Racial and Ethnic Disparities in Nonalcoholic Fatty Liver Disease Prevalence, Severity, and Outcomes in the United States: A Systematic Review and Meta-analysis

Rich, Nicole E.; Oji, Stefany; Mufti, Arjmand; Browning, Jeffrey D.; Parikh, Neehar D.; Odewole, Mobolaji; Mayo, Helen; Singal, Amit G.

doi:10.1016/j.cgh.2017.09.041

Cited by 333 publications

(320 citation statements)

References 47 publications

Supporting

Mentioning

291

Contrasting

Unclassified

Order By: Relevance

“…This is in keeping with a study of adolescents with obesity by Schwimmer et al (34) that demonstrated that those of Black ethnicity had lower prevalence of abnormal ALT levels compared with those of other ethnicities (White and Hispanic), although adolescents of South Asian ethnicity were not included in that study. The same ethnicity-related disparities in NAFLD prevalence in adults has been reported in many studies (35).…”

Section: Discussionsupporting

confidence: 76%

Obesity Predicts Liver Function Testing and Abnormal Liver Results

Homer

Hull

et al. 2019

Obesity

View full text Add to dashboard Cite

Objective Abnormal liver function tests in children and young people (CYP) predict a greater burden of liver disease in adulthood, especially in the context of obesity. This study aimed to determine whether obesity and metabolic risk factors predict liver function testing and abnormal liver test results in CYP. Methods This was a retrospective cross‐sectional population study using electronic health care records from 257,746 CYP aged 10 to 25 years who were registered with 170 contiguous general practices in London, UK. Demographic and clinical data were extracted, including serum alanine aminotransferase (ALT) tests between 2015 and 2017. BMI category thresholds were adjusted according to age group and ethnicity. Results Fourteen percent of CYP had ALT measured, of whom 5.4% had abnormal results; 36.3% had BMI indicating overweight or obesity. Nonalcoholic fatty liver disease was the most common liver diagnosis. Multivariate analyses demonstrated that overweight or obesity was an independent predictor of ALT testing in young people (ages 18‐25) but not in children (ages 10‐17) and of abnormal test results in all CYP, irrespective of ALT threshold. Conclusions Overweight and obesity are predictors of liver testing (not in children) and abnormal test results, irrespective of ALT threshold. Given the rising prevalence of metabolic dysfunction, a coordinated strategy is needed for liver testing and interpreting results in this young population.

show abstract

Section: Discussionsupporting

confidence: 76%

Obesity Predicts Liver Function Testing and Abnormal Liver Results

Homer

Hull

et al. 2019

Obesity

View full text Add to dashboard Cite

show abstract

“…Despite its high prevalence, NAFLD was described by a relatively non‐specific code in ICD‐9‐CM: 571.8 ‘Other Chronic Non‐Alcoholic liver disease’ until October 2015 . Thus, population‐based studies, including ours, rely upon related conditions since approximately 50% of patients with diabetes, obesity and metabolic syndrome also have NAFLD . We were unable to identify and remove treated HBV‐HCC and HCV‐HCC cases.…”

Section: Discussionmentioning

confidence: 96%

The association between etiology of hepatocellular carcinoma and race‐ethnicity in Florida

Pinheiro

Medina

Callahan

et al. 2020

Liver International

View full text Add to dashboard Cite

Background and Aim:The incidence of hepatocellular carcinoma (HCC) has risen considerably in the US since 1980. The main causes include metabolic disorders (NAFLD, diabetes, obesity, metabolic syndrome), alcohol-related disease (ALD) and hepatitis C and B virus infections (HCV, HBV). Etiology-specific HCC incidence rates by detailed race-ethnicity are needed to improve HCC control and prevention efforts.Methods: All HCC cases diagnosed in Florida during 2014-2015 were linked to statewide hospital discharge data to determine etiology. Age-specific and age-adjusted rates were used to assess the intersection between etiology and detailed racial-ethnicities, including White, African American, Afro-Caribbean, Asian, Cuban, Puerto Rican and Continental Hispanic (Mexican, South and Central American). Results:Of 3666 HCC cases, 2594 matched with discharge data. HCV was the leading cause of HCC among men and women (50% and 43% respectively), followed by metabolic disorders (25% and 37%) and ALD (16% and 9%). Puerto Rican and African American men had the highest HCV-HCC rates, 7.9 and 6.3 per 100 000 respectively. Age-specific rates for HCV-HCC peaked among baby boomers (those born in 1945-1965). Metabolic-HCC rates were highest among populations above age 70 and among Continental Hispanics. Afro-Caribbean men had high rates of HBV-HCC, whereas Puerto Rican men had high ALD-HCC.Conclusions: HCC etiology is associated with specific race/ethnicity. While HCVrelated HCC rates are projected to decrease soon, HCC will continue to affect Hispanics disproportionately, based on higher rates of metabolic-HCC (and ALD-HCC) among Continental Hispanics, who demographically represent 80% of all US Hispanics. Multifaceted approaches for HCC control and prevention are needed. K E Y W O R D S African American, alcohol-liver disease, Caribbean, cause, Cuban, ethnicity, etiology, Florida, HBV, HCV, hepatocellular carcinoma, incidence, NAFLD, Puerto Rican, race, subgroup S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. How to cite this article: Pinheiro PS, Medina HN, Callahan KE, et al. The association between etiology of hepatocellular carcinoma and race-ethnicity in Florida. Liver Int.

show abstract

“…Prior studies have suggested racial/ethnic group's prevalence differs for NAFLD and those with NAFLD‐related fibrosis . However, population‐based data for Asian Americans have been limited with a most recent study reporting that the prevalence of NAFLD amongst Asian Americans was 18% which is considerably lower than reported for non‐Hispanic Whites at 24% .…”

Section: Introductionmentioning

confidence: 89%

Ethnic influence on nonalcoholic fatty liver disease prevalence and lack of disease awareness in the United States, 2011–2016

Yeo

Cheung

et al. 2020

J Intern Med

View full text Add to dashboard Cite

Background Nonalcoholic fatty liver disease (NAFLD) is a rising global disease associated with clinical and economic burdens. Objectives We aimed to quantify NAFLD prevalence and awareness to provide stakeholders necessary information to combat NAFLD burden. Methods This study utilizes data from the National Health and Nutrition Examination Survey 2011–2016 and included 4538 adult participants who did not have heavy drinking or viral hepatitis history. The US fatty liver index defined NAFLD and NAFLD fibrosis score defined fibrosis. NAFLD awareness was captured by questionnaire. Results Amongst the study population of 4538 persons, NAFLD prevalence was 32.5%, lowest in non‐Hispanic Blacks (18.0%) and Asians (18.1%), highest amongst Mexican Americans (48.4%). Within the NAFLD group, advanced fibrosis was highest in non‐Hispanic Blacks (28.5%) and lowest amongst non‐Hispanic Asians (2.7%). Of the 1473 (97.5%) NAFLD participants who answered NAFLD awareness question, 90% visited a healthcare centre at least once in the past year, but only 5.1% were aware of having NAFLD. On weighted population estimates, 77.33 million persons had NAFLD, 17.63 million had advanced fibrosis, and 73.39 million NAFLD participants were not aware of having NAFLD. Conclusions Of 77.33 million people in the United States have NAFLD with 17.63 million having advanced fibrosis, with lowest prevalence in non‐Hispanic Asians and highest in Mexican Americans. A conundrum exists amongst non‐Hispanic Blacks who have low NAFLD prevalence but highest prevalence of advanced fibrosis. Awareness of NAFLD was low across all ethnicities. Effort is needed to improve disease awareness whilst addressing NAFLD clinical burden across ethnicities.

show abstract

Racial and Ethnic Disparities in Nonalcoholic Fatty Liver Disease Prevalence, Severity, and Outcomes in the United States: A Systematic Review and Meta-analysis

Cited by 333 publications

References 47 publications

Obesity Predicts Liver Function Testing and Abnormal Liver Results

Obesity Predicts Liver Function Testing and Abnormal Liver Results

The association between etiology of hepatocellular carcinoma and race‐ethnicity in Florida

Ethnic influence on nonalcoholic fatty liver disease prevalence and lack of disease awareness in the United States, 2011–2016

Contact Info

Product

Resources

About