title: Racial differences in the association between adiposity measures and the risk of hepatitis C-related liver disease.
abstract: BACKGROUND
  African Americans have lower reported likelihood of hepatitis C virus-related cirrhosis than whites. It is unknown whether relative differences in the distribution of adipose tissue, lean mass, and other anthropometric measurements may explain these observed interethnic differences in disease risk.
  
  
  OBJECTIVE
  : To evaluate the association between anthropometric measurements and advanced liver disease in a cross-sectional study of African American and white male veterans.
  
  
  METHODS
  We used the validated FibroSURE-ActiTest to assess hepatic pathology, and direct segmental multichannel bioelectric impedance analysis for anthropometric measurements. Race-stratified logistic regression was employed to evaluate risk of high fibrosis progression rate (FPR) and advanced inflammation (A2 to A3).
  
  
  RESULTS
  Among 330 eligible males (59% African American), there were 43 white and 57 African American males with high FPR, and 70 African American and 59 white with advanced inflammation. Percentage body fat (%BF) was a stronger predictor of high FPR risk than was a high body mass index in African Americans [odds ratio (OR)(adj)=2.08; 95% confidence interval (CI),0.83-5.23 for highest %BF vs. lowest tertile and OR(adj)=1.50; 95% CI,0.60-3.75 for obese vs. normal body mass index, respectively], but not in whites. Highest lean leg mass was associated with a nonsignificant increased risk of both high FPR and advanced inflammation in African Americans (OR(highFPRadj)=1.73; 95% CI, 0.73-4.10; OR(AdvancedinflammationAdj)=1.65; 95% CI, 0.76-3.56) versus a decreased risk of both in whites (OR(highFPRadj)=0.62; 95% CI, 0.21-1.79; OR(AdvancedinflammationAdj)=0.58; 95% CI, 0.22-1.48).
  
  
  CONCLUSIONS
  Interethnic differences in nontraditional anthropometric measurements like %BF suggests their potential role in understanding interethnic differences in hepatitis C virus-related liver disease risk in males.
authors.affiliation: Clinical Epidemiology and Outcomes Program, Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA. dwhite1@bcm.edu
authors.forename: Donna L
authors.initials: DL
authors.lastname: White
authors.forename: Shahriar
authors.initials: S
authors.lastname: Tavakoli-Tabasi
authors.forename: Jill
authors.initials: J
authors.lastname: Kuzniarek
authors.forename: David J
authors.initials: DJ
authors.lastname: Ramsey
authors.forename: Hashem B
authors.initials: HB
authors.lastname: El-Serag
mesh_terms: D050154:Adiposity; D001741:Black or African American; D044383:Black People; D050218:Body Fat Distribution; D003430:Cross-Sectional Studies; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000208:ethnology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000208:ethnology*; D012306:Risk; D012307:Risk Factors; D014728:Veterans; D044465:White People