B0526 - NAFLD in an African American Dominant Urban Medical Center Population

Astha Saini, DO¹, Brian Rutledge, MD¹, Alexander Yang, MD, PhD², Mohamad Khaled Almujarkesh, MD¹, Anirudh R. Damughatla, DO¹, Zaid Kaloti, MD¹, Sarvani Surapaneni, MD¹, Paul Naylor, PhD³, Milton G. Mutchnick, MD³, Murray N. Ehrinpreis, MD^4
1Wayne State University/Detroit Medical Center, Detroit, MI; ²University of Alabama Birmingham, Detroit, MI; ³Wayne State University School of Medicine, Detroit, MI; ⁴Wayne State University School of Medicine, Huntington Woods, MI

Introduction: Obesity, DM, HTN and metabolic syndrome (MtS) are associated with nonalcoholic fatty liver disease (NAFLD). NAFLD is characterized into, nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH), which are increasingly prevalent chronic liver diseases in the US. Data shows that there is a high incidence of MtS in African American (AA) individuals, however the AA population is known to have a lower incidence of NAFLD as compared to Caucasian and Hispanic Americans. Given the high number of AA patients in our clinic and paucity of data on the reason for the low incidence of NAFLD in the AA population, we assessed risk factors and non-invasive serum markers for fibrosis between AA and nonAA patients at their earliest clinic visits to ascertain potential underlying causes.

Methods: Using the ICD-10 codes for NAFLD (K76.0) and NASH (K75.81), we identified patients between 2017 and 2020 with sufficient data to confirm accurate diagnosis. We defined NAFL patients as those with significant steatosis (by ultrasound) and minimal fibrosis and NASH patients as those with significant steatosis and advanced fibrosis (F2-F4). Statistical analysis was performed using JMP-SAS software.

Results: We identified 216 patients with NAFLD (NAFL=133, NASH=83). Despite the predominance ( >80%) of AA patients in our clinic, AA patients constituted only 54% of the NAFLD patients (AA=116, Asian=18, Caucasian=48, Hispanic=17, Middle Eastern=16). Of the total AA patients with NAFLD, 34% had NASH which was not statistically significant in proportion when compared to the nonAA NASH patients. When differences between AA and nonAA NAFL patients were evaluated, age at diagnosis (AA older), APRI and FIB-4 (AA lower) were significantly different. APRI and FIB-4 scores were lower in AA NASH than nonAA NASH patients but the difference was not significant. Common risk factors for NAFLD (HTN, DM, obesity, and MtS) were not significant when compared in proportion of population between AA and nonAA patients (Table 1).

Discussion: Our percentage of NAFLD AA patients did not reflect the percentage of the broader clinic population suggesting a potential protective effect of ethnicity with relation to NAFLD. Most of the risk factors were more pronounced in NASH as compared to NAFL, but there were no major racial differences in risk factors that could account for the known lower incidence of NAFLD in AA versus nonAA patients. Further study over a longer time period is necessary to elucidate the underlying causality.


Disclosures:


Astha Saini, DO¹, Brian Rutledge, MD¹, Alexander Yang, MD, PhD², Mohamad Khaled Almujarkesh, MD¹, Anirudh R. Damughatla, DO¹, Zaid Kaloti, MD¹, Sarvani Surapaneni, MD¹, Paul Naylor, PhD³, Milton G. Mutchnick, MD³, Murray N. Ehrinpreis, MD⁴. B0526 - NAFLD in an African American Dominant Urban Medical Center Population, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.