Epidemiology of diet, metabolism and non-alcoholic fatty liver disease in Hispanic/Latino adults

Abstract Nonalcoholic fatty liver disease (NAFLD) belongs to a cluster of metabolic conditions that disproportionately affects Latinos, the largest US minority group. Known NAFLD risk factors, like obesity, diabetes, poor diet, and genetic risk alleles, are more common in Latino populations, but we don’t fully understand how these factors contribute to Latinos’ high risks of developing NAFLD and its sequelae of non-alcoholic steatohepatitis (NASH), cirrhosis, and liver cancer. Moreover, prior study designs have been largely limited to case-control comparisons focused on clinically recognized disease. This represents only the “tip of the iceberg,” ignoring the large group with subclinical liver disease due to their abundance of risk factors. This proposal will examine host and bacteria produced metabolic products of diet in a large study sample of Latinos (Hispanic Community Health Study – Study of Latinos, N=16,415 adults from four US centers) with state-of-the-art imaging of subclinical liver fibrosis and steatosis. Based upon our results, diet and metabolome features that predict NAFLD may be translated into low-cost risk screening tests. By improving understanding of specific mechanisms, the study may also help to design interventions to prevent NAFLD, by diet modifications or pharmacologic or non-pharmacologic interventions.