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Background and aims Susceptibility to fatty liver disease (FLD) varies among individuals and between racial/ethnic groups. Several genetic variants influence FLD risk, but whether these variants explain racial/ethnic differences in FLD prevalence is unclear. We examined the contribution of genetic risk factors to racial/ethnic‐specific differences in FLD. Methods A case–control study comparing FLD patients (n = 1194) and population‐based controls (n = 3120) was performed. Patient characteristics, FLD risk variants (PNPLA3‐rs738409 + rs6006460, TM6SF2‐rs58542926, HSD17B13‐rs80182459 + rs72613567, MBOAT7/TMC4‐rs641738, and GCKR‐rs1260326) and a multi‐locus genetic risk score (GRS) were examined. The odds of FLD for individuals with different risk factor burdens were determined. Results Hispanics and Whites were over‐represented (56% vs. 38% and 36% vs. 29% respectively) and Blacks under‐represented (5% vs. 23%) among FLD patients, compared to the population from which controls were selected (p < .001). Among cases and controls, Blacks had a lower and Hispanics a greater, net number of risk alleles than Whites (p < .001). GRS was associated with increased odds of FLD (ORQ5vsQ1 = 8.72 [95% CI = 5.97–13.0], p = 9.8 × 10−28), with the association being stronger in Hispanics (ORQ5vsQ1 = 14.8 [8.3–27.1]) than Blacks (ORQ5vsQ1 = 3.7 [1.5–11.5], P‐interaction = 0.002). After accounting for GRS, the odds of FLD between Hispanics and Whites did not differ significantly (OR = 1.06 [0.87–1.28], p = .58), whereas Blacks retained much lower odds of FLD (OR = 0.21, [0.15–0.30], p < .001). Conclusions Blacks had a lower and Hispanics a greater FLD risk allele burden than Whites. These differences contributed to, but did not fully explain, racial/ethnic differences in FLD prevalence. Identification of additional factors protecting Blacks from FLD may provide new targets for prevention and treatment of FLD.

Background The identification of autoantibodies directed against neuronal antigens has led to the recognition of a wide spectrum of neurological autoimmune disorders (NAD). With timely recognition and treatment, many patients with NAD see rapid improvement. Symptoms associated with NAD can be diverse and are determined by the regions of the nervous system affected. In addition to neurological symptoms, a number of these disorders present with prominent gastrointestinal (GI) manifestations such as nausea, diarrhea, weight loss, and gastroparesis prompting an initial evaluation by gastroenterologists. Purpose This review provides a general overview of autoantibodies within the nervous system, focusing on three scenarios in which nervous system autoimmunity may initially present with gut symptoms. A general approach to evaluation and treatment, including antibody testing, will be reviewed.

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