Abstract：
Point-of-care tools to assess advanced liver fibrosis, including the NFS, BARD, FIB-4, and APRI, are of major interest due to their noninvasive nature. However, these tools have not been investigated extensively in the Latina population. Given that the highest rate of NAFLD in Latinos and the most severe presentation of non-alcoholic fatty liver disease (NAFLD) is more common in women, we hypothesize that ethnicity may play a role in predicting liver fibrosis, particularly in women. We determined whether ethnicity alone or in association with other parameters can predict the severity of fibrosis in women with NAFLD when included in four tools. We retrospectively included 562 Latina and 133 White Caucasian women with a history of NAFLD. Associations between ethnicity and liver fibrosis severity using the four fibrosis predictor models were studied using backward selection multinomial logistic regression. Latina women compared to White showed lower body mass index (p < 0.001), higher HbA1c (p < 0.001), lower prevalence of bariatric surgery (p < 0.001), lower likelihood to smoke (p = 0.003), and higher prevalence of chronic kidney disease stages 3-5 (p = 0.01). Some clinical variables were associated with fibrosis but not univocally in each tool. We did not find differences in the outcome of the four models when holding all other factors and examining ethnicity alone between Latina and White women. Although we did not include data on liver histology, this is the first study examining the role of ethnicity in predicting the severity of fibrosis using established noninvasive scores and documenting no association between Latina ethnicity and the severity of fibrosis in women with NAFLD.
摘要：
点护理工具，以评估晚期肝纤维化，包括NFS,BARD,FIB-4和APRI，由于它们的非侵入性，它们是非常感兴趣的。然而,这些工具尚未在拉丁裔人口中进行广泛调查。鉴于拉丁美洲人的NAFLD发生率最高，NAFLD的最严重表现在女性中更为常见，我们假设种族可能在预测肝纤维化中发挥作用，尤其是女性。我们确定了单独的种族或与其他参数相关是否可以预测NAFLD女性纤维化的严重程度，当包括在四个工具中时。我们回顾性地纳入了562名具有NAFLD病史的拉丁裔和133名白人白人女性。使用向后选择多项逻辑回归研究使用四个肝硬化预测模型的种族和肝纤维化严重程度之间的关联。与白人相比，拉丁裔女性的BMI较低（p<0.001），较高的HbA1c（p<0.001），减肥手术的患病率较低（p<0.001），吸烟的可能性较低(p=0.003)，慢性肾脏病（CKD）3-5期患病率较高（p=0.01）。一些临床变量与纤维化相关，但在每种工具中不是唯一的。在持有所有其他因素并仅检查拉丁裔和白人女性之间的种族时，我们没有发现四种模型的结果差异。虽然我们没有包括肝脏组织学的数据，这是第一项研究,使用已建立的非侵入性评分,研究种族在预测纤维化严重程度中的作用,并记录了拉丁裔种族与NAFLD女性纤维化严重程度之间的相关性.
