Racial differences in nonalcoholic fatty liver disease in the U.S. population

Andrea L.C. Schneider, Mariana Lazo-Elizondo, Elizabeth Selvin, Jeanne M. Clark

Research output: Contribution to journalArticlepeer-review

69 Scopus citations


Objective To characterize the prevalence of nonalcoholic fatty liver disease (NAFLD) by race in a nationally representative sample of the U.S. population and to investigate potential explanatory factors for racial disparities. Design and Methods Cross-sectional study of 4,037 non-Hispanic white, 2,746 non-Hispanic black, and 2,892 Mexican-American adults in the Third National Health and Nutrition Examination Survey. NAFLD was defined using ultrasound and with elevated aminotransferases. Results Age-adjusted prevalence of NAFLD was highest in Mexican-Americans (21.2%), followed by non-Hispanic whites (12.5%), and was lowest in non-Hispanic blacks (11.6%). Even after adjustment for demographic, lifestyle, adiposity, and metabolic factors, compared to non-Hispanic whites, Mexican-Americans were more likely to have NAFLD (OR: 1.67, 95% CI: 1.26, 2.22). Non-Hispanic blacks were significantly less likely to have NAFLD with elevated aminotransferases (OR: 0.51, 95% CI: 0.27, 0.97). Racial differences were attenuated among those with normal BMI and among "never drinkers." Conclusion In this representative sample of the U.S. population, we found significant racial differences in the prevalence of ultrasound-defined NAFLD (with and without elevated liver enzymes). The racial differences were not fully explained by lifestyle, adiposity, and metabolic factors. More works is needed to identify potential contributors.

Original languageEnglish (US)
Pages (from-to)292-299
Number of pages8
Issue number1
StatePublished - Jan 2014

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics


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