{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:26:34Z","timestamp":1791919594253,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,1,15]],"date-time":"2019-01-15T00:00:00Z","timestamp":1547510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>To elucidate features of nonobese non\u2010alcoholic fatty liver disease (NAFLD), we assessed Japanese patients with NAFLD stratified by body mass index (BMI) and by sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Biopsy\u2010proven 762 NAFLD patients (404 men) were classified into three groups by the Japanese criteria: nonobese group (BMI &lt;\u00a025\u00a0kg\/m<jats:sup>2<\/jats:sup>), obese group (25 to 30), and severely obese group (\u2265\u00a030). Clinicopathological features and single nucleotide polymorphism of patatin\u2010like phospholipase 3 (<jats:italic>PNPLA3<\/jats:italic>) rs738409 were investigated, and body composition analysis was performed by bioelectrical impedance analysis and computed tomography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over 25% of men and almost 40% of women were nonobese, but most of them had visceral fat obesity and\/or insulin resistance. The median age (years) of the nonobese, obese, and severely obese men was 49.9, 46.8, and 40.5 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01), respectively, while those of women was 60.2, 59.6, and 48.5 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01), respectively. The prevalence of metabolic comorbidities and <jats:italic>PNPLA3<\/jats:italic> risk alleles did not differ among these groups in both sexes. Also, the prevalence of non\u2010alcoholic steatohepatitis was not significantly different in both sexes, although nonobese patients had a higher prevalence of mild steatosis. Advanced fibrosis showed a marked difference between men and women. Advanced fibrosis was significantly more frequent among severely obese men (nonobese: 31.0%, obese: 41.6%, severely obese: 60.9%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01), but it was lower among severely obese women (51.4%, 62.9%, 33.7%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). Skeletal muscle mass was significantly lower in nonobese patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Non\u2010alcoholic fatty liver disease was not milder in nonobese patients. Histological steatosis was associated with BMI, but advanced fibrosis was not and showed a significant sex difference.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14585","type":"journal-article","created":{"date-parts":[[2018,12,27]],"date-time":"2018-12-27T22:14:26Z","timestamp":1545948866000},"page":"1404-1410","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Characteristics of non\u2010alcoholic steatohepatitis among lean patients in Japan: Not uncommon and not always benign"],"prefix":"10.1111","volume":"34","author":[{"given":"Maki","family":"Tobari","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Gastroenterology Tokyo Women's Medical University Yachiyo Medical Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estuko","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makiko","family":"Taniai","sequence":"additional","affiliation":[{"name":"Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuuichi","family":"Ikarashi","sequence":"additional","affiliation":[{"name":"Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhisa","family":"Kodama","sequence":"additional","affiliation":[{"name":"Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1248-4324","authenticated-orcid":false,"given":"Tomomi","family":"Kogiso","sequence":"additional","affiliation":[{"name":"Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsutoshi","family":"Tokushige","sequence":"additional","affiliation":[{"name":"Internal Medicine, Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishino","family":"Takayoshi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Gastroenterology Tokyo Women's Medical University Yachiyo Medical Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naotake","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Tokyo Women's Medical University Yachiyo Medical Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-015-1050-7"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.11.004"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13857"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29367"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28431"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24283"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.476"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12609"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.235"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)15268-3"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2001.49"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/60.1.23"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.01.046"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67402-8"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.08.028"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28839"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.09.037"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-014-0488-5"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2014.983160"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28697"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1872-034X.2007.00156.x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-010-0311-8"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26761"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.2957\/kanzo.55.199"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28376"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29420"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.08.019"},{"key":"e_1_2_7_29_1","first-page":"751","article-title":"Validity of NAFLD fibrosis score in Japanese population","volume":"105","author":"Nakano M","year":"2012","journal-title":"Nihon Shokakibyo Gakkai Zasshi"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12333"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20701"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25889"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27173"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28514"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27097"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yfrne.2013.08.001"}],"updated-by":[{"DOI":"10.1111\/jgh.15015","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2020,3,11]],"date-time":"2020-03-11T00:00:00Z","timestamp":1583884800000}}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjgh.14585","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.14585","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T06:23:33Z","timestamp":1694327013000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.14585"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,15]]},"references-count":35,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1111\/jgh.14585"],"URL":"https:\/\/doi.org\/10.1111\/jgh.14585","archive":["Portico"],"relation":{"correction":[{"id-type":"doi","id":"10.1111\/jgh.15015","asserted-by":"object"}]},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,15]]},"assertion":[{"value":"2018-08-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}