Gastroenterology

Gastroenterology

Volume 156, Issue 4, March 2019, Pages 966-975.e10
Gastroenterology

Original Research
Full Report: Clinical—Liver
Propensity for Intra-abdominal and Hepatic Adiposity Varies Among Ethnic Groups

https://doi.org/10.1053/j.gastro.2018.11.021Get rights and content

Background & Aims

We compared fat storage in the abdominal region among individuals from 5 different ethnic–racial groups to determine whether fat storage is associated with disparities observed in metabolic syndrome and other obesity-associated diseases.

Methods

We collected data from 1794 participants in the Multiethnic Cohort Study (60–77 years old; of African, European [white], Japanese, Latino, or Native Hawaiian ancestry) with body mass index values of 17.1–46.2 kg/m2. From May 2013 through April 2016, participants visited the study clinic to undergo body measurements, an interview, and a blood collection. Participants were evaluated by dual-energy x-ray absorptiometry and abdominal magnetic resonance imaging. Among ethnic groups, we compared adiposity of the trunk, intra-abdominal visceral cavity, and liver, adjusting for total fat mass; we evaluated the association of adult weight change with abdominal adiposity; and we examined the prevalence of metabolic syndrome mediated by abdominal adiposity.

Results

Relative amounts of trunk, visceral, and liver fat varied significantly with ethnicity—they were highest in Japanese Americans, lowest in African Americans, and intermediate in the other groups. Compared with African Americans, the mean visceral fat area was 45% and 73% greater in Japanese American men and women, respectively, and the mean measurements of liver fat were 61% and 122% greater in Japanese American men and women. The visceral and hepatic adiposity associated with weight gain since participants were 21 years old varied in a similar pattern among ethnic–racial groups. In the mediation analysis, visceral and liver fat jointly accounted for a statistically significant fraction of the difference in metabolic syndrome prevalence, compared with white persons, for African Americans, Japanese Americans, and Native Hawaiian women, independently of total fat mass.

Conclusions

In an analysis of data from the participants in the Multiethnic Cohort Study, we found extensive differences among ethnic–racial groups in the propensity to store fat intra-abdominally. This observation should be considered by clinicians in the prevention and early detection of metabolic disorders.

Section snippets

Study Population

A detailed description of the study methods is provided in the Supplementary Materials. In short, the study was conducted in a subset of the Multiethnic Cohort Study (MEC) participants.21 At baseline (1993–1996), the MEC was composed of more than 215,000 men and women 45–75 years old of mainly 5 ethnic groups (Japanese Americans, Native Hawaiians, and whites mostly from Hawaii and African Americans and Latinos mostly from Los Angeles County, California) who returned a mailed questionnaire on

Results

The stratified recruitment resulted in a comparable number of study participants across sex–ethnicity–BMI categories, except for smaller numbers in the African American male and extreme BMI categories (Supplementary Figure 1). Characteristics, such as age, education, past smoking, alcohol intake, and anthropometric measurements, showed only limited variation across ethnic groups (Table 1).

Figure 1 (and Supplementary Table 1) presents a comparison of mean adiposity outcomes across ethnic groups

Discussion

Using dual-energy x-ray absorptiometry and MRI in a large multiethnic population of healthy older adults, abdominal and intra-abdominal adiposities were measured relative to total adiposity and found to be largest in Japanese Americans, followed by Native Hawaiians, Latinos, and whites, and smallest in African Americans. These ethnic–racial differences for Japanese Americans compared with African Americans were modest and similar in size between sexes for relative trunk fat (17% in men, 16% in

Acknowledgments

We thank the Multiethnic Cohort Study participants who generously donated their time and effort for the Adiposity Phenotype Study. We acknowledge the contribution of the study staff members whose excellent performance made this research possible: the Recruitment and Data Collection Core staff at the University of Southern California (Dr Valencerina, Adelaida Irimian, Chanthel Figueroa, Brenda Figueroa, Carla Flores, and Karla Soriano) and the University of Hawaii (Dr Terrilea Burnett, Jane

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    Conflicts of interest The authors disclose the following: Bruce S. Kristal is a consultant for Metabolon, which played no role in this study. Thomas Ernst is a consultant for KinetiCor, Inc, which played no role in this study. The other authors disclose no conflicts of interest.

    Funding Funding for this study was provided by a program project grant from the National Cancer Institute of the National Institutes of Health (P01 CA168530 to Loïc Le Marchand). The Multiethnic Cohort Study is funded by grant U01 CA164973 (to Loïc Le Marchand, Lynne R. Wilkens, and Christopher Haiman at the University of Southern California). The University of Hawaii Cancer Center Shared Resources (Analytical Biochemistry, Biostatistics, and Nutrition Support) were supported in part by the National Cancer Institute (P30 CA071789). Recruitment activities at the University of Southern California were supported in part by grants to the Southern California Clinical and Translational Science Institute (UL1 TR000130) from the National Institutes of Health National Center for Advancing Translational Science. The funding agencies had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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