Epidemiology of diet, metabolism and non-alcoholic fatty liver disease in Hispanic/Latino adults

摘要 非酒精性脂肪性肝病(NAFLD)属于一组代谢疾病 这对拉美裔美国最大的少数民族群体造成了不成比例的影响。已知NAFLD 风险因素，如肥胖、糖尿病、不良饮食和遗传风险等位基因更为常见。 但我们并不完全了解这些因素是如何导致 拉美裔非酒精性脂肪性肝病的高风险及其后遗症 脂肪性肝炎(NASH)、肝硬变和肝癌。此外，先前的研究设计已经 在很大程度上局限于病例对照比较，重点是临床上公认的 疾病。这只是“冰山一角”，忽略了拥有 亚临床肝病由于其危险因素的丰富。这项提议将 在大样本研究中检验寄主和细菌产生的日粮代谢产物 拉美裔(拉美裔社区健康研究-拉美裔研究，N=16,415成年人，来自 四个美国中心)拥有最先进的亚临床肝纤维化成像和 脂肪变性。根据我们的结果，饮食和代谢组特征可以预测NAFLD 可能转化为低成本的风险筛查测试。通过提高对 具体机制，这项研究也可能有助于设计干预措施，以防止 NAFLD，通过改变饮食或药物或非药物干预。

Abstract Nonalcoholic fatty liver disease (NAFLD) belongs to a cluster of metabolic conditions that disproportionately affects Latinos, the largest US minority group. Known NAFLD risk factors, like obesity, diabetes, poor diet, and genetic risk alleles, are more common in Latino populations, but we don’t fully understand how these factors contribute to Latinos’ high risks of developing NAFLD and its sequelae of non-alcoholic steatohepatitis (NASH), cirrhosis, and liver cancer. Moreover, prior study designs have been largely limited to case-control comparisons focused on clinically recognized disease. This represents only the “tip of the iceberg,” ignoring the large group with subclinical liver disease due to their abundance of risk factors. This proposal will examine host and bacteria produced metabolic products of diet in a large study sample of Latinos (Hispanic Community Health Study – Study of Latinos, N=16,415 adults from four US centers) with state-of-the-art imaging of subclinical liver fibrosis and steatosis. Based upon our results, diet and metabolome features that predict NAFLD may be translated into low-cost risk screening tests. By improving understanding of specific mechanisms, the study may also help to design interventions to prevent NAFLD, by diet modifications or pharmacologic or non-pharmacologic interventions.