Brief Article
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World J Gastroenterol. May 7, 2014; 20(17): 4987-4993
Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.4987
NAFLD prevalence differs among hispanic subgroups: The multi-ethnic study of atherosclerosis
Michael Wayne Fleischman, Matthew Budoff, Ifran Zeb, Dong Li, Temitope Foster
Michael Wayne Fleischman, Temitope Foster, Division of Digestive Diseases, Department of Medicine, Emory University, Atlanta, GA 30324, United States
Matthew Budoff, Ifran Zeb, Dong Li, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, United States
Author contributions: Fleischman MW wrote the manuscript; Budoff M provided financial support for the work and edited the manuscript; Zeb I compiled the database; Li D compiled the database and provided statistical support; Foster T designed the study, performed the statistical analysis and edited the manuscript.
Supported by National Heart, Lung, and Blood Institute at the National Institutes of Health grants R01 HL071739 and by contracts N01-HC-95159 through N01-HC-95165 and N01 HC 95169
Correspondence to: Temitope Foster, MD, MSCR, Division of Digestive Diseases, Department of Medicine, Emory University, 49 Jesse Hill Jr. Dr. S.E. Rm 437, Atlanta, GA 30324, United States. tyfoste@emory.edu
Telephone: +1-404-7781682 Fax: +1-404-7781681
Received: August 15, 2013
Revised: December 21, 2013
Accepted: February 17, 2014
Published online: May 7, 2014
Processing time: 117 Days and 7.3 Hours
Abstract

AIM: To compare prevalence rates of non-alcoholic fatty liver disease (NAFLD) between Hispanics of Mexican origin and Hispanics of Dominican and Puerto Rican origin.

METHODS: We evaluated prevalence rates of NAFLD between the two largest sub-populations of Hispanics in the United States; Hispanics of Mexican origin and Hispanics of Caribbean origin (Dominican and Puerto Rican), in the multi-ethnic study of atherosclerosis (MESA) cohort. MESA is a large, population based, multi-center cohort study comprised of 6814 healthy Caucasian, African-American, Hispanic, and Asian men and women aged 45-84. We utilized the baseline serum, anthropometric and radiographic measurements obtained between 2000 and 2002. NAFLD was measured via computed tomography scan and was defined as liver/spleen attenuation ratio < 1.

RESULTS: There were 788 Hispanic participants included in the study after exclusions. The prevalence of NAFLD was 29% (n = 225). Hispanics of Mexican origin had a significantly higher prevalence of NAFLD (33%), compared to Hispanics of Dominican origin (16%), (P < 0.01) and Hispanics of Puerto Rican origin (18%), (P < 0.01). After controlling for age, sex, BMI, waist circumference, hypertension, serum HDL, triglyceride and CRP level and insulin resistance, Hispanics of Mexican origin remained significantly more likely to have NAFLD than those of Dominican and Puerto Rican origin.

CONCLUSION: United States Hispanics of Mexican origin have a significantly higher prevalence of NAFLD when compared to United States Hispanics of Dominican or Puerto Rican origin after controlling for known risk factors. Care should be taken when performing risk assessment in Hispanic populations not to make assumptions of homogeneity.

Keywords: Non-alcoholic fatty liver disease; Prevalence; Hispanic subpopulations

Core tip: Hispanics have a significantly higher prevalence of non-alcoholic fatty liver disease (NAFLD) and evidence of more advanced disease when compared to other ethnic groups. As a consequence it has been proposed that clinicians perform biopsies on Hispanics diagnosed with NAFLD given the increased of fibrosis development. Most of the studies examining Hispanics with NAFLD evaluated those of Mexican descent. It is unknown if this increased propensity to develop NAFLD is uniform among all people classified as Hispanics or if certain subpopulations are at higher risk. This study aims to compare the prevalence rates of NAFLD between US Hispanic subgroups.