TY - JOUR
T1 - Metabolic-associated fatty liver disease as assessed by the fatty liver index among migrant and non-migrant ghanaian populations
AU - van Dijk, Anne-Marieke
AU - Dingerink, Sjoerd
AU - Chilunga, Felix Patience
AU - Meeks, Karlijn Anna Catharina
AU - Bahendeka, Silver
AU - Schulze, Matthias Bernd
AU - Danquah, Ina
AU - Serné, Erik
AU - Osei, Tracy Bonsu
AU - Agyemang, Charles
AU - Holleboom, Adriaan Georgius
N1 - Funding Information: This work was supported by the European Commission under the Framework Programme (Grant No. 278901). The study sponsor was not involved in the design of the study; the collection, analysis and interpretation of data; writing the report; nor the decision to submit the report for publication. AGH was supported by the Amsterdam UMC Fellowship grant, a Holland Health TKI-PPP grant and by research grants from Gilead and Novo Nordisk. KACM was supported by the Intramural Research Program of the National Institutes of Health in the Center for Research on Genomics and Global Health (CRGGH). The CRGGH was supported by the National Human Genome Research Institute, the National Institute of Diabetes and Digestive and Kidney Diseases, the Center for Information Technology, and the Office of the Director at the National Institutes of Health (No. 1ZIAHG200362). Publisher Copyright: © 2021 The Author(s).
PY - 2021/5/21
Y1 - 2021/5/21
N2 - Background and Aims: Metabolic-associated fatty liver disease (MAFLD) is driven by high caloric intake and sed-entary lifestyle. Migration towards high income countries may induce these driving factors; yet, the influence of such on the prevalence of MAFLD is clearly understudied. Here, we investigated the Fatty Liver Index (FLI), a proxy of steatosis in MAFLD, after migration of Ghanaian sub-jects. Methods: Cross-sectional data of 5282 rural, urban and migrant participants from the Research on Obesity and Diabetes among African Migrants (also known as RODAM) study were analyzed with logistic regression for geographi-cal differences in FLI and associations with type 2 diabetes mellitus (T2DM), waist-to-hip ratio, and 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD). Results: Both FLI and the proportion with an FLI indica-tive of MAFLD steatosis (FLI ≥60) were higher in migrants compared with non-migrants. Prevalence of elevated FLI (FLI ≥60) in non-migrant males was 4.2% compared to 28.9% in migrants. For females, a similar gradient was ob-served, from 13.6% to 36.6% respectively. Compared to rural residents, the odds for a FLI ≥60 were higher in migrants living in urban Europe (odds ratio [OR] 9.02, 95% confidence interval [CI]: 5.02–16.20 for men, and 4.00, 95% CI: 3.00–5.34 for women). Compared to controls, the ORs for FLI ≥60 were 2.43 (95% CI: 1.73–3.41) for male T2DM cases and 2.02 (95% CI: 1.52–2.69) for female T2DM cases. One-unit higher FLI was associated with an elevated (≥7.5%) 10-year ASCVD risk (OR: 1.051, 95% CI: 1.041–1.062 for men, and 1.020, 95% CI: 1.015–1.026 for women). Conclusions: FLI as a proxy for MAFLD increased stepwise in Ghanaians from rural areas, through urban ar-eas, to Europe. Our results clearly warrant awareness for MAFLD in migrant population as well as confirmation with imaging modalities.
AB - Background and Aims: Metabolic-associated fatty liver disease (MAFLD) is driven by high caloric intake and sed-entary lifestyle. Migration towards high income countries may induce these driving factors; yet, the influence of such on the prevalence of MAFLD is clearly understudied. Here, we investigated the Fatty Liver Index (FLI), a proxy of steatosis in MAFLD, after migration of Ghanaian sub-jects. Methods: Cross-sectional data of 5282 rural, urban and migrant participants from the Research on Obesity and Diabetes among African Migrants (also known as RODAM) study were analyzed with logistic regression for geographi-cal differences in FLI and associations with type 2 diabetes mellitus (T2DM), waist-to-hip ratio, and 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD). Results: Both FLI and the proportion with an FLI indica-tive of MAFLD steatosis (FLI ≥60) were higher in migrants compared with non-migrants. Prevalence of elevated FLI (FLI ≥60) in non-migrant males was 4.2% compared to 28.9% in migrants. For females, a similar gradient was ob-served, from 13.6% to 36.6% respectively. Compared to rural residents, the odds for a FLI ≥60 were higher in migrants living in urban Europe (odds ratio [OR] 9.02, 95% confidence interval [CI]: 5.02–16.20 for men, and 4.00, 95% CI: 3.00–5.34 for women). Compared to controls, the ORs for FLI ≥60 were 2.43 (95% CI: 1.73–3.41) for male T2DM cases and 2.02 (95% CI: 1.52–2.69) for female T2DM cases. One-unit higher FLI was associated with an elevated (≥7.5%) 10-year ASCVD risk (OR: 1.051, 95% CI: 1.041–1.062 for men, and 1.020, 95% CI: 1.015–1.026 for women). Conclusions: FLI as a proxy for MAFLD increased stepwise in Ghanaians from rural areas, through urban ar-eas, to Europe. Our results clearly warrant awareness for MAFLD in migrant population as well as confirmation with imaging modalities.
KW - African population
KW - Fatty liver
KW - Migration
KW - Non-invasive test
UR - http://www.scopus.com/inward/record.url?scp=85117189770&partnerID=8YFLogxK
U2 - https://doi.org/10.14218/JCTH.2021.00066
DO - https://doi.org/10.14218/JCTH.2021.00066
M3 - Article
C2 - 34447678
SN - 2225-0719
VL - 9
SP - 494
EP - 502
JO - Journal of clinical and translational hepatology
JF - Journal of clinical and translational hepatology
IS - 4
ER -