Prevalence of hepatic steatosis in an urban population in the United States: Impact of ethnicity
Prevalence of hepatic steatosis in an urban population in the United States: Impact of ethnicity
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DOI：
10.1002/hep.20466
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发表时间：
2004-12-01
期刊：
影响因子：
13.5
通讯作者：
Hobbs, HH
中科院分区：
文献类型：
--
作者：
Browning, JD;Szczepaniak, LS;Hobbs, HH
尽管非酒精性脂肪性肝病(NAFLD)的发病率越来越高，但其发病机制和临床意义仍不清楚。在这项研究中，我们用质子磁共振波谱检测和比较了2,287名多民族人群样本(白人占32.1%，黑人占48.3%，西班牙裔占17.5%)肝脏甘油三酯含量(HTGC)的分布。HTGC在人群中的变化范围很大(0.0%-41.7%；中位数3.6%)。几乎三分之一的人患有肝脏脂肪变性，大多数肝脏脂肪变性的受试者血清丙氨酸转氨酶水平正常(79%)。肝脏脂肪变性的发生率在种族(西班牙裔45%；白人33%；黑人24%)和性别(白人男性42%；白人女性24%)之间存在显著差异。拉美裔美国人肝脏脂肪变性的发生率较高是由于该民族肥胖和胰岛素抵抗的发生率较高。然而，黑人肝脏脂肪变性的发生率较低并不能用体重指数、胰岛素抵抗、酒精摄入或药物使用方面的种族差异来解释。在白人中，男性肝脏脂肪变性的患病率高于女性，但在黑人或西班牙裔美国人中并不如此。在这项研究中，肝脏脂肪变性频率的种族差异反映了以前观察到的与NAFLD相关的肝硬变(西班牙裔白人和黑人)的差异。总而言之，本研究中记载的肝脏脂肪变性患病率的显著种族和性别差异可能对脂肪变性相关肝病的易感性有深远的影响。
Despite the increasing prevalence of nonalcoholic fatty liver disease (NAFLD), its pathogenesis and clinical significance remain poorly defined. In this study, we examined and compared the distribution of hepatic triglyceride content (HTGC) in 2,287 subjects from a multiethnic, population-based sample (32.1% white, 48.3% black, and 17.5% Hispanic) using proton magnetic resonance spectroscopy. HTGC varied over a wide range (0.0%-41.7%; median, 3.6%) in the population. Almost one third of the population had hepatic steatosis, and most subjects with hepatic steatosis had normal levels of serum alanine aminotransferase (79%). The frequency of hepatic steatosis varied significantly with ethnicity (45% in Hispanics; 33% in whites; 24% in blacks) and sex (42% in white men; 24% in white women). The higher prevalence of hepatic steatosis in Hispanics was due to the higher prevalence of obesity and insulin resistance in this ethnic group. However, the lower frequency of hepatic steatosis in blacks was not explained by ethnic differences in body mass index, insulin resistance, ethanol ingestion, or medication use. The prevalence of hepatic steatosis was greater in men than women among whites, but not in blacks or Hispanics. The ethnic differences in the frequency of hepatic steatosis in this study mirror those observed previously for NAFLD-related cirrhosis (Hispanics > whites > blacks). In conclusion, the significant ethnic and sex differences in the prevalence of hepatic steatosis documented in this study may have a profound impact on susceptibility to steatosis-related liver disease.