PMID- 29133343
OWN - NLM
STAT- MEDLINE
DCOM- 20180508
LR  - 20221207
IS  - 1935-5548 (Electronic)
IS  - 0149-5992 (Linking)
VI  - 41
IP  - 1
DP  - 2018 Jan
TI  - Clinical and Histologic Characterization of Nonalcoholic Steatohepatitis in 
      African American Patients.
PG  - 187-192
LID - 10.2337/dc17-1349 [doi]
AB  - OBJECTIVE: There has been a widespread misconception among physicians that 
      African Americans are protected from developing nonalcoholic steatohepatitis 
      (NASH). However, a formal histologic and metabolic comparison against 
      well-matched Caucasians has never been performed. RESEARCH DESIGN AND METHODS: 
      Sixty-seven African American patients were matched 2:1 to Caucasians (n = 134) 
      for age, sex, BMI, hemoglobin A(1c), and prevalence of type 2 diabetes mellitus 
      (T2DM). Screening for NASH included measurement of intrahepatic triglyceride 
      content by proton MRS ((1)H-MRS), followed by a liver biopsy if patients had 
      hepatic steatosis. Insulin resistance was estimated during an oral glucose 
      tolerance test using the Matsuda Index. RESULTS: Compared with Caucasians, 
      African American patients had a lower intrahepatic triglyceride content (mean +/- 
      SD 6.1 +/- 6.8% vs. 9.4 +/- 7.5%, P = 0.007) and the presence of nonalcoholic fatty 
      liver disease (NAFLD) was less common (25.0% vs. 51.9%, P = 0.003). However, 
      prevalence of NASH was not different between ethnicities in patients with NAFLD 
      (57.1% vs. 73.3%, P = 0.12). Moreover, they showed similar severity in each of 
      the individual histologic parameters (inflammation, ballooning, and fibrosis). 
      Among patients with NAFLD, insulin resistance was similar between both ethnic 
      groups (Matsuda Index: 3.3 +/- 1.8 vs. 3.1 +/- 1.9, P = 0.61; adipose tissue insulin 
      resistance [Adipo-IR] index: 5.7 +/- 4.6 vs. 6.4 +/- 4.7 mmol/L ⋅ microU/mL, P = 0.53) 
      but appeared to be worse in African American versus Caucasian patients without 
      NAFLD (Matsuda Index: 4.9 +/- 3.6 vs. 7.0 +/- 4.9, P = 0.11; Adipo-IR: 3.9 +/- 2.8 vs. 
      2.7 +/- 2.3 mmol/L ⋅ microU/mL, P = 0.06). African American patients also had lower 
      plasma triglycerides and higher HDL cholesterol, independent of the severity of 
      intrahepatic triglyceride. CONCLUSIONS: Although African Americans have lower 
      intrahepatic triglyceride accumulation, once NAFLD develops, NASH occurs as 
      frequently, and as severe, as in Caucasian patients. Therefore, African Americans 
      with NAFLD should be screened for NASH with the same degree of clinical resolve 
      as in Caucasian patients.
CI  - (c) 2017 by the American Diabetes Association.
FAU - Bril, Fernando
AU  - Bril F
AD  - Division of Endocrinology, Diabetes & Metabolism, University of Florida, 
      Gainesville, FL.
AD  - Malcom Randall Veterans Administration Medical Center, Gainesville, FL.
FAU - Portillo-Sanchez, Paola
AU  - Portillo-Sanchez P
AD  - Division of Endocrinology, Diabetes & Metabolism, University of Florida, 
      Gainesville, FL.
FAU - Liu, I-Chia
AU  - Liu IC
AD  - Division of Endocrinology, Diabetes & Metabolism, University of Florida, 
      Gainesville, FL.
FAU - Kalavalapalli, Srilaxmi
AU  - Kalavalapalli S
AD  - Division of Endocrinology, Diabetes & Metabolism, University of Florida, 
      Gainesville, FL.
FAU - Dayton, Kristin
AU  - Dayton K
AD  - Division of Pediatric Endocrinology, University of Florida, Gainesville, FL.
FAU - Cusi, Kenneth
AU  - Cusi K
AUID- ORCID: 0000-0002-8629-418X
AD  - Division of Endocrinology, Diabetes & Metabolism, University of Florida, 
      Gainesville, FL kenneth.cusi@medicine.ufl.edu.
AD  - Malcom Randall Veterans Administration Medical Center, Gainesville, FL.
LA  - eng
PT  - Journal Article
DEP - 20171113
PL  - United States
TA  - Diabetes Care
JT  - Diabetes care
JID - 7805975
RN  - 0 (Cholesterol, HDL)
RN  - 0 (Cholesterol, LDL)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Insulin)
RN  - 0 (Triglycerides)
RN  - EC 2.6.1.1 (Aspartate Aminotransferases)
RN  - EC 2.6.1.2 (Alanine Transaminase)
SB  - IM
CIN - Diabetes Care. 2018 Sep;41(9):e136. PMID: 30135201
CIN - Diabetes Care. 2018 Sep;41(9):e137-e138. PMID: 30135202
MH  - Adult
MH  - *Black or African American
MH  - Alanine Transaminase/blood
MH  - Aspartate Aminotransferases/blood
MH  - Body Mass Index
MH  - Cholesterol, HDL/blood
MH  - Cholesterol, LDL/blood
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 2/*epidemiology
MH  - Female
MH  - Glucose Tolerance Test
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Insulin/blood
MH  - Insulin Resistance
MH  - Male
MH  - Middle Aged
MH  - Non-alcoholic Fatty Liver Disease/diagnosis/*epidemiology
MH  - Prevalence
MH  - Triglycerides/blood
MH  - White People
EDAT- 2017/11/15 06:00
MHDA- 2018/05/09 06:00
CRDT- 2017/11/15 06:00
PHST- 2017/07/06 00:00 [received]
PHST- 2017/10/18 00:00 [accepted]
PHST- 2017/11/15 06:00 [pubmed]
PHST- 2018/05/09 06:00 [medline]
PHST- 2017/11/15 06:00 [entrez]
AID - dc17-1349 [pii]
AID - 10.2337/dc17-1349 [doi]
PST - ppublish
SO  - Diabetes Care. 2018 Jan;41(1):187-192. doi: 10.2337/dc17-1349. Epub 2017 Nov 13.