title: Cirrhosis and Advanced Fibrosis in Hispanics in Texas: The Dominant Contribution of Central Obesity.
abstract: Liver cirrhosis is a leading cause of death in Hispanics and Hispanics who live in South Texas have the highest incidence of liver cancer in the United States. We aimed at determining the prevalence and associated risk factors of cirrhosis in this population. Clinical and demographic variables were extracted for 2466 participants in the community-based Cameron County Hispanic Cohort in South Texas. Aspartate transaminase to Platelet Ratio Index (APRI) was used to predict cirrhosis in Cameron County Hispanic Cohort. The prevalence of cirrhosis using APRI≥2 was 0.94%, which is nearly 4-fold higher than the national prevalence. Using APRI≥1, the overall prevalence of cirrhosis/advanced fibrosis was 3.54%. In both analyses, highest prevalence was observed in males, specifically in the 25-34 age group. Risk factors independently associated with APRI≥2 and APRI≥1 included hepatitis C, diabetes and central obesity with a remarkable population attributable fraction of 52.5% and 65.3% from central obesity, respectively. Excess alcohol consumption was also independently associated with APRI≥2. The presence of patatin-like phospholipase domain-containing-3 gene variants was independently associated with APRI≥1 in participants >50 years old. Males with both central obesity and excess alcohol consumption presented with cirrhosis/advanced fibrosis at a young age. Alarmingly high prevalence of cirrhosis and advanced fibrosis was identified in Hispanics in South Texas, affecting young males in particular. Central obesity was identified as the major risk factor. Public health efforts are urgently needed to increase awareness and diagnosis of advanced liver fibrosis in Hispanics.
authors.affiliation: Department of Molecular and Cellular Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Jiao
authors.affiliation: School of Public Health, University of Texas Health Science Center at Houston, Brownsville Regional Campus, Brownsville, Texas, United States of America.
authors.forename: Gordon P
authors.initials: GP
authors.lastname: Watt
authors.affiliation: Department of Internal Medicine, Division of Clinical and Translational Sciences, The University of Texas Medical School at Houston, Houston, Texas, United States of America.|Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America.
authors.forename: MinJae
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Division of Clinical and Translational Sciences, The University of Texas Medical School at Houston, Houston, Texas, United States of America.|Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America.|The University of Texas School of Public Health at Houston, Houston, Texas, United States of America.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Rahbar
authors.affiliation: School of Public Health, University of Texas Health Science Center at Houston, Brownsville Regional Campus, Brownsville, Texas, United States of America.
authors.forename: Kristina P
authors.initials: KP
authors.lastname: Vatcheva
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Medical School at Houston, Houston, Texas, United States of America.
authors.forename: Jen-Jung
authors.initials: JJ
authors.lastname: Pan
authors.affiliation: School of Public Health, University of Texas Health Science Center at Houston, Brownsville Regional Campus, Brownsville, Texas, United States of America.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: McCormick
authors.affiliation: School of Public Health, University of Texas Health Science Center at Houston, Brownsville Regional Campus, Brownsville, Texas, United States of America.
authors.forename: Susan P
authors.initials: SP
authors.lastname: Fisher-Hoch
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Medical School at Houston, Houston, Texas, United States of America.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Fallon
authors.affiliation: Department of Molecular and Cellular Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Laura
authors.initials: L
authors.lastname: Beretta
mesh_terms: D015331:Cohort Studies; D005260:Female; D006630:Hispanic or Latino / Q000235:genetics / Q000706:statistics & numerical data*; D006801:Humans; D008049:Lipase / Q000235:genetics; D008103:Liver Cirrhosis / Q000150:complications* / Q000453:epidemiology* / Q000208:ethnology / Q000235:genetics; D008297:Male; D008565:Membrane Proteins / Q000235:genetics; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications*; D020641:Polymorphism, Single Nucleotide; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology / Q000208:ethnology; D000217:Acyltransferases; D054512:Phospholipases A2, Calcium-Independent
chemical_list: D008049:Lipase; D008565:Membrane Proteins; C533682:PNPLA3 protein, human; D000217:Acyltransferases; D054512:Phospholipases A2, Calcium-Independent