Prevalence of Hepatic Steatosis in An Urban Population in the United States: Impact of Ethnicity
Abstract
Despite the increasing prevalence of nonalcoholic fatty liver disease (NAFLD), its pathogenesis and clinical significance remain poorly defined. In this study, we examined and compared the distribution of hepatic triglyceride content (HTGC) in 2,287 subjects from a multiethnic, population–based sample (32.1% white, 48.3% black, and 17.5% Hispanic) using proton magnetic resonance spectroscopy. HTGC varied over a wide range (0.0%–41.7%; median, 3.6%) in the population. Almost one third of the population had hepatic steatosis, and most subjects with hepatic steatosis had normal levels of serum alanine aminotransferase (79%). The frequency of hepatic steatosis varied significantly with ethnicity (45% in Hispanics; 33% in whites; 24% in blacks) and sex (42% in white men; 24% in white women). The higher prevalence of hepatic steatosis in Hispanics was due to the higher prevalence of obesity and insulin resistance in this ethnic group. However, the lower frequency of hepatic steatosis in blacks was not explained by ethnic differences in body mass index, insulin resistance, ethanol ingestion, or medication use. The prevalence of hepatic steatosis was greater in men than women among whites, but not in blacks or Hispanics. The ethnic differences in the frequency of hepatic steatosis in this study mirror those observed previously for NAFLD–related cirrhosis (Hispanics > whites > blacks). In conclusion , the significant ethnic and sex differences in the prevalence of hepatic steatosis documented in this study may have a profound impact on susceptibility to steatosis–related liver disease. (Hepatology 2004;40:1387-1395.)
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Ectopic lipid accumulation in muscle and liver seemingly predisposes to insulin resistance and dyslipidemia.
“Ectopic lipid accumulation in muscle and liver seemingly predisposes to insulin resistance 29 and dyslipidemia.30”
From Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement (2005) · cites this paper as [30]
Insulin resistance and the metabolic syndrome are associated with several other conditions, including fatty liver, polycystic ovary syndrome, cholesterol gallstones, sleep apnea, lipodystrophies, and protease-inhibitor therapy for HIV.
“Finally, insulin resistance and the metabolic syndrome are associated with a variety of other conditions [75][76][77] ; some of these are fatty liver, 30,78 polycystic ovary syndrome, 79 cholesterol gallstones, 80 sleep apnea, 81 lipodystrophies, 82 and protease-inhibitor therapy for HIV.83”
From Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement (2005) · cites this paper as [30]
The prevalence of diabetes is higher in Hispanics and Blacks compared with Caucasians.
“In addition, the prevalence of diabetes has been found to be much higher in Hispanics and Blacks compared with Caucasians (4).”
From Increased prevalence of insulin resistance and nonalcoholic fatty liver disease in Asian-Indian men (2006) · cites this paper as [4]
There is increasing evidence for a causal relationship between hepatic steatosis and hepatic insulin resistance in rodent models and in patients with nonalcoholic fatty liver disease.
“There is increasing evidence for a causal relationship between hepatic steatosis and hepatic insulin resistance both in rodent models with hepatic steatosis and in patients with nonalcoholic fatty liver disease (4, 18-25).”
From Increased prevalence of insulin resistance and nonalcoholic fatty liver disease in Asian-Indian men (2006) · cites this paper as [4]
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- Authors
- Browning, J. D., Szczepaniak, L. S., Dobbins, R., Nuremberg, P., Horton, J. D., Cohen, J. C., Grundy, S. M., & Hobbs, H. H.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Texas Scottish Rite Hospital for Children (US)
- Veterans Health Administration (US)
- Howard Hughes Medical Institute (US)
- Venue
- Hepatology
- Published
- 2004-12
- Volume
- 40
- Issue
- 6
- Pages
- 1387-1395
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2098555833
- Cited by
- 3,664
- References
- 47
- Citations by year
- 2026: 47 · 2025: 57 · 2024: 98 · 2023: 106 · 2022: 146 · 2021: 197 · 2020: 196 · 2019: 191 · 2018: 203 · 2017: 242 · 2016: 256 · 2015: 289 · 2014: 245 · 2013: 258 · 2012: 217
- FWCI
- 49.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL-20948, P01HL020948)
- National Institute of Diabetes and Digestive and Kidney Diseases (T32DK07745, T32DK007745)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- hepatic steatosis, non-alcoholic fatty liver disease, hepatic triglyceride content, ethnicity, sex differences, Hispanic population, obesity, insulin resistance, alanine aminotransferase, 1H NMR, urban population
- MeSH terms
- Adult, Black or African American, Fatty Liver, Female, Hispanic or Latino, Humans, Liver, Male, Middle Aged, Magnetic Resonance Spectroscopy, Protons, Texas, Triglycerides, Urban Population, Prevalence, White People
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