PDF(Pubmed)
Abstract：
Introduction: The Hispanic population in the US faces a higher risk of nonalcoholic fatty liver disease (NAFLD). Multiple factors influence this risk, including genetics, environmental factors, and socioeconomic statuses. Inadequate access to nutritious foods, or food insecurity, is prevalent among Hispanic individuals and poses a metabolic risk for both the onset and development of NAFLD. Materials and Methods: We utilized the National Health and Nutrition Examination Survey (NHANES) 2017-2020 pre-pandemic data to analyze the association between Hispanic ethnicity, hepatic steatosis, fibrosis, and food insecurity. Vibration-controlled transient elastography (VCTE) was employed to assess liver stiffness (LSM) and controlled attenuation parameter (CAP) scores to determine fibrosis and steatosis, respectively. Linear and ordinal logistic regression models were applied to their continuous, log-transformed, and categorical forms, adjusting for demographics, metabolic comorbidities, and socioeconomic factors. Models were subsequently stratified based on food security statuses. Results: A total of 7396 Hispanic participants were included in the study. Under multivariable analysis, Hispanic individuals had higher CAP scores (Beta-coefficient: 10.2 dB/m, 95% CI: 6.1-14.4 dB/m, p = 0.001)) vs. non-Hispanic individuals, without statistically significant differences in fibrosis. Food-insecure participants exhibited higher CAP scores than their food-secure counterparts. After stratification, a stronger association between Hispanic ethnicity and CAP scores was evident in the food-insecure group (Beta-coefficient: 11.8 dB/m, 95% CI: 4.4-19.3 dB/m, p = 0.003). Discussion: This study demonstrates the heightened risk of hepatic steatosis among individuals with Hispanic ancestry in the US. The risk is exacerbated by food insecurity, particularly for Hispanic individuals. The contribution is linked to the dietary habits in this population that lead to metabolic risk factors associated with hepatic steatosis. Considering the rising prevalence of NAFLD and food insecurity, interventions focusing on nutritional support and healthcare access among this population could mitigate these burdens.
摘要：
简介：美国的西班牙裔人口面临非酒精性脂肪性肝病（NAFLD）的高风险。多种因素影响这种风险，包括遗传学,环境因素,和社会经济地位。获得营养食品的机会不足，或者粮食不安全，在西班牙裔个体中普遍存在，并对NAFLD的发生和发展构成代谢风险。材料和方法：我们利用国家健康和营养检查调查(NHANES)2017-2020年大流行前数据来分析西班牙裔种族之间的关联，肝脂肪变性,纤维化，和粮食不安全。振动控制瞬时弹性成像（VCTE）用于评估肝脏硬度（LSM）和受控衰减参数（CAP）评分，以确定纤维化和脂肪变性，分别。线性和有序逻辑回归模型被应用于它们的连续，对数变换，和分类形式，适应人口统计，代谢合并症，和社会经济因素。随后根据粮食安全状况对模型进行了分层。结果：共有7396名西班牙裔参与者被纳入研究。在多变量分析下，西班牙裔个体的CAP得分较高(β系数：10.2dB/m，95%CI：6.1-14.4dB/m，p=0.001))与非西班牙裔人，纤维化没有统计学上的显著差异。粮食不安全参与者的CAP分数高于粮食安全参与者。分层后,在食物不安全组中，西班牙裔种族与CAP评分之间的关联更强（Beta系数：11.8dB/m，95%CI:4.4-19.3dB/m,p=0.003)。讨论：这项研究表明，在美国具有西班牙血统的个体中，肝脏脂肪变性的风险增加。粮食不安全加剧了这种风险，特别是对于西班牙裔人。这种贡献与该人群的饮食习惯有关，这些饮食习惯导致与肝性脂肪变性相关的代谢风险因素。考虑到NAFLD患病率上升和粮食不安全，在这一人群中重点关注营养支持和医疗服务的干预措施可以减轻这些负担.
