title: The histologic spectrum of liver disease in African-American, non-Hispanic white, and Hispanic obesity surgery patients.
abstract: OBJECTIVE
  Non-alcoholic fatty liver disease (NAFLD) is a prominent cause of chronic liver disease in African Americans, non-Hispanic whites, and Hispanics. The aim of this study was to evaluate ethnic differences in the prevalence of NAFLD and non-alcoholic steatohepatitis (NASH) and to compare the severity of histologic features of NASH in obesity surgery patients.
  
  
  METHODS
  Subjects consisted of 238 patients who had a routine liver biopsy at the time of obesity surgery. Demographic and clinical variables pertaining to the metabolic syndrome were collected retrospectively. Liver biopsies were evaluated according to the scoring system proposed by the Nonalcoholic Steatohepatitis Clinical Research Network and NASH was defined as a NASH activity score > or =5.
  
  
  RESULTS
  African Americans had lower rates of steatosis than non-Hispanic whites (P<0.001) and Hispanics (P=0.03). Among patients with steatosis, African Americans had lower rates of NASH than non-Hispanic whites (P=0.05) and Hispanics (P=0.02) and lower rates of fibrosis score > or =F2 than non-Hispanic whites (P=0.002) and Hispanics (P=0.04). Ethnic differences in rates of NAFLD, NASH, and fibrosis > or =F2 persisted when controlling for demographic variables and features of the metabolic syndrome in logistic regression analysis. There were no significant differences in steatosis, NASH, or fibrosis > or =F2 between non-Hispanic whites and Hispanics.
  
  
  CONCLUSIONS
  African-American obesity surgery patients have a lower rate of NAFLD, NASH, and less severe fibrosis than non-Hispanic whites and Hispanics.
authors.affiliation: Department of Medicine, University of Illinois at Chicago, 840 S Wood Street, Chicago, IL 60612, USA. Kallwitz@uic.edu
authors.forename: Eric R
authors.initials: ER
authors.lastname: Kallwitz
authors.forename: Grace
authors.initials: G
authors.lastname: Guzman
authors.forename: Veronica
authors.initials: V
authors.lastname: TenCate
authors.forename: Joseph
authors.initials: J
authors.lastname: Vitello
authors.forename: Jennifer
authors.initials: J
authors.lastname: Layden-Almer
authors.forename: Jamie
authors.initials: J
authors.lastname: Berkes
authors.forename: Roshan
authors.initials: R
authors.lastname: Patel
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Layden
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Cotler
mesh_terms: D000328:Adult; D001741:Black or African American; D050110:Bariatric Surgery; D001707:Biopsy, Needle; D005234:Fatty Liver / Q000150:complications / Q000208:ethnology* / Q000473:pathology; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D012307:Risk Factors; D044465:White People