Race/ethnic and sex disparities in the non-alcoholic fatty liver disease-abdominal aortic calcification association: The Multi-Ethnic Study of Atherosclerosis

Abstract

Background and aims This study investigated the associations of non-alcoholic fatty liver disease (NAFLD) and abdominal aortic calcification (AAC) volume and density, and whether these relationships vary by race/ethnicity and/or sex, information that are limited in current literature. Methods We studied 1,004 adults from the Multi-Ethnic Study of Atherosclerosis to assess the relationship between NAFLD (liver-to-spleen ratio <1) and the following measures of AAC: presence (volume score >0, using Poisson regression); change in volume score (increasing vs. no change, using Poisson regression); and morphology (volume and density score, where volume score >0, using linear regression); and interaction by race/ethnicity and sex. Results Among Blacks, those with NAFLD had greater prevalence for AAC compared to Whites regardless of sex (Prevalence Ratio [PR]=1.41, CI=1.15–1.74, p-interaction=0.02). Concurrent interaction by race/ethnicity and sex was found comparing Chinese and Blacks to Whites (p-interaction=0.017 and 0.042, respectively) in the association between NAFLD and the prevalence of increasing AAC. Among women, this relationship was inverse among Chinese (PR=0.59, CI=0.28–1.27), and positive among Whites (PR=1.34, CI=1.02–1.76). This finding was reversed evaluating the men counterpart. Black men also had a positive association (PR=1.86, CI=1.29–2.70), which differed from the inverse relationship among White men, and was greater compared to Black women (PR=1.45, CI=1.09–1.94). NAFLD was unrelated to AAC morphology. Conclusions NAFLD was related to the presence of AAC, however, limited to Blacks. Significant concurrent interaction by race/ethnicity (Chinese and Blacks vs. Whites) and sex was found in the relationship between NAFLD and increasing AAC. These findings suggest disparities in the pathophysiologic pathways in which atherosclerosis develops.

<p>Ethnic differences and heterogeneity in genetic and metabolic makeup contributing to nonalcoholic fatty liver disease</p>

“…110 Most of the studies reviewed utilized primary data collection done by the Third National Health and Nutrition Examination Survey (1988)(1989)(1990)(1991)(1992)(1993)(1994), or MESA (2002)(2003)(2004)(2005), which may produce outdated results. 2,50,51,84,86,111 Prevalence of NAFLD, thus, in current, prospective population-based studies, may be higher.…”

“…However, only a few studies compare this cohort with patients from a Caucasian, Hispanic, or African origin. 44,50,51 Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy downloaded from https://www.dovepress.com/ by 44.224.250…”

Abdominal aortic calcification is associated with morbidity of cardiovascular disease and Fib-4 index in type 2 diabetes: a retrospective cross-sectional study

“…The association between NAFLD and AAC may differ between ethnic groups. In a Multi-Ethnic Study of Atherosclerosis (MESA), NAFLD was signi cantly associated with the prevalence of AAC in African Americans but was not signi cantly associated with the prevalences in Caucasians, Asians, or Hispanics [25]. A cohort study of African Americans also showed that NAFLD was independently correlated with AAC [26].…”

Serum 25-hydroxyvitamin-D and nonalcoholic fatty liver disease: Does race/ethnicity matter? Findings from the MESA cohort

“…Using these ROIs, HU attenuation were calculated for liver and spleen. As in previous work from MESA [16,17], NAFLD was defined as L/S ratio <1.0. The L/S ratio was calculated by taking mean attenuation values of both right liver lobe ROIs and dividing it by the spleen's attenuation value [18].…”