Racial differences in nonalcoholic fatty liver disease in the U.S. population - PubMed (original) (raw)

Racial differences in nonalcoholic fatty liver disease in the U.S. population

Andrea L C Schneider et al. Obesity (Silver Spring). 2014 Jan.

Abstract

Objective: To characterize the prevalence of nonalcoholic fatty liver disease (NAFLD) by race in a nationally representative sample of the U.S. population and to investigate potential explanatory factors for racial disparities.

Design and methods: Cross-sectional study of 4,037 non-Hispanic white, 2,746 non-Hispanic black, and 2,892 Mexican-American adults in the Third National Health and Nutrition Examination Survey. NAFLD was defined using ultrasound and with elevated aminotransferases.

Results: Age-adjusted prevalence of NAFLD was highest in Mexican-Americans (21.2%), followed by non-Hispanic whites (12.5%), and was lowest in non-Hispanic blacks (11.6%). Even after adjustment for demographic, lifestyle, adiposity, and metabolic factors, compared to non-Hispanic whites, Mexican-Americans were more likely to have NAFLD (OR: 1.67, 95% CI: 1.26, 2.22). Non-Hispanic blacks were significantly less likely to have NAFLD with elevated aminotransferases (OR: 0.51, 95% CI: 0.27, 0.97). Racial differences were attenuated among those with normal BMI and among "never drinkers."

Conclusion: In this representative sample of the U.S. population, we found significant racial differences in the prevalence of ultrasound-defined NAFLD (with and without elevated liver enzymes). The racial differences were not fully explained by lifestyle, adiposity, and metabolic factors. More works is needed to identify potential contributors.

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Figures

Appendix Figure 1

Age-adjusted prevalence (95% confidence interval) for NAFLD* by race and body mass index group among participants without diabetes (Panel A) and among participants with diabetes (Panel B). *NAFLD was defined as the presence of moderate or severe hepatic steatosis by ultrasound in the absence of alcohol consumption >1 drink/day for women and >2 drinks/day for men and in the absence of the current use of zydovudine or didanosine, medications shown to induce hepatic steatosis. † p<0.05 comparing Mexican-Americans to non-Hispanic whites ‡ p<0.05 comparing non-Hispanic blacks to non-Hispanic whites

Appendix Figure 2

Age-adjusted prevalence (95% confidence interval) for NAFLD* by race and body mass index group among physically active participants (Panel A) and among physically inactive participants (Panel B). *NAFLD was defined as the presence of moderate or severe hepatic steatosis by ultrasound in the absence of alcohol consumption >1 drink/day for women and >2 drinks/day for men and in the absence of the current use of zydovudine or didanosine, medications shown to induce hepatic steatosis. † p<0.05 comparing Mexican-Americans to non-Hispanic whites ‡ p<0.05 comparing non-Hispanic blacks to non-Hispanic whites

Figure

Age-adjusted prevalence (95% confidence interval) for NAFLD* (Panels A [men] and B [women]) and NAFLD with elevated aminotransferases** (Panels C [men] and D [women]) by race and body mass index group. *NAFLD was defined as the presence of moderate or severe hepatic steatosis by ultrasound in the absence of alcohol consumption >1 drink/day for women and >2 drinks/day for men and in the absence of the current use of zydovudine or didanosine, medications shown to induce hepatic steatosis. **NAFLD with elevated aminotransferases was defined as the presence of NAFLD and elevated ALT or AST, defined as above the upper limit of normal of the NHANES laboratory values (ALT: >40 U/L for men and >31 U/L for women; AST: >37 U/L for men and >31 U/L for women), in the absence of hepatitis B, hepatitis C, and transferrin saturation >50%. † p<0.05 comparing Mexican-Americans to non-Hispanic whites ‡ p<0.05 comparing non-Hispanic blacks to non-Hispanic whites

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Racial differences in nonalcoholic fatty liver disease in the U.S. population - PubMed (original) (raw)