Cirrhosis and Advanced Fibrosis in Hispanics in Texas: The Dominant Contribution of Central Obesity

Jiao, Jingjing; Watt, Gordon P.; Lee, Minjae; Rahbar, Mohammad H.; Vatcheva, Kristina; Pan, Jen Jung; McCormick, Joseph B.; Fisher‐Hoch, Susan P.; Fallon, Michael B.

doi:10.1371/journal.pone.0150978

Cited by 22 publications

(24 citation statements)

References 46 publications

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“…Plasma samples were also collected from 96 participants of the Cameron County Hispanic Cohort (CCHC) with aspartate transaminase (AST) to platelet ratio index (APRI) scores !1, indicative of the presence of cirrhosis/advanced fibrosis. The demographic and clinical parameters of the 96 CCHC subjects were described previously (7). All these subjects were enrolled in 4 Texas counties with high rates of liver cancer.…”

Section: Patients and Biospecimensmentioning

confidence: 99%

“…Other risk factors contributing to HCC include chronic hepatitis B or C virus (HBV, HCV) infection, alcohol abuse, nonalcoholic steatohepatitis (NASH) and aflatoxin exposure (6). We previously reported that the prevalence of cirrhosis in Hispanics in South Texas is 0.94%, which is 4-fold higher than the national prevalence (7). Risk factors independently associated with cirrhosis in this population are central obesity, diabetes, HCV, and alcohol with a remarkable population attributable fraction of 65.3% from central obesity.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Aflatoxin-Associated TP53R249S Mutation in Hepatocellular Carcinoma in Hispanics in South Texas

Jiao¹,

Niu²,

Wang³

et al. 2018

Cancer Prev Res

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We aimed to determine whether aflatoxin dietary exposure plays a role in the high incidence of hepatocellular carcinoma (HCC) observed among Hispanics in South Texas. We measured somatic mutation, hallmark of aflatoxin etiology in HCC, using droplet digital PCR and RFLP. mutation was detected in 3 of 41 HCC tumors from Hispanics in South Texas (7.3%). We also measured mutation in plasma cell-free DNA (cfDNA) from 218 HCC patients and 96 Hispanic subjects with advanced fibrosis or cirrhosis, from South Texas. The mutation was detected only in Hispanic and Asian HCC patients, and patients harboring mutation were significantly younger and had a shorter overall survival. The mutation was not detected in any Hispanic subject with advanced fibrosis or cirrhosis. Genes involved in cell-cycle control of chromosomal replication and in BRCA1-dependent DNA damage response were enriched in HCCs with mutation. The E2F1 family members, E2F1 and E2F4, were identified as upstream regulators. mutation was detected in 5.7% to 7.3% of Hispanics with HCC in South Texas. This mutation was associated with a younger age and worse prognosis. was however not detected in Hispanics in South Texas with cirrhosis or advanced fibrosis. Aflatoxin exposure may contribute to a small number of HCCs in Hispanics in South Texas, but the detection of mutation in plasma cfDNA is not a promising biomarker of risk assessment for HCC in subjects with cirrhosis or advanced fibrosis in this population. .

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Section: Patients and Biospecimensmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of Aflatoxin-Associated TP53R249S Mutation in Hepatocellular Carcinoma in Hispanics in South Texas

Jiao¹,

Niu²,

Wang³

et al. 2018

Cancer Prev Res

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“…CCHC is a population‐based Mexican‐American cohort in South Texas, with high rates of obesity, NAFLD, and HCC. ( 16‐19 )…”

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confidence: 99%

Bile Acid Changes Associated With Liver Fibrosis and Steatosis in the Mexican‐American Population of South Texas

Kwan

Jiao

et al. 2020

Hepatol Commun

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Biomarkers to predict risk of liver fibrosis in subjects with nonalcoholic fatty liver disease, a common risk factor for hepatocellular carcinoma, would allow for early preventive interventions. We sought to characterize bile acid profiles associated with liver fibrosis in subjects from the community‐based Cameron County Hispanic Cohort, a population in South Texas with high rates of nonalcoholic fatty liver disease, liver fibrosis and hepatocellular carcinoma. Plasma bile acid levels were measured in 390 subjects. These subjects were screened with liver elastography, detecting significant liver fibrosis in 58 subjects and steatosis in 186 subjects. Unsupervised clustering of the bile acid profiles revealed five clusters that differed by liver fibrosis, liver steatosis, liver injury, age and gender, identifying these parameters as major determinants of circulating bile acid changes. Total bile acid levels were significantly higher in subjects with fibrosis, with chenodeoxycholic acid displaying the greatest increase among individual bile acids. The primary conjugated bile acids, glycocholic and glycochenodeoxycholic acids, displayed the strongest association with fibrosis by logistic regression. High lithocholic acid levels were strongly associated with advanced fibrosis. In contrast, deoxycholic acid and total unconjugated secondary bile acids were positively associated with steatosis, whereas relative glycoursodeoxycholic acid abundance was negatively associated. Milk and yogurt intake notably contributed to fibrosis‐associated bile acid changes. In addition, multiple families within the Firmicutes phylum, Prevotellaceae, and Bacteroides species in stool significantly correlated with fibrosis‐associated and steatosis‐associated bile acid parameters, suggesting that the gut microbiome contributes to bile acid changes in the context of liver disease. Conclusion: Circulating bile acid levels were markedly but differently changed in liver fibrosis and steatosis in a high‐risk Mexican‐American population.

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“…23 A long-standing, largely Mexican-American prospective cohort of patients in South Texas highlights the profound net impact of obesity and excess alcohol consumption, as well as potential genetic and environmental factors: in those men with central adiposity and alcohol use, advanced fibrosis or cirrhosis developed in 12.5% of all patients, at a median 30 years of age. 24 Interestingly, our data demonstrate better patient and graft survival for Hispanic LT recipients as compared with white patients on multivariable analysis. A similar observation has also been reported in a recent analysis for both LT alone and liver-kidney recipients.…”

Section: Characteristics Of Lt Recipients With Bashmentioning

confidence: 58%

Both Alcoholic and Nonalcoholic Steatohepatitis Is an Emerging Indication for Liver Transplantation in the United States

Fritze

Singh

Lawitz

et al. 2020

Digestive Disease Interventions

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Abstract Background Nonalcoholic steatohepatitis (NASH) and alcoholic liver disease (ALD) are now the most common indications for liver transplantation (LT) in the United States. A subset of patients have both alcoholic and nonalcoholic steatohepatitis (BASH). This study characterizes patients with BASH requiring LT and assesses changes in the prevalence of BASH as an indication for LT. Methods The United Network for Organ Sharing database was analyzed for all patients ≥ 18 years of age who received their first deceased donor LT from 2002 to 2016 for ALD, NASH, or BASH. Baseline demographics, clinical parameters, and LT outcomes were compared between groups. Results Since 2002, 85,448 patients underwent LT:15,327 had ALD, 9,971 had NASH, and 2,779 had BASH. The prevalence of BASH as an indication for LT increased from 0.5% in 2002 to 5% in 2016. Compared with patients with NASH, those with BASH were significantly more likely to be male (85.6 vs. 57%), younger (mean 56.4 vs. 58.6 years), and Hispanic (22.2 vs. 13.6%) (p < 0.001 for all). While indication for transplant was not significantly associated with transplant outcomes on multivariable analysis, patient and graft survival curves do differ significantly by indication for transplant, with worse outcomes for patients with BASH (patient survival at 5 years: NASH 78.1%, ALD 77.2%, BASH 73.5%, p = 0.013; graft survival at 5 years: NASH 75.3%, ALD 74.0%, BASH 70.8%, p = 0.046). Conclusions BASH is a rising indication for LT, especially for Hispanic males, due to the increasing prevalence of ALD and NASH in the United States.

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Cirrhosis and Advanced Fibrosis in Hispanics in Texas: The Dominant Contribution of Central Obesity

Cited by 22 publications

References 46 publications

Prevalence of Aflatoxin-Associated TP53R249S Mutation in Hepatocellular Carcinoma in Hispanics in South Texas

Prevalence of Aflatoxin-Associated TP53R249S Mutation in Hepatocellular Carcinoma in Hispanics in South Texas

Bile Acid Changes Associated With Liver Fibrosis and Steatosis in the Mexican‐American Population of South Texas

Both Alcoholic and Nonalcoholic Steatohepatitis Is an Emerging Indication for Liver Transplantation in the United States

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