Non-alcoholic fatty liver disease (NAFLD), a clinical syndrome that is predicted to affect millions of people worldwide, will become the next global epidemic. The natural course of this disease, including its subtype, non-alcoholic steatohepatitis (NASH), is not clearly defined, especially in the US minority populations. The aim of this review is to report the global epidemiology of NAFLD, with emphasis on US minority populations on the basis of database searches using using Pubmed and other online databases. The US Hispanic population is the most disproportionately affected ethnic group with hepatic steatosis whereas African-Americans are the least affected. Genetic disparities involved in lipid metabolism seem to be the leading explanation for the lowest incidence and prevalence of both NAFLD and NASH in African-Americans.

No abstract

Metformin, a biguanide class of anti-diabetic drugs, not only may reduce primary cancer risk, but might also be an effective therapy with chemotherapy regimens for recurring colorectal cancers. The aim of this study was to evaluate the association between Metformin therapy and colorectal neoplasia among type 2 diabetic mellitus African American patients. We reviewed the medical records of 3950 patients underwent diagnostic colonoscopy from 2000 to 2012. Diabetic patients with and without colon neoplastic lesions (cases and Controls, respectively) were evaluated for their drugs (Metformin and Insulin) usage. Patients in this study were evaluated in two groups: diabetic patients diagnosed with colorectal neoplasia (Cases) and diabetic patients without colorectal neoplastic lesions (Controls). The median duration of diabetes was 5 years in controls vs. 4.5ys in the case group. Controls were more on Metformin as compared to patients in the case (60% vs. 43%; P=0.02). There were no difference between single therapy with Metformin and combination therapy of Metformin and Insulin. Median duration of Metformin in control paients were 2 years vs 1 year in the case group. Multivariate logistic regression adjusted for age and gender demonstrated that patients on Metformin for more than 5 years had less neoplastic lesion when compared to patients on Metformin less than 5 years (OR=0.2(95% CI 0.1-0.4), P=<0.001). Patients on Metformin had lower rate of colorectal neoplastic lesions. As such, Metformin might have a protective effect that can be capitalized on for the treatment and prevention of colorectal neoplastic lesions.

No abstract

No abstract