Prevalence of Metabolic Obese Normal Weight and Related Risk Factors in South China

[Objectives]Metabolic obese normal weight(MONW)is becoming one of the pubic problems which are threatening human health.Whereas,MONW was facing a great challenge for limited attention,especially for the female in China.The aim of this research was to estimate the prevalence of MONW and its related risk components in South China.[Methods]A community-based cross-sectional study was performed on 3349 residents aged 18-93 years in The First Affiliated Hospital of Jinan University,Guangzhou,China,in 2019.Data was collected by physical examination data which included physical measurements and laboratory examinations.[Results]In all subjects,55%were females(M/F=1509/1840).The prevalence of MONW was 16.09%(0.04%for male,16.05%for female,P<0.001).The prevalence increased significantly with increasing age in both genders(P<0.001).The binary logistic regression analysis shows that among the risk factors with MONW,age,BMI,gender,systolic pressure,hypertension[Male:ORs=2.56,95%CI(1.23,5.32);Female:ORs=2.88,95%CI(1.76,4.71)]and hypertriglyceridemia[Male:ORs=3.23,95%CI(1.67,6.19);Female:ORs=2.57,95%CI(1.64,4.03)]were found to be statistically significant.The level of ALT in MONW group was(27.88±15.85)in male and(24.33±15.75)in female,which were significantly higher than those in the non-MetS group.[Conclusions]The prevalence of MONW was pretty high.We considered MONW be significantly associated with the increase of ALT.Female gender,advanced age,and elevated ALT were independent risk factors for MONW.It was high time that the government should raise the public attention toward metabolic function in normal weight population.Effective prevention and treatment strategies for MONW and its risk factors should be developed targeting different ages and genders.

Nonalcoholic fatty liver disease in lean subjects:is it all metabolic-associated fatty liver disease?

The epidemiology of nonalcoholic fatty liver disease goes hand-in-hand with the obesity pandemic.The pathogenesis of fatty liver has shifted from an hepatocentric view to an adipocentric view,in which the overloaded adipose tissue spills out lipids that spread to ectopic tissues and organs such as the liver,elicits inflammation,and changes its adipokines profile promoting insulin resistance and the metabolic syndrome.Up to 40%of nonalcoholic fatty liver disease(NAFLD)patients are not obese and up to 20%are actually lean.Furthermore roughly 10%of lean subjects have NAFLD.In fact,adiposopathy can occur in patients with normal weight,and it is associated with expansion of metabolically active visceral fat and a qualitatively different adipose tissue that becomes overwhelmed after challenged by a mildly positive energy balance.This defines the concept of personal fat threshold that when exceeded results in metabolic dysfunction.Overweight/obese persons have higher probability of exceeding that threshold,explaining why adiposopathy/metabolic syndrome/NAFLD is more frequent in the obese.In this article,the epidemiology,pathogenesis,and management of patients with lean NAFLD are reviewed with an emphasis on reconciling the concepts of NAFLD in its relationship with adiposity and of NAFLD in lean individuals.