[1] Ye Q, Zou B, Yeo Y H, et al. Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: a systematic review and meta-analysis [J]. Lancet Gastroenterol Hepatol, 2020, 5(8): 739-752. [2] Long M T, Noureddin M, Lim J K. AGA clinical practice update: diagnosis and management of nonalcoholic fatty liver disease in lean individuals: expert review[J]. Gastroenterology, 2022, 163(3): 764-774.e1. [3] Ye Q, Zou B, Yeo Y H, et al. Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: a systematic review and meta-analysis[J]. Lancet Gastroenterol Hepatol, 2020, 5(8): 739-752. [4] Trifan A, Rotaru A, Stafie R, et al. Clinical and laboratory characteristics of normal weight and obese individuals with non-alcoholic fatty liver disease[J]. Diagnostics (Basel), 2022, 12(4): 801. [5] Younes R, Govaere O, Petta S, et al. Caucasian lean subjects with non-alcoholic fatty liver disease share long-term prognosis of non-lean: time for reappraisal of BMI-driven approach? [J]. Gut, 2022,71(2): 382-390. [6] Feldman A, Eder S K, Felder T K, et al. Clinical and metabolic characterization of lean caucasian subjects with non-alcoholic fatty liver[J]. Am J Gastroenterol, 2017, 112(1): 102-110. [7] Niltwat S, Limwongse C, Charatcharoenwitthaya N, et al. Familial clustering of nonalcoholic fatty liver disease in first-degree relatives of adults with lean nonalcoholic fatty liver disease[J]. Liver Int, 2023,43(12): 2713-2726. [8] Lin H P, Wong G L-H, Whatling C, et al. Association of genetic variations with NAFLD in lean individuals[J]. Liver Int, 2022, 42(1): 149-160. [9] Wang Q Y, You H, Ou X J, et al. Non-obese histologically confirmed NASH patients with abnormal liver biochemistry have more advanced fibrosis[J]. Hepatol Int, 2019, 13(6):766-776. [10] Sun Z W, Pan X C, Tian A W, et al. Genetic variants in HFE are associated with non-alcoholic fatty liver disease in lean individuals[J]. JHEP Rep, 2023, 5(7):100744. [11] Zheng M, Huang D Q, Konkwo C, et al. Genomic analysis of lean individuals with NAFLD identifies monogenic disorders in a prospective cohort study[J]. JHEP REP, 2023, 5(4):100692. [12] Huang X Y, Yao Y C, Hou X L, et al. Macrophage SCAP contributes to metaflammation and lean NAFLD by activating STING-NF-κB signaling pathway[J]. Cell Mol Gastroenterol Hepatol, 2022, 14(1): 1-26. [13] Zhu X P, Huang Q X, Ma S, et al. Presence of sarcopenia identifies a special group of lean NAFLD in middle-aged and older people[J]. Hepatol Int, 2023, 17(2): 313-325. [14] Zhang X X, He Z Y, Si Q Y, et al. The association of sarcopenia and visceral obesity with lean nonalcoholic fatty liver disease in Chinese patients with type 2 diabetes mellitus[J]. J Diabetes Res, 2022, 2022:2229139. [15] Zhang W J, Cheng W L, Li J H, et al. New aspects characterizing non-obese NAFLD by the analysis of the intestinal flora and metabolites using a mouse model[J]. mSystems, 2024, 9(3): eO102723. [16] Demir M, Lang S, Hartmann P, et al. The fecal mycobiome in non-alcoholic fatty liver disease[J]. J Hepatol, 2022, 76(4): 788-799. [17] Chen F, Esmaili S, Rogers G B, et al. Lean NAFLD: a distinct entity shaped by differential metabolic adaptation[J]. Hepatology, 2020, 71(4): 1213-1227. [18] Yoshida K, Yokota K, Kutsuwada Y, et al. Genome-wide association study of lean nonalcoholic fatty liver disease suggests human leukocyte antigen as a novel candidate locus[J]. Hepatol Commun, 2020, 4(8): 1124-1135. [19] Martínez-Domínguez S J, García-Mateo S, Gargallo-Puyuelo C J, et al. Inflammatory bowel disease is an independent risk factor for metabolic dysfunction-associated steatotic liver disease in lean individuals[J]. Inflamm Bowel Dis, 2024, 30(8): 1274-1283. [20] Kountouras J, Papaefthymiou A, Polyzos S A, et al. Letter: higher severe outcomes among Helicobacter pylori-related lean patients with non-alcoholic fatty liver disease and metabolic comorbidities[J]. Aliment Pharmacol Ther, 2023, 57(10): 1186-1187. [21] Yabe Y, Chihara K, Oshida N, et al. Survey of dietary habits and physical activity in japanese patients with non-obese non-alcoholic fatty liver disease[J]. Nutrients, 2023, 15(12): 2764. [22] González-Alvarez M E, Keating A F. Hepatic and ovarian effects of perfluorooctanoic acid exposure differ in lean and obese adult female mice[J]. Toxicol Appl Pharmacol, 2023, 474:116614. [23] Deng P Z, Tang H B, Zhu L Y, et al. Association of long-term ambient fine particulate matter (PM2.5) and incident non-alcoholic fatty liver disease in Chinese adults[J]. Environ Pollut, 2023, 329:121666. [24] Kim J J, Kim D, Yim J Y, et al. Polycystic ovary syndrome with hyperandrogenism as a risk factor for non-obese non-alcoholic fatty liver disease[J]. Aliment Pharmacol Ther, 2017, 45(11): 1403-1412. [25] Souza M, Diaz I, Al-Sharif L. Liver and cardiovascular outcomes in lean non-alcoholic fatty liver disease: an updated systematic review and meta-analysis of about 1 million individuals[J]. Hepatol Int, 2024, 8. [26] Almomani A, Kumar P, Onwuzo S, et al. Epidemiology and prevalence of lean nonalcoholic fatty liver disease and associated cirrhosis, hepatocellular carcinoma, and cardiovascular outcomes in the United States: a population-based study and review of literature[J]. J Gastroenterol Hepatol, 2023, 38(2): 269-273. [27] De A, Mehta M, Singh P, et al. Lean Indian patients with non-alcoholic fatty liver disease (NAFLD) have less metabolic risk factors but similar liver disease severity as non-lean patients with NAFLD[J]. Int J Obes (Lond), 2023, 47(10): 986-992. [28] Nabi Q, Lapidus N, Boursier J, et al. Lean individuals with NAFLD have more severe liver disease and poorer clinical outcomes (NASH-CO Study) [J]. Hepatology, 2023, 78(1): 272-283. [29] Do A, Lim J K. Lean NAFLD is associated with adverse liver events and mortality: moving beyond BMI[J]. Hepatology, 2023,78(1):6-7. [30] Kawanaka M, Nishino K, Kawada M, et al. Lean nonalcoholic fatty liver disease: Age-dependent differences in pathology, prognosis, and liver-related events[J]. Hepatol Res, 2023, 53(9):829-843. [31] Lan Y Q, Lu Y, Li J F, et al. Outcomes of subjects who are lean, overweight or obese with nonalcoholic fatty liver disease: a cohort study in China[J]. Hepatol Commun, 2022, 6(12): 3393-3405. [32] Arvind A, Henson J B , Osganian S A, et al. Risk of cardiovascular disease in individuals with nonobese nonalcoholic fatty liver disease[J]. Hepatol Commun, 2022, 6(2): 309-319. [33] Park H, Yoon E L, Ito T, et al. Diagnostic performance of the fibrosis-4 index and nonalcoholic fatty liver disease fibrosis score in lean adults with nonalcoholic fatty liver disease[J]. JAMA Netw Open, 2023, 6(8): e2329568. [34] Vilarinho S, Ajmera V, Zheng M, et al. Emerging role of genomic analysis in clinical evaluation of lean individuals with NAFLD[J]. Hepatology, 2021, 74(4): 2241-2250. [35] Sinn D H, Kang D, Cho S J, et al. Weight change and resolution of fatty liver in normal weight individuals with nonalcoholic fatty liver disease[J]. Eur J Gastroenterol Hepatol, 2021, 33(1S Suppl 1): e529-e534. [36] Wong V W-S, Wong G L-H, Chan R S-M, et al. Beneficial effects of lifestyle intervention in non-obese patients with non-alcoholic fatty liver disease[J]. J Hepatol, 2018, 69(6): 1349-1356. [37] Lindén D, Ahnmark A, Pingitore P, et al. Pnpla3 silencing with antisense oligonucleotides ameliorates nonalcoholic steatohepatitis and fibrosis in Pnpla3 I148M knock-in mice[J]. Mol Metab, 2019, 22: 49-61. |