Ethnic disparities in liver fat accumulation in school‐aged children

Abstract

ObjectiveNonalcoholic fatty liver disease (NAFLD) has a different prevalence in adults from different ethnic groups. This study examined whether these ethnic differences originate in early life and could be explained by early‐life factors.MethodsThis observational study was embedded in a population‐based prospective cohort study from fetal life onward among 2,570 children born in Rotterdam, the Netherlands. Information about prepregnancy, pregnancy, and childhood factors, as well as childhood BMI, was obtained from questionnaires and physical examinations. Liver fat was assessed by magnetic resonance imaging at age 10 years.ResultsMedian liver fat fraction was 2.0% (95% CI: 1.2%‐5.3%), and NAFLD prevalence was 2.8%. Children from a Turkish background had the highest median liver fat percentage (2.5%, 95% CI: 1.2%‐10.7%) and NAFLD prevalence (9.1%). Children of Cape Verdean, Dutch Antillean, Surinamese‐Creole, or Turkish background had a higher total liver fat fraction compared with children with a Dutch background (p < 0.05). After controlling for early‐life factors, these differences persisted only in children with a Turkish background.ConclusionsPrevalence of liver fat accumulation and NAFLD differs between ethnic subgroups living in the Netherlands, especially for those with a Turkish background. Early‐life factors have a strong influence on these associations and may hold clues for future preventive strategies.

The effectiveness of magnetic resonance imaging (MRI) iron corrected T1 in monitoring metabolic dysfunction-associated steatohepatitis in obesity following bariatric surgery and lifestyle modification: a prospective cohort study

“…However, doing serial biopsies could raise ethical issues. Although our cohort was Chinese and ethnicity has been shown to have an effect on liver fat accumulation in some studies ( 46 ), our findings are comparable with those from other populations. Finally, given the small sample size and our study cohort, caution must be exercised in the interpretation and generalisation of these results.…”

Current landscape of disparity-focused research: a bibliometric analysis of 260 research articles

“…For instance, Groot et al studied ethnic disparities in liver fat accumulation in school-age children and identified groups at increased risk of nonalcoholic fatty liver disease. [8] Moreover, ethnic disparities in liver fat appeared to be driven by preventable lifestyle and socioeconomic factors. By targeting at-risk groups before disease develops, interventional approaches may narrow gaps in adult metabolic, cardiovascular, and liver disease incidences between ethnic groups.…”

Race and Ethnicity in Non-Alcoholic Fatty Liver Disease (NAFLD): A Narrative Review

“…Zhou et al, 2019, in their systematic review and meta-analysis of the nationwide prevalence of NAFLD in China, demonstrated a significantly higher prevalence of NAFLD among Uyghur ethnics compared to Han ethnics, Kazakhs, or Mongolians (46.6% vs. 29.3%, 24.3%, and 25.0%, respectively) [ 25 ]. A recent multiethnic, population-based prospective study by de Groot and colleagues (2022) [ 36 ] on children aged 8–10 from the largest ethnic minorities in the Netherlands has shown that, compared to children with a Dutch background, the children with Surinamese-Creole, Cape Verdean, Moroccan, Dutch Antillean, or Turkish backgrounds had a higher total liver fat fraction measured using MRI. Among them, the children with a Turkish background had the highest median liver fat percentage (2.5% (95% CI: 1.2–10.7%)) and NAFLD prevalence (9.1%) [ 36 ].…”

“…A recent multiethnic, population-based prospective study by de Groot and colleagues (2022) [ 36 ] on children aged 8–10 from the largest ethnic minorities in the Netherlands has shown that, compared to children with a Dutch background, the children with Surinamese-Creole, Cape Verdean, Moroccan, Dutch Antillean, or Turkish backgrounds had a higher total liver fat fraction measured using MRI. Among them, the children with a Turkish background had the highest median liver fat percentage (2.5% (95% CI: 1.2–10.7%)) and NAFLD prevalence (9.1%) [ 36 ]. The higher liver fat fraction observed in children with a Turkish background persisted even after controlling for body mass index (BMI) and several other maternal or perinatal factors, including maternal age, maternal education, maternal pre-pregnancy BMI, smoking during pregnancy, alcohol use during pregnancy, and birth weight, breastfeeding, sugar intake at infancy, screen time, and exercise.…”