P0909 - NAFLD Risk Factors: An Analysis of the All of Us Database

Chizoba Nwankwo, MD, MPA¹, Yong Eun, MD¹, Obinna Nwankwo, MD², Mohamed K.. Osman, MD, MPH², Kesiena Akpoigbe, MD², Joan Culpepper-Morgan, MD, FACG^3
1Harlem Hospital Center - NYCHHC, New York, NY; ²Harlem Hospital Center, New York, NY; ³Harlem Hospital, New York, NY

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of liver fibrosis and cirrhosis in the United States (US). Approximately 100 million Americans are affected. Previous studies have shown that NAFLD is more prevalent in males, increases with age, and is associated with metabolic syndrome. The highest prevalence was found in Hispanics (37%) and Whites (29.3%). Black patients had the lowest prevalence (24.7%). We aimed to confirm these associations and disparities of race/ethnicity using the National Institutes of Health (NIH) All of Us database.

Methods: This cross-sectional study examined data from 287,012 patients with available electronic health record data. Using ICD 9/10 codes, we identified patients diagnosed with NAFLD. We then utilized questionnaire response data to analyze specific characteristics of patients with and without NAFLD. These characteristics included gender, race/ ethnicity, income level, education level, and smoking. We also compared metabolic syndrome related diagnoses between patients with NAFLD and those without. All analyses were carried out on the Jupyter Notebook web-based platform using the R programming language.

Results: We identified 19,909 participants with NAFLD and 267,103 without for an overall prevalence of 6.9% in this cohort. The patients with NAFLD were older (58.1 vs 54.8 years) and more likely to be female (61.5% vs 60%) than those without. Compared to Whites on multivariate analysis: Hispanics (1.26), Middle Easterners (1.30), and Asians (1.31) had the highest odds of NAFLD. Blacks had the lowest odds (0.46). Data on Pacific Islanders was not statistically significant. Results on income level were not statistically significant. Education levels less than college had slightly higher odds of NAFLD (1.07) while college graduate or above had slightly lower odds (0.96). OR was higher with smokers (1.07), the obese (3.13), diabetics (1.96), hypertensives (2.26) and those with hyperlipidemia (2.02). (Table 1)

Discussion: Our study with the All of Us database confirms the association of NAFLD with the metabolic syndrome. It also confirms the increased odds of specific race/ethnicities being more likely to develop NAFLD. We did not find any significant advantage of higher education or wealth for this diagnosis in our cohort despite the over representation of higher education in this database. Socioeconomic differences do not seem risk defining in NAFLD.


Disclosures:


Chizoba Nwankwo, MD, MPA¹, Yong Eun, MD¹, Obinna Nwankwo, MD², Mohamed K.. Osman, MD, MPH², Kesiena Akpoigbe, MD², Joan Culpepper-Morgan, MD, FACG³. P0909 - NAFLD Risk Factors: An Analysis of the All of Us Database, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.