Influence of ethnicity on histological differences in non-alcoholic fatty liver disease

Background/Aims Previous studies examining ethnic differences in non-alcoholic fatty liver disease (NAFLD) are limited by small sample sizes and the lack of liver biopsy as a diagnostic modality. Methods We retrospectively examined the influence of ethnicity on the biochemical and liver histological differences in NAFLD patients. Results The proportion of African Americans (AA) in the NAFLD sample (total 238 patients; 15.1% AA) was lower than in the base population (68.2%). Median ALT (47 IU/L; p=0.05) and triglyceride (134mg/dL, p=0.002) levels were lower in AA than other ethnicities. AA showed lower degrees of steatosis [odds ratio (OR) 0.44, 95% confidence interval (CI) 0.22–0.89; p=0.02] than Whites. In contrast, Asians showed higher grades of ballooning than Whites (OR 2.67, 95% CI 1.03–6.93; p=0.04) and other ethnicities combined (OR 2.71, 95% CI 1.06–6.92; p=0.04). Hispanics showed a higher rate of Mallory bodies than Whites (OR 2.38, 95% CI 1.05–5.39; p=0.04) and other ethnicities combined (OR 2.41, 95% CI 1.09–5.34; p=0.03). Conclusions African Americans showed a lower degree of steatosis than Whites. In contrast, Asians and Hispanics showed higher grades of ballooning and Mallory bodies, respectively, than Whites and other ethnicities combined. These findings highlight the need for prospective studies to evaluate ethnic differences in NAFLD.