Ethnicity and nonalcoholic fatty liver disease

Kiran Bambha, Patricia Belt, Maria Abraham, Laura A Wilson, Mark Pabst, Linda Ferrell, Aynur Unalp-Arida, Nathan Bass, Bradley Aouizerat, Nonalcoholic Steatohepatitis Clinical Research Network Research Group

Research output: Contribution to journalArticle

Abstract

UNLABELLED: 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.

Original languageEnglish (US)
Pages (from-to)769-80
Number of pages12
JournalHepatology
Volume55
Issue number3
DOIs
StatePublished - Mar 2012

Fingerprint

Hispanic Americans
Insulin Resistance
Homeostasis
Histology
Fibrosis
Aspartate Aminotransferases
Blood Platelets
Odds Ratio
Confidence Intervals
Hypertension
Hypertriglyceridemia
Liver
Non-alcoholic Fatty Liver Disease
Alanine Transaminase
Research
Alkaline Phosphatase
Logistic Models
Cholesterol
Regression Analysis
Carbohydrates

Keywords

  • Adult
  • Biopsy
  • European Continental Ancestry Group
  • Fatty Liver
  • Female
  • Hispanic Americans
  • Humans
  • Liver
  • Liver Cirrhosis
  • Logistic Models
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Socioeconomic Factors
  • United States

Cite this

Bambha, K., Belt, P., Abraham, M., Wilson, L. A., Pabst, M., Ferrell, L., ... Nonalcoholic Steatohepatitis Clinical Research Network Research Group (2012). Ethnicity and nonalcoholic fatty liver disease. Hepatology, 55(3), 769-80. https://doi.org/10.1002/hep.24726

Ethnicity and nonalcoholic fatty liver disease. / Bambha, Kiran; Belt, Patricia; Abraham, Maria; Wilson, Laura A; Pabst, Mark; Ferrell, Linda; Unalp-Arida, Aynur; Bass, Nathan; Aouizerat, Bradley; Nonalcoholic Steatohepatitis Clinical Research Network Research Group.

In: Hepatology, Vol. 55, No. 3, 03.2012, p. 769-80.

Research output: Contribution to journalArticle

Bambha, K, Belt, P, Abraham, M, Wilson, LA, Pabst, M, Ferrell, L, Unalp-Arida, A, Bass, N, Aouizerat, B & Nonalcoholic Steatohepatitis Clinical Research Network Research Group 2012, 'Ethnicity and nonalcoholic fatty liver disease', Hepatology, vol. 55, no. 3, pp. 769-80. https://doi.org/10.1002/hep.24726
Bambha K, Belt P, Abraham M, Wilson LA, Pabst M, Ferrell L et al. Ethnicity and nonalcoholic fatty liver disease. Hepatology. 2012 Mar;55(3):769-80. https://doi.org/10.1002/hep.24726
Bambha, Kiran ; Belt, Patricia ; Abraham, Maria ; Wilson, Laura A ; Pabst, Mark ; Ferrell, Linda ; Unalp-Arida, Aynur ; Bass, Nathan ; Aouizerat, Bradley ; Nonalcoholic Steatohepatitis Clinical Research Network Research Group. / Ethnicity and nonalcoholic fatty liver disease. In: Hepatology. 2012 ; Vol. 55, No. 3. pp. 769-80.
@article{ee9103b55cf141bc86dab76c95782868,
title = "Ethnicity and nonalcoholic fatty liver disease",
abstract = "UNLABELLED: 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.",
keywords = "Adult, Biopsy, European Continental Ancestry Group, Fatty Liver, Female, Hispanic Americans, Humans, Liver, Liver Cirrhosis, Logistic Models, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Retrospective Studies, Risk Factors, Severity of Illness Index, Socioeconomic Factors, United States",
author = "Kiran Bambha and Patricia Belt and Maria Abraham and Wilson, {Laura A} and Mark Pabst and Linda Ferrell and Aynur Unalp-Arida and Nathan Bass and Bradley Aouizerat and {Nonalcoholic Steatohepatitis Clinical Research Network Research Group}",
note = "Copyright {\circledC} 2011 American Association for the Study of Liver Diseases.",
year = "2012",
month = "3",
doi = "10.1002/hep.24726",
language = "English (US)",
volume = "55",
pages = "769--80",
journal = "Hepatology",
issn = "0270-9139",
publisher = "John Wiley and Sons Ltd",
number = "3",

}

TY - JOUR

T1 - Ethnicity and nonalcoholic fatty liver disease

AU - Bambha, Kiran

AU - Belt, Patricia

AU - Abraham, Maria

AU - Wilson, Laura A

AU - Pabst, Mark

AU - Ferrell, Linda

AU - Unalp-Arida, Aynur

AU - Bass, Nathan

AU - Aouizerat, Bradley

AU - Nonalcoholic Steatohepatitis Clinical Research Network Research Group

N1 - Copyright © 2011 American Association for the Study of Liver Diseases.

PY - 2012/3

Y1 - 2012/3

N2 - UNLABELLED: 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.

AB - UNLABELLED: 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.

KW - Adult

KW - Biopsy

KW - European Continental Ancestry Group

KW - Fatty Liver

KW - Female

KW - Hispanic Americans

KW - Humans

KW - Liver

KW - Liver Cirrhosis

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Non-alcoholic Fatty Liver Disease

KW - Retrospective Studies

KW - Risk Factors

KW - Severity of Illness Index

KW - Socioeconomic Factors

KW - United States

U2 - 10.1002/hep.24726

DO - 10.1002/hep.24726

M3 - Article

VL - 55

SP - 769

EP - 780

JO - Hepatology

JF - Hepatology

SN - 0270-9139

IS - 3

ER -