Current Hepatology Reports

, Volume 15, Issue 2, pp 134–139 | Cite as

Lean NAFLD: an Underrecognized Outlier

  • Julia Wattacheril
  • Arun J. SanyalEmail author
Fatty Liver Disease (SA Harrison and J George, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Fatty Liver Disease


Nonalcoholic fatty liver disease (NAFLD) is commonly diagnosed in obese or overweight individuals. However, lean individuals with NAFLD are not rare but represent one significant end of the phenotypic spectrum of NAFLD. Although initial observations between obese and lean NAFLD reveal some metabolic parallels, these associations vary widely given differences in study populations and metabolic parameters assessed. The role of body composition in risk assessment is significant and incompletely assessed during most clinical encounters. Recent multinational investigation reveals an increased mortality in lean individuals with nonalcoholic steatohepatitis (NASH). Many aspects of lean NAFLD need further exploration including epidemiology, clinical risk assessment, histologic changes unique to lean NAFLD, genetic and pathophysiologic mechanisms predisposing at risk individuals, natural history, and treatment strategies in this underrecognized population.


Lean Nonobese Normal weight Nonalcoholic fatty liver disease (NAFLD) Nonalcoholic steatohepatitis (NASH) 


Compliance with Ethical Standards

Conflict of Interest

JW and AJS declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Center for Liver Disease and Transplantation, Columbia University Medical CenterNew York Presbyterian HospitalNew YorkUSA
  2. 2.VCU Medical CenterVirginia Commonwealth UniversityRichmondUSA

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