Alvarez Christian S, Kaplan Robert C, Camargo M Constanza, Avilés-Santa M Larissa, Daviglus Martha, Garcia-Bedoya Olga, Isasi Carmen R, Pattany Maria S, Thyagarajan Bharat, Talavera Gregory A, Graubard Barry I, McGlynn Katherine A
Division of Intramural Research, National Institute on Minority Health and Health Disparities, NIH, Rockville, MD, USA.
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Lancet Reg Health Am. 2024 Nov 30;41:100953. doi: 10.1016/j.lana.2024.100953. eCollection 2025 Jan.
Hispanic/Latino populations have been reported to have high rates of both metabolic dysfunction-associated steatotic liver disease (MASLD) and infection. Several observational studies, predominantly from Asian populations, have suggested a link between these conditions. Thus, the primary objective of the current study was to examine the association between and MASLD and secondarily, to assess its association with related conditions in the Hispanic Community Health Study/Study of Latinos.
In this cross-sectional study, a total of 16,144 participants with baseline data on serology were included. Based on weighted statistics, the median age was 40 years [interquartile range (IQR): 28, 52]; 52.2% women (n = 9661) and 47.8% men (n = 6483). Participants' Hispanic/Latino heritage included 37.6% Mexicans (n = 6397), 20.1% Cubans (n = 2307), 15.8% Puerto Ricans (n = 2663), 10.0% Dominicans (n = 1447), 7.4% Central Americans (n = 1710), 4.9% South Americans (1052). MASLD was estimated using the Fatty Liver Index (FLI) and the Hepatic Steatosis Index (HSI). Other conditions examined were obesity, central obesity, diabetes and metabolic syndrome. Multivariable logistic regression models were used to calculate the ratios of (adjusted) prevalences (RP) and 95% confidence intervals (CI) for the overall association of seropositivity with MASLD and related conditions. Analyses were also stratified by Hispanic/Latino heritage.
The overall prevalence of MASLD ranged from 47% (FLI) to 65% (HSI). After accounting for age, sex, education, and other key variables, the analysis found a modest association between seropositivity and MASLD as determined by HSI (RP: 1.06, 95% CI: 1.02-1.10) overall, and among individuals of Puerto Rican and Mexican heritages. Furthermore, an overall association between seropositivity and obesity was observed (RP: 1.09, 95% CI: 1.02-1.16).
This study provides support for a positive association of seropositivity with MASLD and obesity among Hispanic/Latino populations. However, given the exploratory nature of these findings, caution is warranted in their interpretation. Further research is necessary to establish causality and examine potential mechanisms of these associations.
The Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), San Diego State University (N01-HC65237), and University of Illinois at Chicago (HHSN268201300003I). The following Institutes/Centers/Offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Institute on Minority Health and Health Disparities, United States, the National Institute of Deafness and Other Communications Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements. This study was also funded in part by the Intramural Research Program of the National Cancer Institute.
据报道,西班牙裔/拉丁裔人群中代谢功能障碍相关脂肪性肝病(MASLD)和感染的发生率都很高。几项主要来自亚洲人群的观察性研究表明了这些情况之间的联系。因此,本研究的主要目的是检验[此处原文缺失某因素,根据前文推测可能是某种感染]与MASLD之间的关联,其次是评估其在西班牙裔社区健康研究/拉丁裔研究中与相关疾病的关联。
在这项横断面研究中,纳入了总共16144名有[此处原文缺失某血清学指标,根据前文推测可能是某种感染的血清学指标]基线数据的参与者。基于加权统计,中位年龄为40岁[四分位间距(IQR):28,52];女性占52.2%(n = 9661),男性占47.8%(n = 6483)。参与者的西班牙裔/拉丁裔血统包括37.6%的墨西哥人(n = 6397)、20.1%的古巴人(n = 2307)、15.8%的波多黎各人(n = 2663)、10.0%的多米尼加人(n = 1447)、7.4%的中美洲人(n = 1710)、4.9%的南美洲人(1052)。使用脂肪肝指数(FLI)和肝脂肪变性指数(HSI)评估MASLD。检查的其他疾病包括肥胖、中心性肥胖、糖尿病和代谢综合征。多变量逻辑回归模型用于计算[此处原文缺失某感染血清学阳性与MASLD及相关疾病总体关联的(调整后)患病率(RP)和95%置信区间(CI)]。分析也按西班牙裔/拉丁裔血统进行分层。
MASLD的总体患病率在47%(FLI)至65%(HSI)之间。在考虑年龄、性别、教育程度和其他关键变量后,分析发现总体上以及在波多黎各人和墨西哥人血统的个体中,[此处原文缺失某感染血清学阳性与由HSI确定的MASLD之间存在适度关联(RP:1.06,95% CI:1.02 - 1.10)]。此外,观察到[此处原文缺失某感染血清学阳性与肥胖之间存在总体关联(RP:1.09,95% CI:1.02 - 1.16)]。
本研究为西班牙裔/拉丁裔人群中[此处原文缺失某感染血清学阳性与MASLD和肥胖之间的正相关提供了支持]。然而,鉴于这些发现的探索性,在解释时应谨慎。有必要进行进一步研究以确定因果关系并检查这些关联的潜在机制。
西班牙裔社区健康研究/拉丁裔研究是一项合作研究,由美国国立心肺血液研究所(NHLBI)与北卡罗来纳大学(N01 - HC65233)、迈阿密大学(N01 - HC65234)、阿尔伯特爱因斯坦医学院(N01 - HC65235)、西北大学(N01 - HC65236)、圣地亚哥州立大学(N01 - HC65237)和伊利诺伊大学芝加哥分校(HHSN268201300003I)签订的合同提供支持。以下研究所/中心/办公室通过向NHLBI转移资金为HCHS/SOL做出贡献:美国国立少数族裔健康与健康差异研究所、国立耳聋与其他交流障碍研究所、国立牙科和颅面研究所以及国立糖尿病、消化和肾脏疾病研究所、国立神经疾病和中风研究所和膳食补充剂办公室。本研究还部分由国立癌症研究所的内部研究项目资助。