title: Racial/ethnic differences in hepatic steatosis in a population-based cohort of post-menopausal women: the Michigan Study of Women's Health Across the Nation.
abstract: OBJECTIVE
  The prevalence of hepatic steatosis may differ between post-menopausal African-American women and non-Hispanic white women and by sex hormone binding globulin level. We examined prevalence of hepatic steatosis by race/ethnicity and associations with sex hormone binding globulin.
  
  
  METHODS
  Participants included post-menopausal women who underwent hepatic ultrasound (n = 345) at the Michigan site of the Study of Women's Health Across the Nation, a population-based study. We examined hepatic steatosis prevalence by race/ethnicity and used logistic regression models to calculate the odds of hepatic steatosis with race/ethnicity and sex hormone binding globulin, after adjustment for age, alcohol use, waist circumference, high density lipoprotein cholesterol, triglycerides, systolic blood pressure and use of medications reported to lower intrahepatic fat.
  
  
  RESULTS
  Fewer African-American women than non-Hispanic white women had hepatic steatosis (23 vs. 36%, P = 0.01). African-American women had lower triglyceride and low-density lipoprotein cholesterol levels, but higher blood pressure and follicle-stimulating hormone levels (P < 0.05). In the optimal-fitting multivariable models, women in the highest tertile of sex hormone binding globulin (60.2-220.3 nmol/l) had a lower odds of hepatic steatosis (odds ratio 0.43, 95% CI 0.20-0.93) compared with women in the lowest tertile of sex hormone binding globulin (10.5-40.3 nmol/l). There was an interaction between race/ethnicity and medication use whereby non-Hispanic white women using medications had three times higher odds of hepatic steatosis compared with African-American women not using medications (odds ratio 3.36, 95% CI 1.07-10.58). Interactions between race/ethnicity and other variables, including sex hormone levels, were not significant.
  
  
  CONCLUSIONS
  Hepatic steatosis on ultrasound may be more common in post-menopausal non-Hispanic white women than African-American women and was associated with lower levels of sex hormone binding globulin.
authors: Department of Medicine, Ann Arbor, MI, USA; Department of Obstetrics and Gynecology, Ann Arbor, MI, USA.
authors: C
authors: C
authors: Kim
authors: S D
authors: SD
authors: Harlow
authors: C A
authors: CA
authors: Karvonen-Gutierrez
authors: J F
authors: JF
authors: Randolph
authors: M
authors: M
authors: Helmuth
authors: S
authors: S
authors: Kong
authors: B
authors: B
authors: Nan
authors: R
authors: R
authors: Carlos
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology; D001794:Blood Pressure; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D005234:Fatty Liver / Q000097:blood / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D008824:Michigan; D008875:Middle Aged; D016017:Odds Ratio; D017698:Postmenopause / Q000097:blood; D015995:Prevalence; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D014280:Triglycerides / Q000097:blood; D014481:United States / Q000453:epidemiology; D044465:White People / Q000208:ethnology; D016387:Women's Health / Q000208:ethnology
chemical_list: D008078:Cholesterol, LDL; D012738:Sex Hormone-Binding Globulin; D014280:Triglycerides; D005640:Follicle Stimulating Hormone
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