Comment on Bril et al. Clinical and Histologic Characterization of Nonalcoholic Steatohepatitis in African American Patients. Diabetes Care 2018;41:187–192

We thank Pearlman et al. (1) for their interest in our article, which recommended screening for nonalcoholic steatohepatitis (NASH) in African American patients with nonalcoholic fatty liver disease (NAFLD), as steatohepatitis may occur in these patients as frequently as in Caucasian patients (2).The authors mention a "recent large systematic review of 34 studies and over 350,000 subjects" where the risk of NASH in African Americans was lower than in Caucasians (relative risk 0.72 [95% CI 0.60-0.87]) (3). However, in a closer look, only 16,083 patients were part of the studies assessing the risk of NASH in patients with NAFLD (10 studies). Moreover, Pearlman et al. (1) missed that from this pool of studies, 8 out of the 10 included fewer African American patients than our study, ranging from 2 to 63 (median 25.5). In the review, the study by Younossi et al. (4) included 211 African American patients, but the authors did not perform liver biopsies and based the diagnosis of NASH on elevated alanine aminotransferase and aspartate aminotransferase levels. Finally, the study by Kallwitz et al. (5) included 92 African American patients and found a prevalence of NASH of 36% among African Americans with NAFLD, supporting the concept that NASH occurs with high frequency in this population. Based on these numbers, our study including 67 African American patients

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Response to Comment on Bril et al. Clinical and Histologic Characterization of Nonalcoholic Steatohepatitis in African American Patients. Diabetes Care 2018;41:187–192

Bril

Cusi

2018

Diabetes Care

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Comment on Bril et al. Clinical and Histologic Characterization of Nonalcoholic Steatohepatitis in African American Patients. Diabetes Care 2018;41:187–192

Cited by 1 publication

References 6 publications

Response to Comment on Bril et al. Clinical and Histologic Characterization of Nonalcoholic Steatohepatitis in African American Patients. Diabetes Care 2018;41:187–192

Response to Comment on Bril et al. Clinical and Histologic Characterization of Nonalcoholic Steatohepatitis in African American Patients. Diabetes Care 2018;41:187–192

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