- Email: [email protected]
P1029 : Racial-ethnic disparities in liver disease mortality in the United States
POSTERS patients. Fifty-six (33.9%), 38 (23.0%) and 11 (6.7%) patients had mild, moderate and severe fatty liver. Mean CAP and liver stiffness measurement in normal, mild, moderate and severe fatty liver were 182.93 (41.8), 247.96 (43.0), 307.86 (39.1), 329.27 (32.5) dB/m, and 4.28 (1.7), 5.02 (3.4), 6.05 (2.1), 9.16 (4.3) kPa. After adjusting for hypertension and BMI, CAP was associated with fatty liver with OR 1.05 (95% CI 1.03–1.07, p < 0.001). The optimal cutoffs of CAP for mild and severe fatty liver were 238 and 315 dB/m yielding the Areas Under ROC curves (AUROC), sensitivity and specificity of 0.92, 79.05%, 95.00% and 0.90, 81.82%, 88.31%. Hypertension (OR 7.94, 95% CI: 1.05–60.00; p = 0.045), BMI 23–25 kg/m2 (OR 71.02, 95% CI: 6.51–774.43; p = 0.000) and BMI >25 kg/m2 (OR 35.32, 95% CI: 3.64– 343.14; p = 0.002) were associated with fatty liver. Conclusions: Sixty-four percents of psoriasis patients have fatty liver by US. Hypertension, overweight, obesity and CAP are related to fatty liver. CAP using TE can be used to evaluate fatty liver in psoriasis patients. P1027 DO LEPTIN PROFILE AND INSULIN RESISTANCE FAVOR OXIDATIVE STRESS AND DISEASE SEVERITY IN NON-ALCOHOLIC FATTY LIVER DISEASE? B. Canbakan1 , H. Senturk2 , I. Hatemi1 , E. Koroglu1 , M. Tuncer1 , K. Atay1 , N. Kepil3 . 1 Gastroenterology, Istanbul Universtiy Cerrahpasa Medical Faculty, 2 Gastroenterology, Bezmi Alem University Medical faculty, 3 Pathology, Istanbul Universtiy Cerrahpasa Medical Faculty, Istanbul, Turkey E-mail: [email protected] Background and Aims: Leptin (L) promotes oxidative stress (OS) and the fibrogenesis. We aimed to evaluate the association between L levels, OS parameters, apoptosis and histopathological findings in Non alcoholic fatty liver disease (NAFLD) with and without IR. Methods: Fifty-eight NAFLD patients were studied (M/F:31/27 mean age 47.4±6.3). Thirty-six NAFLD patients with IR were compared with 22 subjects without IR. For the determination of oxidative stress, malondialdehyde (MDA), and superoxide dismutase (SOD) activities were measured in serum and in tissue specimens. Glutathione (GH) was measured in tissue homogenates. Nitric oxide (NO) and TNF-alpha receptor (TNF-sRp55) levels were measured in serum. For apoptotic activity immunohistochemistry was performed for caspase-3 and 8, transcription nuclear factor kB (NF-kB), and antiapoptotic Bcl-2 protein. Multivariate regression analysis and ROC curve were used to identify the independent predictors for NASH. Results: In bivariate analysis serum leptin levels didn’t show any significant correlation with steatosis grade, necroinflammatory grade and stage. In linear regression analysis serum NO, tissue MDA, caspase-3, caspase-8, and stage were independently associated with increased leptin levels. HOMA-IR index correlated positively with the necroinflammatory grade, the stage, caspase-3 and 8 levels. Patients with IR had significantly higher steatosis grade, necroinflammatory grade, stage, caspase-3, caspase-8, TNF-sRp55, serum NO, tissue MDA, GH and serum leptin levels than those without IR. Using serum leptin levels the ROC curve for distinguishing between non-alcoholic steatohepatitis (NASH) and simple steatosis didn’t show any respective sensitivity and specificity (AUROC=0.46). In multivariate regression analysis increase of tissue MDA, serum NO levels, caspase-3 and caspase-8 levels were risk factors for NASH and increase of leptin activity had preventive effect against NASH (OR:0.048; %95 CI:0.006–0.68, p = 0.04). Conclusions: IR in NAFLD is associated with increased oxidative stress, hepatocyte apoptosis and histopathological disease severity. In patients with IR oxidative stress parameters, apoptotic caspase levels and stage were independently associated with increased L levels and increased L activity showed preventive effect against
NASH. These data indicate that NAFLD patients with IR may have increased risk for disease progression and leptin may have a preventive effect against oxidative stress, apoptosis and liver fibrosis. P1028 IMPAIRED AEROBIC CAPACITY AND CARDIAC AUTONOMIC CONTROL IN SEDENTARY POSTMENOPAUSAL WOMEN WITH NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) S.M. Duarte1 , R.E. Rezende1 , J.T. Stefano1 , L.A. Perandini2 , T. Dassouki2 , A.L. Sa-Pinto2 , H. Roschel2 , B. Gualano2 , F.J. Carrilho1 , C.P. Oliveira1 . 1 Gastroenterology LIM 07, 2 Reumatology, University of S˜ ao Paulo School of Medicine, S˜ ao Paulo, Brazil E-mail: [email protected] Background and Aims: Aerobic capacity indexes and cardiac autonomic control have been associated with cardiovascular risk in general populations. It is important to investigate whether these parameters are also impaired in Nonalcoholic fatty liver disease (NAFLD) patients as compared with healthy controls. The aim of this study was to compare the aerobic capacity and cardiac autonomic control between postmenopausal women with or without NAFLD (CTRL) and investigate this relation according to hepatic severity. Methods: Thirty-seven physically inactive postmenopausal women (age: 55.8±1.4 years; BMI: 33.0±0.7 kg/m2 ) biopsy-proven NAFLD and twenty-four CTRL (age 55.8±0.7 years; BMI: 29.0±1.0 kg/m2 ) performed a cardiopulmonary exercise test to assess the aerobic capacity indexes [i.e., time at ventilatory anaerobic threshold (VAT), time at respiratory compensation point (RCP), time to exhaustion and maximal oxygen uptake (VO2 max)] and heart rate recovery of the first and second minutes after the end of the test (i.e., HRR1min and HRR2min). Results: NAFLD patients showed lower time to exhaustion (11.2±0.3 vs. 12.5±0.4 min, p = 0.026) and time at RCP (8.9±0.4 vs. 10.1±0.4 min, p = 0.047) when compared to CTRL. Additionally, time at VAT presented a tendency to be lower in NAFLD patients when compared with CTRL (4.6±0.2 vs. 5.2±0.3 min, p = 0.067). The HRR1min and HRR2min showed also a tendency to be lower in NAFLD patients compared with CTRL (p = 0.05 and p = 0.059, respectively). No significant changes were noted in the time at RCP between fibrosis degree 0/1/2 in comparison to degree 3/4 (8.5±2.5 vs. 10.2±1.8 min, p = 0.078). HRR2min showed a tendency to be higher in fibrosis degree 0/1/2 when compared to fibrosis degree 3/4 (p = 0.093). Conclusions: NAFLD patients showed lower aerobic capacity and an impaired cardiac autonomic control, which are indexes independently associated with risk of cardiovascular events. However, these findings require future investigations in large population-based studies. P1029 RACIAL-ETHNIC DISPARITIES IN LIVER DISEASE MORTALITY IN THE UNITED STATES C.E. Ruhl1 , A. Unalp-Arida2 . 1 Social & Scientific Systems, Inc., Silver Spring, MD, 2 National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, United States E-mail: [email protected] Background and Aims: Chronic liver disease and cirrhosis was the 12th leading cause of death in the U.S. in 2011 and the mortality rate varies among racial-ethnic groups. Age-adjusted liver disease mortality per 100,000 was 32.3 for Hispanics compared with 21.6 for both non-Hispanic whites and non-Hispanic blacks (http://wonder.cdc.gov/). We examined factors explaining racialethnic differences in liver disease mortality in a U.S. populationbased prospective study. Methods: Data were analyzed from 17,681 adult non-Hispanic white, non-Hispanic black, and Mexican American participants in
Journal of Hepatology 2015 vol. 62 | S263–S864
S733
POSTERS the third U.S. National Health and Nutrition Examination Survey, 1988–1994. Participants were followed through 2011 for mortality as identified by death certificate diagnoses. Hazard rate ratios (HR) for mortality were calculated using Cox proportional hazards regression to adjust for factors associated with both race-ethnicity and mortality. Results: Mexican Americans had adverse measures of socioeconomic status and were more likely to have obesity and diabetes compared with non-Hispanic whites at baseline. During up to 23 years of follow-up, there were 201 deaths with liver disease, including viral hepatitis and primary liver cancer, as the underlying or a contributing diagnosis. In age- and sex-adjusted analysis, liver disease mortality was twice as high among Mexican Americans compared with non-Hispanic whites, while there was no statistically significant difference for non-Hispanic blacks (Table). Adjustment for hepatitis B or C infection or for non-alcoholic fatty liver disease (NAFLD) risk factors (BMI, waist-to-hip ratio, diabetes) attenuated the association of Mexican American ethnicity with higher liver disease mortality. With adjustment for socioeconomic status (SES; education, income) and health insurance, Mexican American ethnicity was not statistically significantly associated with higher liver disease mortality. Results were similar with simultaneous adjustment for all of the above factors. Limiting analyses to deaths with liver disease as underlying cause had little effect on relationships. Table: Liver disease mortality HR (95% CI) compared with non-Hispanic whites Adjusted for
Non-Hispanic blacks
Mexican Americans
Age, sex Age, sex, viral hepatitis Age, sex, NAFLD risk factors Age, sex, SES, insurance All factors listed above
1.6 (1.0–2.5) 1.3 (0.7–2.2) 1.4 (0.8–2.5) 1.2 (0.6–2.1) 0.9 (0.5–1.8)
2.2 (1.3–3.5) 2.0 (1.2–3.5) 1.9 (1.1–3.4) 1.3 (0.6–2.7) 1.3 (0.6–2.5)
Conclusions: In the U.S. population, lower socio-economic status and lack of health insurance made a greater contribution to higher liver disease mortality among Mexican Americans than did viral hepatitis or NAFLD risk factors. P1030 THE PRESENCE OF WHITE MATTER LESIONS IS NOT ASSOCIATED WITH NON-ALCOHOLIC FATTY LIVER DISEASE BUT WITH ITS HISTOLOGICAL SEVERITY S. Petta1 , A. Tuttolomondo2 , C. Gagliardo3 , R. Zafonte4 , G. Brancatelli3 , D. Cabibi5 , C. Camma` 1 , V. Di Marco1 , L. Galvano4 , A. Licata1 , F. Magliozzo4 , G. Merlino4 , M. Midiri3 , A. Pinto2 , A. Craxì1 . 1 Section of Gastroenterology, Di.Bi.MI.S University of Palermo, Italy; 2 Sezione di Medicina Interna, DiBiMIS, University of Palermo, Italy; 3 Department of Radiology, University of Palermo, Italy; 4 Medicina Generale Palermo, 5 Cattedra di Anatomia Patologica, University of Palermo, Italy, palermo, Italy E-mail: [email protected] Background and Aims: Nonalcoholic fatty liver disease (NAFLD) has been associated with increased cardiovascular risk, including coronary artery disease and cerebrovascular events. No studies however assessed the potential relationship between NAFLD and subclinical cerebrovascular alterations. We tested the correlation between NAFLD and its histological severity with vascular white matter lesions (WML) in patients with biopsy-proven NAFLD and in non steatosic controls. Methods: The anthropometric, biochemical and metabolic features were recorded in 77 consecutive biopsy-proven NAFLD (Kleiner score), and in 35 controls with normal ALT, without chronic liver diseases, and without ultrasonographic evidence of steatosis. All patients underwent minimental test (MMT) and magnetic S734
resonance assessment of WML. MMT was considered pathologic if <23. WML were classified according to the Fazekas score in absent (0/III), or present (mild I/III; moderate II/III, and severe I/III). For purpose of analyses all controls, as plausible, were considered without NASH and without F2–F4 liver fibrosis. Results: WML were found in 26% of the entire cohort (29/112), even if of a moderate-severe grade in 5 patients only. The prevalence of WML was similar in NAFLD compared to no NAFLD (27% vs 23%; p = 0.62). Age ≥50 yrs, female gender, type 2 diabetes, arterial hypertension, presence of NASH (35% vs 18%, p = 0.05) and presence of F2–F4 fibrosis (43% vs 17%, p = 0.003) were associated with WML presence (p ≤ 0.01). At multivariate analysis age >50 yrs (OR 3.44, 95% CI 1.01–11.6, p 0.04), female gender (OR 3.71, 95% CI 1.28–10.7, p 0.01), and F2–F4 fibrosis (OR 3.39, 95% CI 1.17–9.84, p 0.02) were maintained as factors independently associated with WML. When considering NAFLD patients only, we confirmed F2–F4 fibrosis as the only independent predictor of WML (OR 4.24, 95% CI 1.14–15.7, p 0.03). A pathological MMT was found in 10/112 patients (9%) – all of them with NAFLD. Specifically the prevalence of an alterated MMT was 17% in patients with WML and 8% in those without. Conclusions: The presence of WML is not asociated with NAFLD but with its histological severity. Clinical implications of this issue need to be assessed by longitudinal studies. The ability of MMT to detect subclinical WML was poor. P1031 COMPARISON OF CLINICAL, BIOCHEMICAL, AND HISTOPATHOLOGICAL PROFILES BETWEEN NAFLD IN ASIAN-INDIANS AND UNITED STATES ADULTS S.P. Singh1 , A. Patel2 , M.K. Panigrahi3 , L. Viswanathan4 , S.K. Kar1 , S.A. Harrison5 . 1 Department of Gastroenterology, S.C.B. Medical College, CUTTACK, 2 Division of Gastroenterology and Hepatology, Department of Medicine, Carl R. Darnall Army Medical Center, Fort Hood, Texas, 3 Department of Gastroenterology & Hepatobiliary Sciences, IMS & SUM Hospital, Bhubaneswar, India; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas, United States E-mail: [email protected] Background and Aims: Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver disorders in Asian and Western countries. The epidemiological and demographic character of NAFLD patients differs with geographic variation. Studies across ethnicities in the United States (U.S.) reveal a higher prevalence in Hispanics and African-Americans with limited studies involving Asians. Data suggest that Asian-Indian patients tend to have different characteristics than their counterparts in the West. This study is the first attempt at comparing the characteristics of AsianIndian and U.S. NAFLD patients. Methods: A retrospective analysis of clinical, biochemical and histological parameters was performed for 633 Asian-Indian NAFLD patients with 451 U.S. NAFLD patients. Comparisons among the study cohort included clinical (i.e.: age, gender, BMI, diabetes, hypertension, etc.), biochemical tests (i.e.: liver function tests, lipid profile, fasting blood sugar), hepatic ultrasound and hepatic histology. Results: The majority of U.S. NAFLD patients (82.3%) were over 40 years of age compared to 51.3% of Asian-Indian patients (c2 = 109.55; p < 0.001). There was significant difference in gender prevalence between U.S. (male 56.3%) and AsianIndians (male 81.7%) (c2 = 82.442; p < 0.001). U.S. patients had higher rates of obesity (BMI 32.6±5.3 kg/m2 versus 26.2±3.4 kg/m2 ; p < 0.001). With respect to co-morbid conditions, U.S. patients had a higher prevalence of both diabetes and hypertension (diabetes 42.1% vs. 33%, and hypertension 56.8% vs 29.7%, respectively; p < 0.001). U.S. NAFLD patients have significantly
Journal of Hepatology 2015 vol. 62 | S263–S864
NASH. These data indicate that NAFLD patients with IR may have increased risk for disease progression and leptin may have a preventive effect against oxidative stress, apoptosis and liver fibrosis. P1028 IMPAIRED AEROBIC CAPACITY AND CARDIAC AUTONOMIC CONTROL IN SEDENTARY POSTMENOPAUSAL WOMEN WITH NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) S.M. Duarte1 , R.E. Rezende1 , J.T. Stefano1 , L.A. Perandini2 , T. Dassouki2 , A.L. Sa-Pinto2 , H. Roschel2 , B. Gualano2 , F.J. Carrilho1 , C.P. Oliveira1 . 1 Gastroenterology LIM 07, 2 Reumatology, University of S˜ ao Paulo School of Medicine, S˜ ao Paulo, Brazil E-mail: [email protected] Background and Aims: Aerobic capacity indexes and cardiac autonomic control have been associated with cardiovascular risk in general populations. It is important to investigate whether these parameters are also impaired in Nonalcoholic fatty liver disease (NAFLD) patients as compared with healthy controls. The aim of this study was to compare the aerobic capacity and cardiac autonomic control between postmenopausal women with or without NAFLD (CTRL) and investigate this relation according to hepatic severity. Methods: Thirty-seven physically inactive postmenopausal women (age: 55.8±1.4 years; BMI: 33.0±0.7 kg/m2 ) biopsy-proven NAFLD and twenty-four CTRL (age 55.8±0.7 years; BMI: 29.0±1.0 kg/m2 ) performed a cardiopulmonary exercise test to assess the aerobic capacity indexes [i.e., time at ventilatory anaerobic threshold (VAT), time at respiratory compensation point (RCP), time to exhaustion and maximal oxygen uptake (VO2 max)] and heart rate recovery of the first and second minutes after the end of the test (i.e., HRR1min and HRR2min). Results: NAFLD patients showed lower time to exhaustion (11.2±0.3 vs. 12.5±0.4 min, p = 0.026) and time at RCP (8.9±0.4 vs. 10.1±0.4 min, p = 0.047) when compared to CTRL. Additionally, time at VAT presented a tendency to be lower in NAFLD patients when compared with CTRL (4.6±0.2 vs. 5.2±0.3 min, p = 0.067). The HRR1min and HRR2min showed also a tendency to be lower in NAFLD patients compared with CTRL (p = 0.05 and p = 0.059, respectively). No significant changes were noted in the time at RCP between fibrosis degree 0/1/2 in comparison to degree 3/4 (8.5±2.5 vs. 10.2±1.8 min, p = 0.078). HRR2min showed a tendency to be higher in fibrosis degree 0/1/2 when compared to fibrosis degree 3/4 (p = 0.093). Conclusions: NAFLD patients showed lower aerobic capacity and an impaired cardiac autonomic control, which are indexes independently associated with risk of cardiovascular events. However, these findings require future investigations in large population-based studies. P1029 RACIAL-ETHNIC DISPARITIES IN LIVER DISEASE MORTALITY IN THE UNITED STATES C.E. Ruhl1 , A. Unalp-Arida2 . 1 Social & Scientific Systems, Inc., Silver Spring, MD, 2 National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, United States E-mail: [email protected] Background and Aims: Chronic liver disease and cirrhosis was the 12th leading cause of death in the U.S. in 2011 and the mortality rate varies among racial-ethnic groups. Age-adjusted liver disease mortality per 100,000 was 32.3 for Hispanics compared with 21.6 for both non-Hispanic whites and non-Hispanic blacks (http://wonder.cdc.gov/). We examined factors explaining racialethnic differences in liver disease mortality in a U.S. populationbased prospective study. Methods: Data were analyzed from 17,681 adult non-Hispanic white, non-Hispanic black, and Mexican American participants in
Journal of Hepatology 2015 vol. 62 | S263–S864
S733
POSTERS the third U.S. National Health and Nutrition Examination Survey, 1988–1994. Participants were followed through 2011 for mortality as identified by death certificate diagnoses. Hazard rate ratios (HR) for mortality were calculated using Cox proportional hazards regression to adjust for factors associated with both race-ethnicity and mortality. Results: Mexican Americans had adverse measures of socioeconomic status and were more likely to have obesity and diabetes compared with non-Hispanic whites at baseline. During up to 23 years of follow-up, there were 201 deaths with liver disease, including viral hepatitis and primary liver cancer, as the underlying or a contributing diagnosis. In age- and sex-adjusted analysis, liver disease mortality was twice as high among Mexican Americans compared with non-Hispanic whites, while there was no statistically significant difference for non-Hispanic blacks (Table). Adjustment for hepatitis B or C infection or for non-alcoholic fatty liver disease (NAFLD) risk factors (BMI, waist-to-hip ratio, diabetes) attenuated the association of Mexican American ethnicity with higher liver disease mortality. With adjustment for socioeconomic status (SES; education, income) and health insurance, Mexican American ethnicity was not statistically significantly associated with higher liver disease mortality. Results were similar with simultaneous adjustment for all of the above factors. Limiting analyses to deaths with liver disease as underlying cause had little effect on relationships. Table: Liver disease mortality HR (95% CI) compared with non-Hispanic whites Adjusted for
Non-Hispanic blacks
Mexican Americans
Age, sex Age, sex, viral hepatitis Age, sex, NAFLD risk factors Age, sex, SES, insurance All factors listed above
1.6 (1.0–2.5) 1.3 (0.7–2.2) 1.4 (0.8–2.5) 1.2 (0.6–2.1) 0.9 (0.5–1.8)
2.2 (1.3–3.5) 2.0 (1.2–3.5) 1.9 (1.1–3.4) 1.3 (0.6–2.7) 1.3 (0.6–2.5)
Conclusions: In the U.S. population, lower socio-economic status and lack of health insurance made a greater contribution to higher liver disease mortality among Mexican Americans than did viral hepatitis or NAFLD risk factors. P1030 THE PRESENCE OF WHITE MATTER LESIONS IS NOT ASSOCIATED WITH NON-ALCOHOLIC FATTY LIVER DISEASE BUT WITH ITS HISTOLOGICAL SEVERITY S. Petta1 , A. Tuttolomondo2 , C. Gagliardo3 , R. Zafonte4 , G. Brancatelli3 , D. Cabibi5 , C. Camma` 1 , V. Di Marco1 , L. Galvano4 , A. Licata1 , F. Magliozzo4 , G. Merlino4 , M. Midiri3 , A. Pinto2 , A. Craxì1 . 1 Section of Gastroenterology, Di.Bi.MI.S University of Palermo, Italy; 2 Sezione di Medicina Interna, DiBiMIS, University of Palermo, Italy; 3 Department of Radiology, University of Palermo, Italy; 4 Medicina Generale Palermo, 5 Cattedra di Anatomia Patologica, University of Palermo, Italy, palermo, Italy E-mail: [email protected] Background and Aims: Nonalcoholic fatty liver disease (NAFLD) has been associated with increased cardiovascular risk, including coronary artery disease and cerebrovascular events. No studies however assessed the potential relationship between NAFLD and subclinical cerebrovascular alterations. We tested the correlation between NAFLD and its histological severity with vascular white matter lesions (WML) in patients with biopsy-proven NAFLD and in non steatosic controls. Methods: The anthropometric, biochemical and metabolic features were recorded in 77 consecutive biopsy-proven NAFLD (Kleiner score), and in 35 controls with normal ALT, without chronic liver diseases, and without ultrasonographic evidence of steatosis. All patients underwent minimental test (MMT) and magnetic S734
resonance assessment of WML. MMT was considered pathologic if <23. WML were classified according to the Fazekas score in absent (0/III), or present (mild I/III; moderate II/III, and severe I/III). For purpose of analyses all controls, as plausible, were considered without NASH and without F2–F4 liver fibrosis. Results: WML were found in 26% of the entire cohort (29/112), even if of a moderate-severe grade in 5 patients only. The prevalence of WML was similar in NAFLD compared to no NAFLD (27% vs 23%; p = 0.62). Age ≥50 yrs, female gender, type 2 diabetes, arterial hypertension, presence of NASH (35% vs 18%, p = 0.05) and presence of F2–F4 fibrosis (43% vs 17%, p = 0.003) were associated with WML presence (p ≤ 0.01). At multivariate analysis age >50 yrs (OR 3.44, 95% CI 1.01–11.6, p 0.04), female gender (OR 3.71, 95% CI 1.28–10.7, p 0.01), and F2–F4 fibrosis (OR 3.39, 95% CI 1.17–9.84, p 0.02) were maintained as factors independently associated with WML. When considering NAFLD patients only, we confirmed F2–F4 fibrosis as the only independent predictor of WML (OR 4.24, 95% CI 1.14–15.7, p 0.03). A pathological MMT was found in 10/112 patients (9%) – all of them with NAFLD. Specifically the prevalence of an alterated MMT was 17% in patients with WML and 8% in those without. Conclusions: The presence of WML is not asociated with NAFLD but with its histological severity. Clinical implications of this issue need to be assessed by longitudinal studies. The ability of MMT to detect subclinical WML was poor. P1031 COMPARISON OF CLINICAL, BIOCHEMICAL, AND HISTOPATHOLOGICAL PROFILES BETWEEN NAFLD IN ASIAN-INDIANS AND UNITED STATES ADULTS S.P. Singh1 , A. Patel2 , M.K. Panigrahi3 , L. Viswanathan4 , S.K. Kar1 , S.A. Harrison5 . 1 Department of Gastroenterology, S.C.B. Medical College, CUTTACK, 2 Division of Gastroenterology and Hepatology, Department of Medicine, Carl R. Darnall Army Medical Center, Fort Hood, Texas, 3 Department of Gastroenterology & Hepatobiliary Sciences, IMS & SUM Hospital, Bhubaneswar, India; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas, United States E-mail: [email protected] Background and Aims: Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver disorders in Asian and Western countries. The epidemiological and demographic character of NAFLD patients differs with geographic variation. Studies across ethnicities in the United States (U.S.) reveal a higher prevalence in Hispanics and African-Americans with limited studies involving Asians. Data suggest that Asian-Indian patients tend to have different characteristics than their counterparts in the West. This study is the first attempt at comparing the characteristics of AsianIndian and U.S. NAFLD patients. Methods: A retrospective analysis of clinical, biochemical and histological parameters was performed for 633 Asian-Indian NAFLD patients with 451 U.S. NAFLD patients. Comparisons among the study cohort included clinical (i.e.: age, gender, BMI, diabetes, hypertension, etc.), biochemical tests (i.e.: liver function tests, lipid profile, fasting blood sugar), hepatic ultrasound and hepatic histology. Results: The majority of U.S. NAFLD patients (82.3%) were over 40 years of age compared to 51.3% of Asian-Indian patients (c2 = 109.55; p < 0.001). There was significant difference in gender prevalence between U.S. (male 56.3%) and AsianIndians (male 81.7%) (c2 = 82.442; p < 0.001). U.S. patients had higher rates of obesity (BMI 32.6±5.3 kg/m2 versus 26.2±3.4 kg/m2 ; p < 0.001). With respect to co-morbid conditions, U.S. patients had a higher prevalence of both diabetes and hypertension (diabetes 42.1% vs. 33%, and hypertension 56.8% vs 29.7%, respectively; p < 0.001). U.S. NAFLD patients have significantly
Journal of Hepatology 2015 vol. 62 | S263–S864