P2377 - NASH/NAFLD and its Complications in African Americans: A Population Based Study

Saba Farooq, MD¹, Ritu R. Singh, MD², Mehwish Kishore, MD³, Hari Gopakumar, MD⁴, Sonu Dhillon, MD^5
1UIC Peoria, Peoria, IL; ²University of Illinois College of Medicine at Peoria, Peoria, IL; ³UICOMP, Peoria, IL; ⁴UIC, Peoria, IL; ⁵OSF Peoria, Peoria, IL

Introduction: Background and Objectives: Retrospective data suggest that AA (African American) men and women have a lower propensity to develop non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). We aim to perform a population-based study to explore the progression of NAFLD/NASH to cirrhosis and its complications in AA adults.

Methods: We performed a retrospective cohort study utilizing an EHR-based database (TriNetX) to study the progression of NAFLD to cirrhosis and its complications in AA men and women ≥18 years with NAFLD. We identified patients with NAFLD or NASH but without underlying cirrhosis diagnosed between January 2016 to December 2018 utilizing ICD-10-CM codes. They were collectively called NAFLD. The median follow-up period was five years. Primary outcome was the incidence of cirrhosis during the follow up. Secondary outcomes were development of decompensated cirrhosis, HCC, liver transplantation and overall mortality. Decompensated cirrhosis was defined as the development of ascites, variceal gastrointestinal (GI) bleeding, hepatic encephalopathy, hepatorenal syndrome, or hepatopulmonary syndrome. Control group adults with NAFLD/NASH of races other than AA.

Results: We identified 342,528 adults with NAFLD and 30,700 (9.0%) of them were AAs. NAFLD was more common among AA women compared with non-AA women (64% vs 56%, p< .001). Obesity (41% vs 29%), DM (37% vs 26%) and HTN (59% vs 43%) were more common in the AA cohort compared with non-AA cohort. However HLD was comparable in the two groups (40% vs 39%). 8.8% (N=2,697) of AA adults and 10.7% (N=33,295) of non-AA adults with NAFLD had cirrhosis (HR 0.78, 95% CI 0.75-0.81) during the follow up. Hepatic decompensation (HR 0.47, 95% CI 0.43-0.51), new diagnosis of HCC (HR 0.73, 95% CI 0.65-0.82) and 5-year mortality (HR 0.56, 95% CI 0.50-0.62) were observed less frequently in AA adults with NAFLD-cirrhosis compared with the non-AA adults with NAFLD-cirrhosis. During the mean 5-year follow-up, AA adults with cirrhosis less often underwent liver transplantation compared to the non-AA adults with cirrhosis (OR 0.50, 95% CI 0.42-0.61).

Discussion: Conclusions: NAFLD and NASH are observed less commonly in AA adults compared with other races. The progression of NAFLD/NASH to cirrhosis is less common in AA and complications of cirrhosis, including decompensated cirrhosis and overall mortality, are observed in approximately half in AA adults compared with other races during 5-year follow up.



Disclosures:


Saba Farooq, MD¹, Ritu R. Singh, MD², Mehwish Kishore, MD³, Hari Gopakumar, MD⁴, Sonu Dhillon, MD⁵. P2377 - NASH/NAFLD and its Complications in African Americans: A Population Based Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.