RESUMO
Background and Aim: Hepatic steatosis (HS) is common worldwide, but there is little data on the prevalence of HS in Pacific Islanders (PIs) and Asians within the United States. Our aim was to compare prevalence of HS in obese 18-50-year-olds of Asian and PI ethnicity who underwent computerized tomography (CT). Methods: We performed a retrospective analysis of all members of an integrated healthcare system who self-identified as Asian or PI, were between the ages of 18 and 50 years, had a body mass index (BMI) ≥ 30, and underwent a CT scan that included the liver during 2021, resulting in 748 subjects. Imaging was analyzed using a method sensitive and specific for moderate to severe HS. Additionally, multiple binary logistic regression was performed to explore the relationship between HS and HbA1c, BMI, and age. Results: Of the 748 patients, 311 (41.6%) had HS. We found no significant difference in the prevalence of HS between Asians and PIs (χ2 1 = 1.3, P = 0.25), between Asian and PI men (χ2 1 = 2.8, P = 0.096), or between Asian and PI women (χ2 1 = 0.053, P = 0.82). Higher odds of HS was associated with increasing BMI (OR = 1.08; 95% CI: 1.06-1.11; P < 0.001) and HbA1c (OR = 1.15; 95% CI: 1.04-1.26; P = 0.00489), but HS was not associated with age in this age range (OR = 0.993; 95% CI: 0.973-1.01; P = 0.46). Conclusion: Moderate to severe HS is very common in obese Asian and PI adults, and occurs at similar rates in these ethnicities. Abdominal CT imaging presents an opportunity to diagnose HS and provides relevant information to patients and healthcare providers.
RESUMO
Background and Aim Data on prevalence of nonalcoholic fatty liver disease in Hawaii is limited. This study determined the prevalence of moderate to severe hepatic steatosis within a multicultural, multiethnic, and multiracial cohort in Hawaii undergoing computerized tomography (CT) for reasons unrelated to fatty liver disease. Methods The authors performed a retrospective analysis of all patients who were members of an integrated health care system with CT scans including the liver between January 1, 2020, and December 31, 2020. Moderate to severe hepatic steatosis was determined by an average attenuation value < 40 Hounsfield units for non-contrast-enhanced CT and a mean attenuation value < 90 Hounsfield units for contrast-enhanced CT. Patients' electronic medical records were reviewed for existing diagnoses of hepatic steatosis, obesity, and diabetes mellitus type 2 and data to calculate a Fibrosis-4 (FIB-4) index. Results Approximately 26.6% had moderate to severe hepatic steatosis, while only 11.3% of those patients had an active diagnosis of fatty liver disease. Native Hawaiians and Pacific Islanders (33.1%) had the greatest prevalence of hepatic steatosis, followed by White people (28.4%), Asian people (27.7%), and other ethnicities (10.8%). About 61.4% patients with fatty liver had a diagnosis of obesity, while 33.4% had a body mass index < 30.0 kg/m2. Finally, 86.2% patients had enough information in their electronic medical records from which to calculate a FIB-4 score and the mean FIB-4 index was 1.66 ± 3.50. Conclusions Moderate to severe hepatic steatosis is common among patients undergoing CT studies for reasons not related to hepatic steatosis in this multiethnic population most of whom did not have a diagnosis of fatty liver disease.
