Liver and Biliary Tract
Subject Category: Liver and Biliary Tract
Am J Gastroenterol 2009; 104:64–69; doi:10.1038/ajg.2008.12
The Histologic Spectrum of Liver Disease in African-American, Non-Hispanic White, and Hispanic Obesity Surgery Patients
Eric R Kallwitz MD1, Grace Guzman MD2, Veronica TenCate MD1, Joseph Vitello MD3, Jennifer Layden-Almer MD1, Jamie Berkes MD1, Roshan Patel MD2, Thomas J Layden MD1 and Scott J Cotler MD1
- 1Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
- 2Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA
- 3Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, USA
Correspondence: Eric R. Kallwitz, Department of Medicine, University of Illinois at Chicago, 840 S Wood Street MC 787, Chicago, Illinois 60612, USA. E-mail: Kallwitz@uic.edu
Received 20 May 2008; Accepted 29 July 2008.
Abstract
OBJECTIVES:
Non-alcoholic fatty liver disease (NAFLD) is a prominent cause of chronic liver disease in African Americans, non-Hispanic whites, and Hispanics. The aim of this study was to evaluate ethnic differences in the prevalence of NAFLD and non-alcoholic steatohepatitis (NASH) and to compare the severity of histologic features of NASH in obesity surgery patients.
METHODS:
Subjects consisted of 238 patients who had a routine liver biopsy at the time of obesity surgery. Demographic and clinical variables pertaining to the metabolic syndrome were collected retrospectively. Liver biopsies were evaluated according to the scoring system proposed by the Nonalcoholic Steatohepatitis Clinical Research Network and NASH was defined as a NASH activity score 
5.
RESULTS:
African Americans had lower rates of steatosis than non-Hispanic whites (P<0.001) and Hispanics (P=0.03). Among patients with steatosis, African Americans had lower rates of NASH than non-Hispanic whites (P=0.05) and Hispanics (P=0.02) and lower rates of fibrosis score F2 than non-Hispanic whites (P=0.002) and Hispanics (P=0.04). Ethnic differences in rates of NAFLD, NASH, and fibrosis F2 persisted when controlling for demographic variables and features of the metabolic syndrome in logistic regression analysis. There were no significant differences in steatosis, NASH, or fibrosis F2 between non-Hispanic whites and Hispanics.
CONCLUSIONS:
African-American obesity surgery patients have a lower rate of NAFLD, NASH, and less severe fibrosis than non-Hispanic whites and Hispanics.
