Role of Visceral Adiposity in the Pathogenesis of Non-Alcoholic Fatty Liver Disease in Lean versus Obese Patients: A Comparative Study between Patients at UMHS versus PUHSC

JI Program: GI & Liver


Non-alcoholic fatty liver disease (NAFLD) is a spectrum of liver disease ranging from steatosis alone to steatohepatitis (NASH) and cirrhosis and is an increasing cause of hepatocellular carcinoma (HCC) worldwide. Global prevalence of NAFLD is increasingly rapidly due to the epidemic of obesity and diabetes. The prevalence of NAFLD among adults is estimated to be 30% in the U.S. and 15% in China. The major causes of NAFLD are obesity, diabetes and insulin resistance; however, NAFLD may be present in lean persons. The finding of NAFLD in lean persons is more common among Asians and Caucasians. This is a prospective observational study with the primary goal to understand the pathogenesis of NAFLD in lean Chinese. This study will employ a novel technique, analytic morphomics, to quantify visceral adipose tissue, ectopic adipose tissue and quality of fat in lean Chinese with NAFLD versus lean Chinese with no NAFLD and obese Chinese with NAFLD. We hypothesize that among lean Chinese, models that include data on the quantity and quality of visceral and ectopic adipose tissue determined by analytic morphomics outperform models that include only routinely available demographics, anthropometrics and laboratory data in predicting risk of NAFLD and to implement interventions to improve outcomes of those who are predicted to have high risk of metabolic abnormalities and progressive liver disease. The study will also support one young investigator from PKUHSC to receive 1-year training in clinical research at Michigan Medicine.


  • Enrollment completed at PKU and near completion at UM.
  • Trainee mentored by Dr. Anna Lok and Dr. Lai Wei
  • Dr. Wei Zhang from PKUHSC completed 14 training at UM as visiting scholar.
  • 2 UMMS M1 students completed 6-week summer research program at PKUHSC


1. Zhang W, Chao S, Chen S, Rao H, Huang R, Wei L, Lok AS. Awareness and knowledge of non-alcoholic fatty liver disease among office employees in Beijing, China. Dig Dis Sci 64: 708-717, 2019. PMID: 30483909.

Extramural Funding

Project indirectly contributed to award of $3.38M U01 from National Cancer Institute, NIH to Dr. Anna Lok, Grace Su (co-I in this study), and Thomas Wang (PI of another JI study).