| Summary: | Background: The prevalence of metabolic associated fatty liver disease (MAFLD) in lean patients has grown around the world and the better understanding of this liver disease, in these individuals, has become of interest. Aim: To evaluate the profile of MAFLD in lean compared to obese patients. Methodology: This case-series included patients with MAFLD from a hepatology clinic. MAFLD criteria included the presence of steatosis (ultrasound) and one of the following clinical conditions: overweight/obesity, type 2 diabetes mellitus (T2DM), other features of metabolic dysfunction. Fibrosis was evaluated by FIB4 and APRI scores. Two groups were considered: G1-lean adult (BMI≤24.99 kg/m²); elderly (≥60 years- BMI<28 kg/m²) patients; G2-obese adult (BMI≥25kg/m²); elderly (BMI>28kg/m²). SPSS software was used for data analysis. Results: A total of 135 MAFLD patients were included: 57(42.2%) in G1; 78(57.8%) in G2. G1 characteristics: Mean age was 62.26 years (SD=11.71); 70.2% were women; 75% were of African descent (self-declared); BMI mean: 24.59kg/m²(SD=2.37). Hypertriglyceridemia (HYT) was observed in 42.9% patients, T2DM in 47.4%, arterial hypertension (AH) in 54.4%, and low HDL 41.2%. Fibrosis not observed by FIB4 or APRI in all lean cases. G2 characteristics: Mean age was 55.62 years (SD=10.4); 80.8% were women; BMI mean: 32.05kg/m² (SD=3.78); 91% were of African descent. AH was found in 57.7% of the cases; T2DM in 46.2%; HYT in 36.1% and low HDL in 38.6%. Fibrosis was not observed by FIB4 and 5.5% presented fibrosis by APRI. Conclusions: In these lean patients, MAFLD was frequent in elderly women; hypertriglyceridemia, T2DM were relevant risk factor; and they did not present fibrosis by noninvasive scores. The prevalence of Afro descent in this MAFLD population was elevated and the ethnicity influence in these cases needs to be better understood in future studies.
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