Ethnicity and nonalcoholic fatty liver disease
Kiran Bambha, Patricia Belt, Maria Abraham, Laura A Wilson, Mark Pabst, Linda Ferrell, Aynur Unalp-Arida, Nathan Bass, Nonalcoholic Steatohepatitis Clinical Research Network Research Group, Arthur J McCullough, Patricia Brandt, Diane Bringman, Srinivasan Dasarathy, Jaividhya Dasarathy, Carol Hawkins, Yao-Chang Liu, Nicholette Rogers, Arthur J McCullough, Srinivasan Dasarathy, Mangesh Pagadala, Ruth Sargent, Lisa Yerian, Claudia Zein, Raphael Merriman, Anthony Nguyen, Manal F Abdelmalek, Stephanie Buie, Anna Mae Diehl, Marcia Gottfried, Cynthia Guy, Meryt Hanna, Christopher Kigongo, Paul Killenberg, Samantha Kwan, Yi-Ping Pan, Dawn Piercy, Melissa Smith, Savita Srivastava, Naga Chalasani, Oscar W Cummings, Marwan Ghabril, Ann Klipsch, Linda Ragozzino, Girish Subbarao, Sweta Tandra, Raj Vuppalanchi, Andrea Morris, Joan Siegner, Susan Stewart, Brent A Neuschwander-Tetri, Judy Thompson, Cynthia Behling, Jennifer Collins, Janis Durelle, Tarek Hassanein, Joel E Lavine, Rohit Loomba, Anya Morgan, Heather Patton, Claude Sirlin, Bradley Aouizerat, Kiran Bambha, Marissa Bass, Nathan M Bass, Linda D Ferrell, Bo Gu, Bilal Hameed, Mark Pabst, Monique Rosenthal, Tessa Steel, Matthew Yeh, Sherry Boyett, Melissa J Contos, Michael Fuchs, Amy Jones, Velimir A C Luketic, Puneet Puri, Bimalijit Sandhu, Arun J Sanyal, Carol Sargeant, Kimberly Noble, Melanie White, Sarah Ackermann, Kris V Kowdley, Jane Park, Tracey Pierce, Jody Mooney, James Nelson, Cheryl Shaw, Alice Stead, Chia Wang, Elizabeth M Brunt, David E Kleiner, Edward C Doo, Jay H Hoofnagle, Patricia R Robuck, Averell Sherker, Patricia Belt, Frederick L Brancati, Jeanne M Clark, Ryan Colvin, Michele Donithan, Mika Green, Rosemary Hollick, Milana Isaacson, Wana K Jin, Alison Lydecker, Pamela Mann, Kevin P May, Laura Miriel, Alice Sternberg, James Tonascia, Aynur Ünalp-Arida, Mark Van Natta, Ivana Vaughn, Laura Wilson, Katherine Yates, Kiran Bambha, Patricia Belt, Maria Abraham, Laura A Wilson, Mark Pabst, Linda Ferrell, Aynur Unalp-Arida, Nathan Bass, Nonalcoholic Steatohepatitis Clinical Research Network Research Group, Arthur J McCullough, Patricia Brandt, Diane Bringman, Srinivasan Dasarathy, Jaividhya Dasarathy, Carol Hawkins, Yao-Chang Liu, Nicholette Rogers, Arthur J McCullough, Srinivasan Dasarathy, Mangesh Pagadala, Ruth Sargent, Lisa Yerian, Claudia Zein, Raphael Merriman, Anthony Nguyen, Manal F Abdelmalek, Stephanie Buie, Anna Mae Diehl, Marcia Gottfried, Cynthia Guy, Meryt Hanna, Christopher Kigongo, Paul Killenberg, Samantha Kwan, Yi-Ping Pan, Dawn Piercy, Melissa Smith, Savita Srivastava, Naga Chalasani, Oscar W Cummings, Marwan Ghabril, Ann Klipsch, Linda Ragozzino, Girish Subbarao, Sweta Tandra, Raj Vuppalanchi, Andrea Morris, Joan Siegner, Susan Stewart, Brent A Neuschwander-Tetri, Judy Thompson, Cynthia Behling, Jennifer Collins, Janis Durelle, Tarek Hassanein, Joel E Lavine, Rohit Loomba, Anya Morgan, Heather Patton, Claude Sirlin, Bradley Aouizerat, Kiran Bambha, Marissa Bass, Nathan M Bass, Linda D Ferrell, Bo Gu, Bilal Hameed, Mark Pabst, Monique Rosenthal, Tessa Steel, Matthew Yeh, Sherry Boyett, Melissa J Contos, Michael Fuchs, Amy Jones, Velimir A C Luketic, Puneet Puri, Bimalijit Sandhu, Arun J Sanyal, Carol Sargeant, Kimberly Noble, Melanie White, Sarah Ackermann, Kris V Kowdley, Jane Park, Tracey Pierce, Jody Mooney, James Nelson, Cheryl Shaw, Alice Stead, Chia Wang, Elizabeth M Brunt, David E Kleiner, Edward C Doo, Jay H Hoofnagle, Patricia R Robuck, Averell Sherker, Patricia Belt, Frederick L Brancati, Jeanne M Clark, Ryan Colvin, Michele Donithan, Mika Green, Rosemary Hollick, Milana Isaacson, Wana K Jin, Alison Lydecker, Pamela Mann, Kevin P May, Laura Miriel, Alice Sternberg, James Tonascia, Aynur Ünalp-Arida, Mark Van Natta, Ivana Vaughn, Laura Wilson, Katherine Yates
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder in the United States; however, few data are available about racial and ethnic variation. We investigated relationships between ethnicity, NAFLD severity, metabolic derangements, and sociodemographic characteristics in a well-characterized cohort of adults with biopsy-proven NAFLD. Data were analyzed from 1,026 adults (≥18 years) in the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) from 2004 to 2008, for whom liver histology data were available within 6 months of enrollment. Associations between ethnicity (i.e., Latino versus non-Latino white) and NAFLD severity (i.e., NASH versus non-NASH histology and mild versus advanced fibrosis) were explored with multiple logistic regression analysis. We also investigated effect modification of ethnicity on metabolic derangements for NAFLD severity. Within the NASH CRN, 77% (N = 785) were non-Latino white and 12% (N = 118) were Latino. Sixty-one percent (N = 628) had NASH histology and 28% (N = 291) had advanced fibrosis. Latinos with NASH were younger, performed less physical activity, and had higher carbohydrate intake, compared to non-Latino whites with NASH. Gender, diabetes, hypertension, hypertriglyceridemia, aspartate aminotransferase (AST), platelets, and the homeostasis model assessment of insulin resistance (HOMA-IR) were significantly associated with NASH. Age, gender, AST, alanine aminotransferase, alkaline phosphatase, platelets, total cholesterol, hypertension, and HOMA-IR, but not ethnicity, were significantly associated with advanced fibrosis. The effect of HOMA-IR on the risk of NASH was modified by ethnicity: HOMA-IR was not a significant risk factor for NASH among Latinos (odds ratio [OR] = 0.93; 95% confidence interval [CI]: 0.85-1.02), but was significant among non-Latino whites (OR, 1.06; 95% CI: 1.01-1.11).
Conclusion: Metabolic risk factors and sociodemographic characteristics associated with NASH differ by ethnicity. Additional insights into NASH pathogenesis may come from further studies focused on understanding ethnic differences in this disease.
Copyright © 2011 American Association for the Study of Liver Diseases.
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Source: PubMed