Original Investigation

Histologic Features and Clinical Outcomes of Lean Metabolic Dysfunction–Associated Steatotic Liver Disease

JAMA 10.1001/jama.2026.18491

September 30, 2026 at 11:00 AM EDT

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Lean MASLD represents a distinct phenotype with milder histologic disease but similar clinical outcomes compared with overweight/obese MASLD. Fibrosis severity, rather than body composition, was associated with prognosis and LSM was reliable in lean individuals.

Corresponding Author: Zobair M. Younossi, MD, MPH, Center for Outcomes Research in Liver Diseases, 2411 I St, Washington, DC 20037 (Zobair.Younossi@cldq.org).

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