Nonalcoholic Fatty Liver Disease and Associated Risk Factors in a Community‐Based Sample of Mexican‐Origin Adults

Abstract

The incidence of nonalcoholic fatty liver disease (NAFLD) is highest among Mexican-origin (MO) adults. Few studies have estimated the prevalence of NAFLD in this subpopulation, particularly by sex and age. We assessed the prevalence of NAFLD in a community sample of MO adults residing in a border region of southern Arizona and determined risk factors associated with NAFLD. A total of 307 MO adults (n = 194 women; n = 113 men) with overweight or obesity completed an in-person study visit, including vibration-controlled transient elastography (FibroScan) for the assessment of NAFLD status. A continuous attenuation parameter score of ≥288 dB/m (≥5% hepatic steatosis) indicated NAFLD status. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for NAFLD. We identified 155 participants (50%) with NAFLD, including 52% of women and 48% of men; there were no sex differences in steatosis (men, 287.8 dB/m; women, 288.4 dB/m). Sex, age, patatin-like phospholipase domain containing 3 (PNPLA3) risk allele carrier status, comorbidities, and cultural and behavioral variables were not associated with NAFLD status. There was some evidence for effect modification of body mass index (BMI) by sex (P interaction = 0.08). The estimated OR for an increase in BMI of 5 kg/m 2 was 3.36 (95% CI, 1.90, 5.91) for men and 1.92 (95% CI, 1.40, 2.64) for women. In post hoc analyses treating steatosis as a continuous variable in a linear regression, significant effect modification was found for BMI by sex (P interaction = 0.03), age (P = 0.05), and PNPLA3 risk allele carrier status (P = 0.02). Conclusion: Lifestyle interventions to reduce body weight, with consideration of age and genetic risk status, are needed to stem the higher rates of NAFLD observed for MO populations. (Hepatology Communications 2022;6:1322-1335).N onalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome that is defined as steatosis affecting ≥5% of hepatocytes not caused by excess alcohol intake, hepatitis B or C, autoimmune hepatitis, iron overload, drugs, or toxins. (1)(2)(3) It is estimated to affect approximately 20% (64 million) of the United States (US) population each year, leading to annual medical costs exceeding $100 billion. (4) Although not all individuals with NAFLD progress to end-stage liver disease, nearly 30% are at greater risk for developing cirrhosis, portal hypertension, and hepatocellular carcinoma (HCC), making NAFLD an emerging risk factor for HCC that is projected to become the leading cause of

Advancing Liver Cancer Prevention for American Indian Populations in Arizona: An Integrative Review

“…For instance, transient elastography (Fibroscan ® ) is a noninvasive tool to assess liver steatosis and fibrosis that can be performed in the outpatient clinics and communities with immediate results and excellent reproducibility [ 55 ]. In fact, our research team was among the first to use noninvasive transient elastography (FibroScan) to estimate the prevalence of NAFLD in a community-based sample of 307 Mexican-origin adults in Southern Arizona in which the overall estimated prevalence of NAFLD was 50% [ 56 ]. This effort focused on the early detection of liver disease, given that there are no pharmaceuticals available for NAFLD treatment and weight loss is the cornerstone treatment [ 57 ].…”

Communicating PNPLA3 genetic risk status for NAFLD among Mexican-origin men

“…Participants were recruited from a pool of eligible individuals who had given informed consent to participate in further research during a previous cross-sectional study ( 11 ). Eligible participants: (1) were carriers of PNPLA3 (G/GG genotype); and (2) had NAFLD status identified by continuous attenuation parameter (≥248 dB/m) using a FibroScan ® ( 25 ), a modality of vibration-controlled transient elastography.…”

“…More recently, Martínez et al ( 10 ) found Mexicans living in Mexico carrying two copies of the risk allele had 3.8 times higher risk of having NASH and 2.3 times higher risk of fibrosis. This is concerning as estimates from Mexican-origin populations suggest the frequency of the G risk allele is up to 77% ( 10 , 11 ). Despite the significant genetic basis for PNPLA3 testing for Mexican-origin adults, there are currently no recommendations for routine testing of this genetic variant in screening or clinical care of the disease.…”

LncRNA MALAT1 Promotes PPARα/CD36-Mediated Hepatic Lipogenesis in Nonalcoholic Fatty Liver Disease by Modulating miR-206/ARNT Axis

“…BODIPY fatty acid uptake experiment was referred to Khalifeh-Soltani et al ( Garcia et al, 2022 ). In brief, 1 µM BODIPY-C16 (Invitrogen) was allowed for incubation with HepG2 cells at 37°C for 30 min.…”