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Digestive diseases and sciences
07, 2022;67 (7): 3340-3355.

Metabolic Risk Profiles for Hepatic Steatosis Differ by Race/Ethnicity: An Elastography-Based Study of US Adults.

Kali Zhou, Jennifer L Dodge, Liyun Yuan, Norah A Terrault
Author Information
  1. Kali Zhou: Division of Gastrointestinal and Liver Diseases, University of Southern California, 1450 San Pablo St. HC4, Room 3000, Los Angeles, CA, 90033, USA. kalizhou@usc.edu. ORCID
  2. Jennifer L Dodge: Division of Gastrointestinal and Liver Diseases, University of Southern California, 1450 San Pablo St. HC4, Room 3000, Los Angeles, CA, 90033, USA.
  3. Liyun Yuan: Division of Gastrointestinal and Liver Diseases, University of Southern California, 1450 San Pablo St. HC4, Room 3000, Los Angeles, CA, 90033, USA.
  4. Norah A Terrault: Division of Gastrointestinal and Liver Diseases, University of Southern California, 1450 San Pablo St. HC4, Room 3000, Los Angeles, CA, 90033, USA.
PMID: 34173916 DOI: 10.1007/s10620-021-07124-w

Abstract

BACKGROUND AND AIMS: Most population-based studies of risk profiles for liver steatosis have relied upon serum markers (e.g., ALT or FIB-4) or ultrasound steatosis index to define cases. We sought to examine racial/ethnic differences in metabolic risk factors associated with liver steatosis and fibrosis at the population level using elastography-based measures.
METHODS: In total, 4509 adults completed vibration-controlled transient elastography (VCTE) with controlled attenuated parameter (CAP) examinations in the 2017-2018 National Health and Nutrition Examinations Survey. Race/ethnicity was self-identified; metabolic parameters included waist circumference, obesity, diabetes, hypertension, and hyperlipidemia. Primary outcome was steatosis defined by CAP score ≥ 280 decibels per meter and secondary outcome significant fibrosis by VCTE median stiffness ≥ 8 kilopascals. Race-specific logistic regression models were performed to assess the relationship between metabolic parameters and hepatic steatosis and fibrosis.
RESULTS: Prevalence of elastography-based hepatic steatosis was > 30% for all race/ethnicities. Steatosis was associated with increasing waist circumference for all race/ethnicities (OR ranging 1.7-2.3, p < 0.01). Steatosis was associated with diabetes for Whites (OR 2.4, 95% CI 1.2-4.7), Asians (OR 3.0, 1.4-6.3), and Hispanics (OR 2.2, 1.3-3.6), but not Blacks (OR 1.3, 0.8-2.2); hypertension for Whites (OR 1.7, 1.3-4.7) and Asians (OR 2.1, 1.1-3.8); and hyperlipidemia for Blacks only (OR 2.2, 1.3-3.7). Of metabolic risk factors, higher odds of fibrosis were demonstrated with higher waist circumference per 10 cm increase (OR 2.1, 1.8-2.4) and diabetes (OR 2.5, 1.6-3.7), but the effect of diabetes was present in all racial/ethnic groups except Blacks (p-interaction < 0.05).
CONCLUSION: Blacks have a distinct metabolic phenotype for steatosis, while Asians, Whites, and Hispanics are more similar. Racial/ethnic differences in risk profiles are important to consider in prevention, screening strategies, and interventions for fatty liver disease.

Keywords

Nonalcoholic fatty liver disease Population studies Racial/ethnic differences Ultrasound elastography

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MeSH Term

Elasticity Imaging Techniques
Ethnicity
Humans
Hypertension
Liver
Liver Cirrhosis
Non-alcoholic Fatty Liver Disease
Journal Article Research Support, N.I.H., Extramural
Article has an altmetric score of 1

Word Cloud

Created with Highcharts 10.0.01OR2steatosismetabolic7riskliverfibrosisdiabetes3BlacksdifferencesassociatedwaistcircumferenceSteatosisWhitesAsiansstudiesprofilesracial/ethnicfactorselastography-basedelastographyVCTECAPparametershypertensionhyperlipidemiaoutcomeperhepaticrace/ethnicities40Hispanics3-38-2higherRacial/ethnicfattydiseaseBACKGROUNDANDAIMS:population-basedrelieduponserummarkersegALTFIB-4ultrasoundindexdefinecasessoughtexaminepopulationlevelusingmeasuresMETHODS:total4509adultscompletedvibration-controlledtransientcontrolledattenuatedparameterexaminations2017-2018NationalHealthNutritionExaminationsSurveyRace/ethnicityself-identifiedincludedobesityPrimarydefinedscore ≥ 280decibelsmetersecondarysignificantmedianstiffness ≥ 8kilopascalsRace-specificlogisticregressionmodelsperformedassessrelationshipRESULTS:Prevalencewas > 30%increasingranging7-2p < 00195%CI2-44-663-41-38oddsdemonstrated10 cmincrease56-3effectpresentgroupsexceptp-interaction < 005CONCLUSION:distinctphenotypesimilarimportantconsiderpreventionscreeningstrategiesinterventionsMetabolicRiskProfilesHepaticDifferRace/Ethnicity:Elastography-BasedStudyUSAdultsNonalcoholicPopulationUltrasound

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