Ethnic Disparities in Adiposity: Focus on Non-alcoholic Fatty Liver Disease, Visceral, and Generalized Obesity
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Purpose of Review
Excessive adiposity has become a public health problem worldwide, contributing to the rise in obesity-related diseases and associated morbidity and mortality. This review details the relative significance of race/ethnicity as it pertains to adiposity and non-alcoholic fatty liver disease (NAFLD).
Fat distribution remains a more reliable measure of adiposity than anthropometric measures, with visceral adipose tissue (VAT) associated with increased risk of cardiometabolic disease. While obesity is the most common risk factor for NAFLD, the racial/ethnic prevalence of obesity does not completely parallel NAFLD risk.
Combating racial/ethnic disparities in obesity requires understanding differential risk among various groups. Hispanics are disproportionally impacted by NAFLD and have high rates of obesity, VAT, and insulin resistance (IR). This contrasts with Blacks, who have high prevalence of obesity and IR, accompanied by a paradoxically favorable lipid profile and low prevalence of VAT and NAFLD. Many features of adiposity and NAFLD are mediated by genetic and environmental factors, the latter being modifiable and the focus of interventions.
KeywordsVisceral adiposity NAFLD Obesity Ethnicity Race Health disparities
Body fat percentage
Body mass index
Dallas Heart Study
Food and Drug Administration
Free fatty acids
Framingham Heart Study
Gluteofemoral adipose tissue
International Diabetes Federation
Jackson Heart Study
Multi-Ethnic Study of Atherosclerosis
Metabolically healthy obese
Magnetic resonance imaging
Metabolically unhealthy obese
Non-alcoholic fatty liver disease
- NASH CRN
Nonalcoholic Steatohepatitis Clinical Research Network
National Health and Nutrition Examination Survey
Patatin-like phospholipase domain containing 3
Subcutaneous adipose tissue
Type 2 diabetes mellitus
Visceral adipose tissue
Very low-density lipoprotein
Compliance with Ethical Standards
Conflict of Interest
Uchenna Agbim declares that she has no conflict of interest.
Rotonya M. Carr has served as a co-investigator on a study sponsored by Intercept Pharmaceuticals and has received salary support from Intercept Pharmaceuticals.
Octavia Pickett-Blakely declares that she has no conflict of interest.
Sam Dagogo-Jack has received research support through diabetes clinical trial contracts with the University of Tennessee unrelated to the content of this article from AstraZeneca and Boehringer Ingelheim and has received consultant honoraria for diabetes scientific advisory boards unrelated to the content of this article from Merck, Sanofi, AstraZeneca, Boehringer Ingelhim, and Janssen.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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