Ethnic and Gender Differences in the Prevalence of Nonalcoholic Steatohepatitis among Bariatric Surgery Patients

Background & Aims: Severe obesity is a risk factor for nonalcoholic steatohepatitis (NASH), particularly among ethnic minority groups. The aim of this analysis was to evaluate ethnic group differences in the prevalence of NASH in a large multiethnic sample of bariatric patients not previously well-described in the literature. Methods: A cross-sectional retrospective analysis of 611 liver biopsies among patients, who underwent bariatric surgery from 2001 to 2010, from one bariatric surgery practice in South Florida was conducted. Logistic regression analysis predicted the ethnic group-specific odds of having NASH. Results: Hispanics (43%) and non-Hispanic whites (NHW) (46%) were significantly more likely than non-Hispanic blacks (NHB) (21%) to have advanced steatosis (p = 0.002). Conversely, NHB were significantly more likely to have mild or moderate steatosis (48%) versus both NHW (34%) and Hispanics (36%). Women were over two and a half times as likely as men to have NASH (OR 2.66, 95% CI 1.68-4.24). NHB were almost twice as likely as NHW to have NASH (OR 1.86, 95% CI 1.17-2.94). Conclusions: The prevalence of NASH varies significantly by ethnicity and gender among bariatric surgery patients. These findings have important clinical implications for postoperative health maintenance as NASH carries a risk of progressive liver disease.