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Metabolic dysfunction-associated steatotic liver disease (MASLD) affects more than 30% of the world's adult population. While it is associated with obesity and metabolic syndrome, emerging evidence has shown that a substantial number of MASLD patients have a normal body mass index ("lean individuals with MASLD"). In this article, we provide an overview of the definition, epidemiology, pathogenesis, and clinical outcomes associated with lean individuals with MASLD and updates on current management. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and encompasses a spectrum of pathology from simple steatosis to inflammation and significant fibrosis that leads to cirrhosis. NAFLD and its comorbid conditions extend well beyond the liver. It is a multisystemic clinical disease entity with extrahepatic manifestations such as cardiovascular disease, type 2 diabetes, chronic kidney disease, hypothyroidism, polycystic ovarian syndrome, and psoriasis. Indeed, the most common causes of mortality in subjects with NAFLD are cardiovascular disease, followed by malignancies and then liver-related complications as a distant third. This review focuses on several of the key extrahepatic manifestations of NAFLD and areas for future investigation. Clinicians should learn to screen and initiate treatment for these extrahepatic manifestations in a prompt and timely fashion before they progress to end-organ damage. [ABSTRACT FROM AUTHOR]

OBJECTIVES:Non-alcoholic fatty liver disease (NAFLD) is known to be related to factors that predict the development of coronary heart disease (CHD), such as dyslipidemia, central obesity, and metabolic syndrome (MS). The aim of this study was to determine whether individuals with NAFLD have an elevated risk of CHD, as estimated using the Framingham risk score (FRS).METHODS:A total of 21,130 individuals who underwent a voluntary general health examination were recruited. NAFLD was diagnosed among these individuals on the basis of typical sonographic findings and a level of alcohol consumption of <20 g/day. Of the 21,130 individuals, 3,780 were excluded because they had known causes of liver disease (1,690 were alcoholics, 975 had hepatitis B virus, 242 had hepatitis C virus, 91 had other hepatitis history, and 593 were taking medication known to produce fatty liver) or a history of heart disease (189).RESULTS:NAFLD was diagnosed in 5,769 of the 17,350 individuals (33.3%). The 11,581 normal individuals constituted the control group. The 5,769 individuals with NAFLD were split into two groups on the basis of ultrasonographic findings, that is, into a mild NAFLD group (n=3,278) and a moderate–severe NAFLD group (n=2,491). Individuals with NAFLD had an elevated risk of CHD, as estimated using FRS. Multivariable regression analysis, adjusted for confounding factors, showed a strong association between a higher FRS and NAFLD.CONCLUSIONS:Individuals with ultrasonographically detected NAFLD have an elevated 10-year risk of developing CHD as estimated using FRS. Furthermore, NAFLD was found to be independently related to the risk of developing CHD, regardless of classical risk factors and other components of MS.Am J Gastroenterol 2009; 104:1953–1960; doi:10.1038/ajg.2009.238; published online 2 June 2009 [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) is characterized by histological evidence of hepatic steatosis, lobular inflammation, ballooning degeneration and hepatic fibrosis in the absence of significant alcohol use and other known causes of chronic liver diseases. NAFLD is subdivided into nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). NAFL is generally benign but can progress to NASH, which carries a higher risk of adverse outcomes including cirrhosis, end-stage liver disease, hepatocellular carcinoma and death if liver transplantation is not pursued in a timely fashion. Currently, lifestyle modifications including healthy diet and increased physical activity/exercise culminating in weight loss of 5% to >10% is the cornerstone of treatment intervention for patients with NAFLD. Patients with NAFLD who fail to obtain this goal despite the help of dietitians and regimented exercise programs are left in a purgatory state and remain at risk of developing NASH-related advance fibrosis. For such patients with NAFLD who are overweight and obese, healthcare providers should consider a trial of FDA-approved anti-obesity medications as adjunct therapy to provide further preventative and therapeutic options as an effort to reduce the risk of NAFLD-related disease progression. [ABSTRACT FROM AUTHOR]