ABO blood group and risk of newly diagnosed nonalcoholic fatty liver disease: A case-control study in Han Chinese population

Screening the General Population for Non-Alcoholic Fatty Liver Disease: Model Development and Validation

BACKGROUND

The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing worldwide. Screening the general population for this may help to select appropriate diagnostic and preventive measures before disease progression.

AIMS

We aimed to develop a screening method to identify patients with NAFLD in the general population.

METHODS

We analyzed cross-sectional data from a large Japanese study of NAFLD. Principal component analysis was used to analyze the data. Candidate predictors were patients' demographic, clinical, and laboratory characteristics. The resulting model was externally validated using three data sets from different populations.

RESULTS

Of 15,464 (54.5% men) included patients, 2,741 (17.7%) had NAFLD as determined by ultrasonography. An index was calculated as the arithmetic mean of the scaled body mass index and serum triglyceride levels for both men and women. The area under the receiver operating characteristic curve, sensitivity, specificity, and false positive rate were 0.875, 0.824, 0.770, and 17.6%, respectively. The mean index values were significantly different between the patients with and without non-alcoholic fatty liver disease (p <0.001). The odds ratio of the index cutoff was 15.6 (95% confidence interval [CI]:14.05, 17.39). The model yielded areas under the curve of 0.828, 0.851, and 0.836 for a Chinese (N = 2,319), an Iranian (N = 2,160), and a Brazilian (N = 45,029) data set, respectively.

CONCLUSIONS

The proposed composite index demonstrated high performance and generalizability, suggesting its potential use as a screening tool for NAFLD in the general population.

Genetic variants associated with circulating liver injury markers in Mexican Americans, a population at risk for non-alcoholic fatty liver disease

Objective: Mexican Americans are disproportionally affected by non-alcoholic fatty liver disease (NAFLD), liver fibrosis and hepatocellular carcinoma. Noninvasive means to identify those in this population at high risk for these diseases are urgently needed. Approach: The Cameron County Hispanic Cohort (CCHC) is a population-based cohort with high rates of obesity (51%), type 2 diabetes (28%) and NAFLD (49%). In a subgroup of 564 CCHC subjects, we evaluated 339 genetic variants previously reported to be associated with liver injury markers aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in United Kingdom and Japanese cohorts. Results: Association was confirmed for 86 variants. Among them, 27 had higher effect allele frequency in the CCHC than in the United Kingdom and Japanese cohorts, and 16 had stronger associations with AST and ALT than rs738409 (PNPLA3). These included rs17710008 (MYCT1), rs2519093 (ABO), rs1801690 (APOH), rs10409243 (S1PR2), rs1800759 (LOC100507053) and rs2491441 (RGL1), which were also associated with steatosis and/or liver fibrosis measured by vibration-controlled transient elastography. Main contributors to advanced fibrosis risk were rs11240351 (CNTN2), rs1800759 (LOC100507053), rs738409 (PNPLA3) and rs1801690 (APOH), with advanced fibrosis detected in 37.5% of subjects with 3 of these 4 variants [AOR = 11.6 (95% CI) = 3.8-35.3]. AST- and ALT-associated variants implicated distinct pathways (ethanol and galactose degradation versus antigen presentation and B cell development). Finally, 8 variants, including rs62292950 (DNAJC13), were associated with gut microbiome changes. Conclusion: These genotype-phenotype findings may have utility in risk modeling and disease prevention in this high-risk population.

AB Blood Group Confers Higher Risk for Primary Brain Tumors in Pediatrics

Purpose

Our current study investigates the relationship between ABO blood groups and brain tumor incidence in the Jordanian pediatric population in a case-controlled manner.

Patients and Methods

This case-control study targeted pediatric primary brain tumor patients and tumor-free controls. Cases included patients younger than 18 when given a histologically confirmed diagnosis with a primary brain tumor, ascertained from two tertiary hospitals in Jordan. Controls were age- and gender-matched to cases and acquired from JUH pediatric clinics, with an exclusion for all patients with a personal history of tumors. Through using available records and calling guardians, our team obtained patients’ and controls’ blood groups.

Results

Our case control included 81 (35.4%) pediatric primary brain tumor patients and age- and gender-matched tumor-free controls 148 (64.6%). When compared to O blood group, patients with A and B blood groups were not at higher risk of developing pediatric primary brain tumors (P=0.742, P=1.000, respectively). However, Chi-square analysis revealed a 2.79-fold higher risk for pediatric primary brain tumors in AB blood group patients (P=0.024). Gender-specific analysis revealed a 3.42-fold higher risk for pediatric brain tumors in AB blood group males when compared to O blood group males.

Conclusion

This work represents the first published study on the association between blood groups and pediatric brain tumors. With future research with larger samples and control of confounding factors, AB blood group may become a more established risk factor for pediatric brain tumors, aiding in screening.