Division of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Science Center, Memphis, TN, USA.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Curr Obes Rep. 2019 Sep;8(3):243-254. doi: 10.1007/s13679-019-00349-x.
Excessive adiposity has become a public health problem worldwide, contributing to the rise in obesity-related diseases and associated morbidity and mortality. This review details the relative significance of race/ethnicity as it pertains to adiposity and non-alcoholic fatty liver disease (NAFLD).
Fat distribution remains a more reliable measure of adiposity than anthropometric measures, with visceral adipose tissue (VAT) associated with increased risk of cardiometabolic disease. While obesity is the most common risk factor for NAFLD, the racial/ethnic prevalence of obesity does not completely parallel NAFLD risk. Combating racial/ethnic disparities in obesity requires understanding differential risk among various groups. Hispanics are disproportionally impacted by NAFLD and have high rates of obesity, VAT, and insulin resistance (IR). This contrasts with Blacks, who have high prevalence of obesity and IR, accompanied by a paradoxically favorable lipid profile and low prevalence of VAT and NAFLD. Many features of adiposity and NAFLD are mediated by genetic and environmental factors, the latter being modifiable and the focus of interventions.
肥胖已成为全球公共卫生问题,导致与肥胖相关的疾病及其发病率和死亡率上升。本综述详细介绍了种族/民族在肥胖和非酒精性脂肪性肝病(NAFLD)中的相关性的相对重要性。
脂肪分布仍然是衡量肥胖程度比人体测量学指标更可靠的方法,内脏脂肪组织(VAT)与心血管代谢疾病风险增加相关。虽然肥胖是 NAFLD 的最常见危险因素,但肥胖的种族/民族流行率并不完全与 NAFLD 风险平行。要解决肥胖方面的种族/民族差异,就需要了解不同人群的不同风险。西班牙裔人群受 NAFLD 的影响不成比例,肥胖、VAT 和胰岛素抵抗(IR)的发病率很高。这与黑人形成对比,黑人肥胖和 IR 发病率高,但血脂谱良好,VAT 和 NAFLD 的发病率低,这是一个悖论。肥胖和 NAFLD 的许多特征都受到遗传和环境因素的影响,而后者是可以改变的,也是干预的重点。