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<h5 class="section-title" id="d1103863e170">Background & Aims</h5>
<p id="P1">Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver
disease
in the United States, affecting 75–100 million Americans. However, the disease burden
may not be equally distributed among races or ethnicities. We conducted a systematic
review and meta-analysis to characterize racial and ethnic disparities in NAFLD prevalence,
severity, and prognosis.
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<h5 class="section-title" id="d1103863e175">Methods</h5>
<p id="P2">We searched MEDLINE, EMBASE, and Cochrane databases through August 2016
for studies
that reported NAFLD prevalence in population-based or high-risk cohorts, NAFLD severity
including presence of nonalcoholic steatohepatitis (NASH) and significant fibrosis,
and NAFLD prognosis including development of cirrhosis complications and mortality.
Pooled relative risks, according to race and ethnicity, were calculated for each outcome
using the DerSimonian and Laird method for a random-effects model.
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<h5 class="section-title" id="d1103863e180">Results</h5>
<p id="P3">We identified 34 studies comprising 368,569 unique patients that characterized
disparities
in NAFLD prevalence, severity, or prognosis. NAFLD prevalence was highest in Hispanics,
intermediate in Whites, and lowest in Blacks, although differences between groups
were smaller in high-risk cohorts (range 47.6%–55.5%) than population-based cohorts
(range, 13.0%–22.9%). Among patients with NAFLD, risk of NASH was higher in Hispanics
(relative risk, 1.09; 95% CI, 0.98–1.21) and lower in Blacks (relative risk, 0.72;
95% CI, 0.60–0.87) than Whites. However, the proportion of patients with significant
fibrosis did not significantly differ among racial or ethnic groups. Data were limited
and discordant on racial or ethnic disparities in outcomes of patients with NAFLD.
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<h5 class="section-title" id="d1103863e185">Conclusion</h5>
<p id="P4">In a systematic review and meta-analysis, we found significant racial and
ethnic disparities
in NAFLD prevalence and severity in the United States, with the highest burden in
Hispanics and lowest burden in Blacks. However, data are discordant on racial or ethnic
differences in outcomes of patients with NAFLD.
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