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World J Hepatol. May 27, 2014; 6(5): 274-283
Published online May 27, 2014. doi: 10.4254/wjh.v6.i5.274
Gender and racial differences in nonalcoholic fatty liver disease
Jen-Jung Pan, Michael B Fallon
Jen-Jung Pan, Michael B Fallon, Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, United States
Author contributions: Pan JJ and Fallon MB wrote the paper.
Correspondence to: Jen-Jung Pan, MD, PhD, Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 4.234, Houston, TX 77030, United States. jenjung.pan@uth.tmc.edu
Telephone: +1-713-5006677 Fax: +1-713-5006699
Received: November 15, 2013
Revised: December 14, 2013
Accepted: April 9, 2014
Published online: May 27, 2014
Processing time: 193 Days and 7.8 Hours
Abstract

Due to the worldwide epidemic of obesity, nonalcoholic fatty liver disease (NAFLD) has become the most common cause of elevated liver enzymes. NAFLD represents a spectrum of liver injury ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) which may progress to advanced fibrosis and cirrhosis. Individuals with NAFLD, especially those with metabolic syndrome, have higher overall mortality, cardiovascular mortality, and liver-related mortality compared with the general population. According to the population-based studies, NAFLD and NASH are more prevalent in males and in Hispanics. Both the gender and racial ethnic differences in NAFLD and NASH are likely attributed to interaction between environmental, behavioral, and genetic factors. Using genome-wide association studies, several genetic variants have been identified to be associated with NAFLD/NASH. However, these variants account for only a small amount of variation in hepatic steatosis among ethnic groups and may serve as modifiers of the natural history of NAFLD. Alternatively, these variants may not be the causative variants but simply markers representing a larger body of genetic variations. In this article, we provide a concise review of the gender and racial differences in the prevalence of NAFLD and NASH in adults. We also discuss the possible mechanisms for these disparities.

Keywords: Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Race; Gender; Prevalence; Genetic polymorphism

Core tip: According to the population-based studies, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are more prevalent in males and in Hispanics. Both the gender and racial ethnic differences in NAFLD and NASH are likely attributed to interaction between environmental, behavioral, and genetic factors. In this article, we provide a concise review of the gender and racial differences in the prevalence of NAFLD and NASH in adults. We also discuss the possible mechanisms for these disparities.