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Page 12 of 13 Oliveira et al. Hepatoma Res 2020;6:xx I http://dx.doi.org/10.20517/2394-5079.2020.73

In summary, the current study provides novel information on the variability in disease phenotype in lean as
well as overweight and obese subjects in different parts of the world. It challenges the paradigm that all lean
subjects with NAFLD have mild IR and have mild forms of liver disease. Conversely, it also demonstrates
that a fraction of obese subjects with the full spectrum of NAFLD may be relatively insulin sensitive. Future
studies to define the mechanistic basis for these differences may inform therapeutic choices in subjects in
different regions.

DECLARATIONS
Authors’ contributions
Design: Paredes A, Siddiqui M, Boyett S, Sanyal AJ
Performance: Oliveira CP, Paredes A, Siddiqui M, Serfaty L, Chowdhury A, Stefano JT, Vanni DS, Boyett S,
Sanyal AJ
Analysis: Oliveira CP, Paredes A, Serfaty L, Chowdhury A, Sanyal AJ
Writing: Oliveira CP, Serfaty L, Chowdhury A, Stefano JT, Vanni DS, Sanyal AJ

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
This was a retrospective study, approval from the study number 164.116 at the local Ethics Committee.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020.

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