Prevalence of Suspected Nonalcoholic Fatty Liver Disease in Hispanic/Latino Individuals Differs by Heritage

Abstract

Background & Aims Non-alcoholic fatty liver disease (NAFLD) was shown to disproportionally affect Hispanic persons. We examined the prevalence of suspected NAFLD in Hispanic/Latino persons with diverse backgrounds. Methods We studied the prevalence of suspected NAFLD among 12,133 persons included in The Hispanic Community Health Study/Study of Latinos. We collected data on levels of aminotransferase, metabolic syndrome (defined by National Cholesterol Education Program-Adult Treatment Panel III guidelines), demographics, and health behaviors. Suspected NAFLD was defined based on increased level of aminotransferase in the absence of serologic evidence for common causes of liver disease or excessive alcohol consumption. In multivariate analyses, data were adjusted for metabolic syndrome, age, acculturation, diet, physical activity, sleep, and levels of education and income. Results In multivariate analysis, compared to persons of Mexican heritage, persons of Cuban (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.57–0.85), Puerto Rican (OR, 0.67; 95% CI, 0.52–0.87), and Dominican backgrounds (OR, 0.71; 95% CI, 0.54–0.93) had lower rates of suspected NAFLD. Persons of Central American and South American heritage had a similar prevalence of suspected NAFLD compared to persons of Mexican heritage. NAFLD was less common in women than men (OR, 0.49; 95% CI, 0.40–0.60). Suspected NAFLD associated with the metabolic syndrome and all 5 of its components. Conclusion Based on an analysis of a large database of health in Latino populations, we found the prevalence of suspected NAFLD among Hispanic/Latino individuals to vary by region of heritage.

Acculturation and Nonalcoholic Fatty Liver Disease Risk Among Hispanics of Mexican Origin: Findings From the National Health and Nutrition Examination Survey

“…As in previously published NHANES-based analyses of NAFLD, ultrasounds showing moderate or severe hepatic steatosis were classified as NAFLD and ultrasounds showing no or mild hepatic steatosis were classified as non-NAFLD (6). Consistent with previously published population-based analyses of NAFLD, aminotransferase thresholds used to identify NAFLD were: AST > 37 or ALT > 40 U/L in males or AST or ALT > 31 U/L in females (2). …”

“…We read with interest recent publications in Clinical Gastroenterology and Hepatology highlighting the high burden of nonalcoholic fatty liver disease (NAFLD) among Hispanics in the United States (1), as well as the variability in prevalence among Hispanics according to their heritage (2). NAFLD occurs as the consequence of a complex interplay of genetic, environmental, and lifestyle factors.…”

Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention

“…The prevalence of NAFLD is also related to socioeco nomic factors, but their exact role is debated. In a study exploring the role of environmental factors in different ethnic groups with NAFLD, acculturation, education level, health care use and income, along with dietary and lifestyle factors and sleep, were not found to be indepen dently associated with risk of developing NAFLD, suggest ing that environmental factors might have a role on a background of genetic predisposition 16 .…”

“…Specifically, NAFLD prevalence (assessed by ultrasonography) for South America has been estimated to be ~30.45% (95% CI 22.74-39.4%) 1 . The majority of studies reporting the preva lence of NAFLD from South America have been performed in Brazil [15][16][17] . Nevertheless, in a study reported from Chile, the prevalence of NAFLD (diagnosed using…”

Nonalcoholic Fatty Liver Disease

“…6 Among the Hispanic population, those of Mexican heritage have the highest prevalence while Dominican Republicans have the lowest prevalence. 7, 8 The etiology of this racial and ethnic disparity is likely multi-factorial and includes contributions from genetic, behavioral and socio-economic factors. 9 …”