title: Racial differences in nonalcoholic fatty liver disease in the U.S. population.
abstract: OBJECTIVE
  To characterize the prevalence of nonalcoholic fatty liver disease (NAFLD) by race in a nationally representative sample of the U.S. population and to investigate potential explanatory factors for racial disparities.
  
  
  METHODS
  Cross-sectional study of 4,037 non-Hispanic white, 2,746 non-Hispanic black, and 2,892 Mexican-American adults in the Third National Health and Nutrition Examination Survey. NAFLD was defined using ultrasound and with elevated aminotransferases.
  
  
  RESULTS
  Age-adjusted prevalence of NAFLD was highest in Mexican-Americans (21.2%), followed by non-Hispanic whites (12.5%), and was lowest in non-Hispanic blacks (11.6%). Even after adjustment for demographic, lifestyle, adiposity, and metabolic factors, compared to non-Hispanic whites, Mexican-Americans were more likely to have NAFLD (OR: 1.67, 95% CI: 1.26, 2.22). Non-Hispanic blacks were significantly less likely to have NAFLD with elevated aminotransferases (OR: 0.51, 95% CI: 0.27, 0.97). Racial differences were attenuated among those with normal BMI and among "never drinkers."
  
  
  CONCLUSIONS
  In this representative sample of the U.S. population, we found significant racial differences in the prevalence of ultrasound-defined NAFLD (with and without elevated liver enzymes). The racial differences were not fully explained by lifestyle, adiposity, and metabolic factors. More works is needed to identify potential contributors.
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Andrea L C
authors.initials: AL
authors.lastname: Schneider
authors.forename: Mariana
authors.initials: M
authors.lastname: Lazo
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Clark
mesh_terms: D050154:Adiposity / Q000502:physiology; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004032:Diet; D005234:Fatty Liver / Q000208:ethnology*; D005260:Female; D006801:Humans; D008019:Life Style; D008099:Liver / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009749:Nutrition Surveys; D015995:Prevalence; D044469:Racial Groups; D000637:Transaminases / Q000097:blood; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000637:Transaminases