A Surprise and a Mystery: NAFLD in Lean Patients Linked to CVD Risk

A surprise finding from a new study reveals that People with nonalcoholic fatty liver disease (NAFLD) and a lean or healthy body mass index (BMI) are at increased risk for peripheral vascular disease, stroke, and cardiovascular disease,

The investigators saw this increased risk of cardiovascular disease despite this group having a lower prevalence of atherosclerotic risk factors and metabolic disease.

This study suggests physicians should consider the risk of cardiovascular disease in all patients with Non alcoholic fatty liver disease, not just in those who are overweight or living with obesity that are traditionally thought to carry more risk.

The investigators retrospectively studied a cohort of 18,793 adults diagnosed with this condition at the University of Michigan Hospital. One aim was to compare the prevalence of cirrhosis, cardiovascular disease, metabolic diseases, and chronic kidney disease in relation to BMI.

They also classified people into four BMI categories: lean, overweight, obesity class 1, and obesity class 2-3. It was found that compared to non-lean patients, lean patients had a higher prevalence of peripheral arterial disease and stroke and a similar rate of cardiovascular disease. Almost 6% of lean patients had peripheral arterial disease. Similarly, more than 6% of the lean group experienced a stroke compared with 5% or less of the other BMI groups.

Researchers hence concluded that lean patients with Non alcoholic fatty liver disease also had a significant higher prevalence of cardiovascular disease, independent of age, sex, race, smoking status, diabetes, hypertension, and dyslipidemia.