Research
Hormonal
In lean individuals, the PNPLA3 rs738409 G allele is an independent predictor of NAFLD and NASH severity, whereas it is not associated with histological severity in obese patients.
If you are lean and have fatty liver, genetic testing for PNPLA3 may help predict your risk of progression to NASH. This information can guide how frequently you need liver biopsies or advanced imaging, even if you maintain a healthy weight.
GoodQualifiesHIGH confidence
In a Japanese cohort of biopsy-proven NAFLD patients... lobular inflammation, hepatocyte ballooning, and NAFLD activity score were strictly associated with the GG-PNPLA3 single-nucleotide polymorphism, which was more prevalent in the nonobese cohort and was not associated with histological severity in NAFLD obese patients.
Why this rating
Consistent findings across multiple genetic association studies in Asian and Caucasian cohorts.
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
More from this paper
- 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.Good
- High fructose intake is a significant independent environmental risk factor for NAFLD in lean, non-obese individuals, particularly children and adolescents.Moderate
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