Observational Study
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World J Clin Cases. May 6, 2022; 10(13): 4097-4109
Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4097
Metabolic dysfunction is associated with steatosis but no other histologic features in nonalcoholic fatty liver disease
Yi-Ning Dai, Cheng-Fu Xu, Hong-Ying Pan, Hai-Jun Huang, Mei-Juan Chen, You-Ming Li, Chao-Hui Yu
Yi-Ning Dai, Cheng-Fu Xu, You-Ming Li, Chao-Hui Yu, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Yi-Ning Dai, Hong-Ying Pan, Hai-Jun Huang, Mei-Juan Chen, Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
Author contributions: Yu CH and Li YM contributed to the study design; Dai YN, Xu CF, and Chen MJ contributed to data collection; Huang HJ and Chen MJ analyzed the data; Dai YN drafted the manuscript; Xu CF and Yu CH contributed to critical comments on the manuscript; Pan HY contributed to the manuscript revision.
Supported by the National Natural Science Foundation of China, No. 81800507; the Public Welfare Project of the Science and Technology Agency, Zhejiang Province, No. LGF18H030010; and Medical and Health Research Project of Zhejiang Province, No. 2018KY256 and No. 2019KY294.
Institutional review board statement: This study was approved by the People’s Hospital of Hangzhou Medical College Institutional Review Board (No. 2021QT257).
Informed consent statement: All study participants provided informed written consent prior to liver biopsy.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao-Hui Yu, MD, PhD, Chief Doctor, Professor, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. zyyyych@zju.edu.cn
Received: July 26, 2021
Peer-review started: July 26, 2021
First decision: August 19, 2021
Revised: September 1, 2021
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: May 6, 2022
Core Tip

Core Tip: Non-obese and metabolically healthy patients with fatty liver are excluded from the definition of metabolic-associated fatty liver disease (MAFLD), but their clinical course has seldom been demonstrated. We analysed a group of nonalcoholic fatty liver disease (NAFLD) subjects, and found that the MAFLD subgroup had a higher NAFLD activity score and higher severity of hepatic steatosis than the non-MAFLD subgroup. There was no difference in other histologic features, including lobular and portal inflammation, balloon degeneration, and fibrosis, between the MAFLD and non-MAFLD patients. The grade of steatosis correlated positively with the hepatocellular ballooning degree, and the presence of nonalcoholic steatohepatitis. We believe that our study can provide insight into the histologic features of various subsets of fatty liver disease.