19 kg/m2 (CI95% 26.85-27.54 kg/m2). The majority of the groups had T2DM, DLP and SAH. IR occurred in 26% and 14% of overweight and lean, respectively. In the lean group, 13% didn't have IR or T2DM. ALT, AST, GGT, ferritin, liver stiffness and CAP between groups had no significant statistical difference (p > 0.05). Advanced fibrosis (≥ F3) in 7 (50%) lean and 30 (68%) overweight patients (p= 0.182). NASH (NAS ≥ 4) in 9 (64%) of the lean and 44 (81%) of the overweight (p= 0.222). Conclusions: In this small population study, preliminary results infer that lean and overweight NAFLD patients have similar characteristics. A large-scale study could confirm this data. Perhaps we should consider lean and overweight as one non-obese NAFLD group and eventually compare them with obese counterparts in future studies.