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 17 June 2018

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News

Disparities found in NAFLD prevalence and severity in the USA

This month's publication of Clinical Gastroenterology and Hepatology determines racial and ethnic disparities in nonalcoholic fatty liver disease prevalence, severity, and outcomes in the USA.

News image

Nonalcoholic fatty liver disease is the most common chronic liver disease in the United States, affecting 75–100 million Americans.

However, the disease burden may not be equally distributed among races or ethnicities.

Dr Amit Singal and colleagues from Texas, USA conducted a systematic review and meta-analysis to characterize racial and ethnic disparities in nonalcoholic fatty liver disease prevalence, severity, and prognosis.

The team searched MEDLINE, EMBASE, and Cochrane databases through 2016 for studies that reported nonalcoholic fatty liver disease prevalence in population-based or high-risk cohorts, nonalcoholic fatty liver disease severity including presence of nonalcoholic steatohepatitis and significant fibrosis, and nonalcoholic fatty liver disease prognosis including development of cirrhosis complications and mortality.

Pooled relative risks, according to race and ethnicity, were calculated for each outcome using the DerSimonian and Laird method for a random-effects model.

The researchers identified 34 studies comprising 368,569 unique patients that characterized disparities in nonalcoholic fatty liver disease prevalence, severity, or prognosis.


Nonalcoholic fatty liver disease prevalence was highest in Hispanics, intermediate in Whites, and lowest in Blacks

Clinical Gastroenterology and Hepatology


Nonalcoholic fatty liver disease prevalence was highest in Hispanics, intermediate in Whites, and lowest in Blacks, although differences between groups were smaller in high-risk cohorts than population-based cohorts.

Among patients with nonalcoholic fatty liver disease, risk of nonalcoholic steatohepatitis was higher in Hispanics and lower in Blacks than Whites.

The team found that the proportion of patients with significant fibrosis did not significantly differ among racial or ethnic groups.

Data were limited and discordant on racial or ethnic disparities in outcomes of patients with nonalcoholic fatty liver disease.

Dr Singal's team concludes, "In a systematic review and meta-analysis, we found significant racial and ethnic disparities in nonalcoholic fatty liver disease prevalence and severity in the United States, with the highest burden in Hispanics and lowest burden in Blacks."

"However, data are discordant on racial or ethnic differences in outcomes of patients with nonalcoholic fatty liver disease."

Clin Gastroenterol Hepatol 2018: 16 (2), 198-210 e2

15 March 2018

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