title: Frequency of Nonalcoholic Fatty Liver Disease and Subclinical Atherosclerosis Among Young Mexican Americans.
abstract: Nonalcoholic fatty liver disease (NAFLD) is considered as the hepatic manifestation of the metabolic syndrome, whose criteria are risk factors for atherosclerotic cardiovascular disease. We aimed to evaluate the prevalence of NAFLD, its association with subclinical atherosclerosis, and factors that may account for this association in Mexican Americans. In a population-based cross-sectional sample drawn from the Cameron County Hispanic Cohort in Texas, carotid intima media thickness (cIMT), an indicator of subclinical atherosclerosis, was measured. Abnormal carotid ultrasound study was defined as mean cIMT >75th percentile for age and gender and/or plaque presence. NAFLD was defined as steatosis by ultrasound in the absence of other causes of liver disease. Multivariable weighted regression analyses were performed to evaluate associations between NAFLD and cIMT. Mean age was 50.4 ± 1.2 years with 58.3% women. Mean body mass index was 31.0 ± 0.4 kg/m2, and 54.0% had the metabolic syndrome. NAFLD was highly prevalent (48.80%); subjects with NAFLD had greater body mass index, central obesity, fasting glucose levels, and dyslipidemia and were more likely to have the metabolic syndrome. Nearly 1/3 of subjects with NAFLD also had evidence of subclinical atherosclerosis (31.2%). After adjusting for covariates, there was an independent association between NAFLD and increased cIMT only in younger subjects <45 years (p = 0.0328). Subjects with both abnormal liver and carotid ultrasound studies tended to be obese, diabetic and have the metabolic syndrome. In conclusion, NAFLD is highly prevalent in this Mexican American cohort, with an independent association between NAFLD and subclinical atherosclerosis among younger subjects; clustering of diabetes, obesity, and metabolic syndrome in this health disparity cohort increases the risk of both liver disease and early atherosclerosis in young adults.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Clarence
authors.initials: C
authors.lastname: Gill
authors.affiliation: University of Texas Health Science Center at Houston, Division of Epidemiology, School of Public Health, Brownsville Campus, Brownsville, Texas.
authors.forename: Kristina P
authors.initials: KP
authors.lastname: Vatcheva
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Jen-Jung
authors.initials: JJ
authors.lastname: Pan
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Beverly
authors.initials: B
authors.lastname: Smulevitz
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: David D
authors.initials: DD
authors.lastname: McPherson
authors.affiliation: Department of Internal Medicine, University of Arizona, Phoenix, Arizona.
authors.forename: Michael
authors.initials: M
authors.lastname: Fallon
authors.affiliation: University of Texas Health Science Center at Houston, Division of Epidemiology, School of Public Health, Brownsville Campus, Brownsville, Texas.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: McCormick
authors.affiliation: University of Texas Health Science Center at Houston, Division of Epidemiology, School of Public Health, Brownsville Campus, Brownsville, Texas.
authors.forename: Susan P
authors.initials: SP
authors.lastname: Fisher-Hoch
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas. Electronic address: Susan.T.Laing@uth.tmc.edu.
authors.forename: Susan T
authors.initials: ST
authors.lastname: Laing
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000175:diagnosis / Q000208:ethnology*; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology