Non-Alcoholic Fatty Liver Disease Ethnicity and Hepatic Metabolism

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DESCRIPTION (provided by applicant): I am a gastroenterologist/hepatologist and Assistant Instructor in Internal Medicine at the University of Texas Southwestern Medical Center. My long-term goal is to develop an independent career as a translational researcher, bridging the gap between basic science applications and clinical research. I am interested in the epidemiology and metabolic basis of non-alcoholic fatty liver disease (NAFLD), with a special interest in the ethnic disparities that exist with this disease. This field of interest developed during fellowship when I became interested in the association between cryptogenic cirrhosis and NAFLD. My proposed career development plan incorporates a multi-disciplinary program designed to provide an intense, closely mentored, patient-oriented research experience in association with a comprehensively structured didactic curriculum in clinical research. Under the mentorship of Jay D. Morton, M.D. and Craig Malloy, M.D., I will investigate the metabolic basis of NAFLD. This research will focus on intermediary hepatic metabolism by using stable isotope techniques in combination with nuclear magnetic resonance and gas chromatography-mass spectroscopy and will test the hypothesis that primary NAFLD is the result of multiple metabolic abnormalities, with more than one metabolic phenotype being associated with this disease. The study will be conducted in a cohort of 2,287 subjects from the Dallas Heart Study whose liver triglyceride content has been previously characterized by magnetic resonance spectroscopy. A previous study in this cohort demonstrated significant differences in the prevalence of hepatic steatosis between African-Americans and Hispanics despite an equal prevalence of risk factors for NAFLD (i.e., obesity, diabetes, metabolic syndrome). Therefore, a second objective of this research will be to define ethnic differences in hepatic metabolism and relate these differences to the risk of developing hepatic steatosis.