More Evidence for the Genetic Susceptibility of Mexican Population to Nonalcoholic Fatty Liver Disease through PNPLA3

Stepanova

et al. 2019

Gut

398

298

ObjectiveGiven significant advances in treatment of viral hepatitis and the growing epidemic of obesity, the burden of the different types of liver diseases in the USA may be changing. Our aim was to assess the shift in the prevalence of different liver disease aetiologies in the USA over the past three decades.DesignNational Health and Nutrition Examination Surveys (NHANES; cross-sectional 1988–1994 and 1999–2016) were used.ResultsA total of 58 731 adults from NHANES (1988–2016) were included. Over the study period, the prevalence of chronic hepatitis B and alcoholic liver disease remained stable: 0.3%–0.4% and 0.8%–1.0%, respectively (p>0.05). The prevalence of chronic hepatitis C decreased nearly twofold: 1.6% in 1988–1994 to 0.9% in 2013–2016 (p=0.03). In contrast, the prevalence of non-alcoholic fatty liver disease (NAFLD; by US-Fatty Liver Index) increased from 20.0% (1988–1994) to 28.3% (1999–2004) to 33.2% (2009–2012) and 31.9% (2013–2016) (p<0.0001). Furthermore, steady increases were observed in the rates of obesity (22.2% in 1988–1994 to 31.0% in 1999–2004 to 38.9% in 2013–2016), type 2 diabetes mellitus (T2DM) (from 7.2% to 8.2% to 13.5% same years), insulin resistance and hypertension (all p<0.0001). Yearly trend analyses showed that the only LD with consistently increasing prevalence was NAFLD (trend p=0.01). Multivariable regression analysis showed that obesity (OR 10.4; 95% CI 9.5 to 11.3) and T2DM (OR 3.7; 95% CI 3.2 to 4.2) were the major independent predictors of NAFLD.ConclusionsOver the past 30 years in the USA, NAFLD is the only liver disease with growing prevalence, synchronous with the increasing rates of obesity and T2DM.

Section: Discussionmentioning

confidence: 52%

Epidemiology of chronic liver diseases in the USA in the past three decades

Stepanova

et al. 2019

Gut

398

298

“…In our current study, non‐Hispanic Blacks did have higher prevalence of diabetes compared to non‐Hispanic Whites; however, we did not observe the same trend amongst Mexican Americans and other Hispanics. As such, the high prevalence of NAFLD amongst Mexican Americans and other Hispanics observed in our study may be due to other genetic factors, as genetic susceptibility for NAFLD is significantly higher in those of Mexican and Hispanic descent . Adoption of American culture and lifestyle amongst Hispanics has not been found to be a risk factor for NAFLD, though this effect should be further studied as more data on other ethnic groups is released in NHANES .…”

Section: Discussionmentioning

confidence: 57%

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

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.

“…Thus, a higher African genetic ancestry contribution has been found in the Brazilian population, whereas the contribution of Native American ancestry is higher in Bolivia, Peru, Mexico, Ecuador, Chile, and Colombia. Clinically, data from Mexico and Brazil have confirmed the association of the PNPLA3 rs738409 variant with NAFLD in biopsy‐proved patients.…”

Section: Factors Responsible For the Higher Prevalence Of Nafld In Lamentioning

confidence: 80%

Nonalcoholic Fatty Liver Disease Risk Factors in Latin American Populations: Current Scenario and Perspectives

Oliveira

Cotrim

Arrese

2019

Clinical Liver Disease

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