Frequency, Clinical Characteristics, and Risk Factors of Nonalcoholic Fatty Liver Disease in Lean Individuals attending Qena University Hospital

Background: Non-alcoholic fatty liver disease (NAFLD) involves liver fat accumulation without alcohol, including NAFL and Non alcoholic steatohepatitis (NASH). Rising globally due to obesity, and diabetes, affecting even lean individuals (lean-NAFLD), demanding focused management and prevention. Objectives: To assess the frequency, clinical characteristics, and risk factors of NAFLD in lean individuals. Patients and methods: The cross-sectional study at South Valley University Hospital involved 200 lean participants with BMI within ethnic-specific cutoffs. Comprehensive assessments included history, examinations, laboratory tests, and abdominal ultrasonography. Fibroscan, Fibrosis-4 (FIB-4), and Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) scores were used to determine liver fibrosis stages and predict fibrosis and cirrhosis. Results: The study involved 200 lean participants with an average age of 40.72 ± 6.71 years, 166 (83%) non-NAFLD patients and 34 (17%) NAFLD patients. Males made up 60.2% of the non-NAFLD group and 70.6% of the NAFLD group, while females made up 39.8% of the non-NAFLD group and 29.4% of the NAFLD. Lean NAFLD was associated with increased hip circumference, altered waist-to-height ratio and arm circumference, higher Systolic and diastolic blood pressure, also higher levels of HOMA-IR, TSH, and uric acid. 6% of the NAFLD group had ASMA, AMA positive with significant elevations in fibrosis and liver stiffness measurements. Conclusion: Lean NAFLD associated to elevated lipid profile, liver enzymes, protein, HOMA-IR, blood sugar, uric acid, TSH.