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Liver Int. 2019 Apr;39(4):748-757. doi: 10.1111/liv.14038. Epub 2019 Feb 13.

Prevalence and outcomes of non-alcoholic fatty liver disease (NAFLD) among Asian American adults in the United States.

Author information

1
Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia.
2
Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
3
Center for Asian Health, Saint Barnabas Medical Center, Florham Park, New Jersey.
4
Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University, Richmond, Virginia.
5
Center for Liver Disease and Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia.

Abstract

BACKGROUND & AIMS:

Non-alcoholic fatty liver disease (NAFLD) affects about 25% of the general population worldwide. Although epidemiology of NAFLD is well studied in the United States, there is paucity of data for the Asian Americans. Our aim was to assess the prevalence and risk factors for NAFLD among Asian Americans.

METHODS:

We utilized NHANES data for 2011-2016. We defined NAFLD using recently derived US-FLI. Relative risks (RRs) and population attributable fractions (PAFs) of metabolic components on atherosclerotic cardiovascular disease (ASCVD) and advanced fibrosis were calculated for Asian Americans, and these rates were compared to non-Hispanic whites.

RESULTS:

NAFLD prevalence was 18.3% among Asian Americans and 28.4% among non-Hispanic whites. Asian Americans with NAFLD had lower BMI and waist circumference than non-Hispanic whites with NAFLD and were less likely to have metabolic syndrome, cardiovascular disease (CVD), chronic obstructive pulmonary disease, cancer and incident ASCVD (P < 0.05). Hyperlipidaemia had the highest attributable fraction (76.6%) for risk of ASCVD among Asian Americans with NAFLD, followed by diabetes (24.0%), current smoking (9.2%), and obesity (3.7%). Advanced fibrosis in Asian American with NAFLD was independently associated with presence of type 2 diabetes (RR = 2.70, 95% CI: 1.00-7.27).

CONCLUSIONS:

Asian Americans have lower prevalence of NAFLD than non-Hispanic whites. However, Asian Americans with NAFLD have similar risk factors for advanced fibrosis and ASCVD than non-Hispanic Whites.

KEYWORDS:

Asian American; epidemiology; fibrosis; non-alcoholic fatty liver disease; outcome

PMID:
30597715
DOI:
10.1111/liv.14038

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