Research
Hormonal
Lean individuals (BMI < 25 kg/m² for Caucasians, < 23 kg/m² for Asians) with NAFLD face a higher risk of severe liver disease and mortality compared to obese NAFLD patients, challenging the belief that lean NAFLD follows a benign clinical course.
If you have fatty liver but are not overweight, do not assume your condition is mild. You are at higher risk for severe liver complications than obese patients with fatty liver. You require regular monitoring for fibrosis progression and metabolic health, just as strictly as obese patients.
GoodRefutesHIGH confidence
Despite a better metabolic profile, less insulin resistance, and fibrosis, lean subjects have a higher overall mortality than patients with NAFLD who are overweight or obese.
Why this rating
Based on multiple longitudinal cohort studies with long follow-up (up to 19.9 years) and consistent findings across ethnicities.
Source
NASH in Lean Individuals
Ramy Younes et al. · Seminars in Liver Disease · 2019
DOI 10.1055/s-0038-1677517
narrative_reviewCited 233×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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