Journal of clinical and experimental hepatology · 2026
Impact of Acculturation Associated With Metabolic Dysfunction-Associated Steatotic Liver Disease Among Mexican Americans.
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Vutukuri Rithvik, Poonja Sharan, Delk Molly, Lin Wei-Ting, Lin Hui-Yi, Tseng Tung-Sung, Chen Po-Hung, Ting Peng-Sheng
Аннотация
BACKGROUND/AIMS: Latin America holds the highest global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), affecting up to 44.4% of the population. With the growing Hispanic population in the U.S., understanding MASLD in this group is increasingly relevant. Acculturation, the adoption of host-country norms, may influence health behavior. This study examines associations between acculturation, MASLD, and fibrosis among Hispanic American adults using a U.S. national survey.
METHODS: National Health and Nutrition Examination Survey (NHANES) 2017-2020 prepandemic data were analyzed for Hispanic adults ≥20 years without other liver diseases or significant alcohol use. The population was classified as Mexican Americans and non-Mexican Hispanic Americans. An acculturation index (scored 0-5) was adapted from prior literature. MASLD was defined as ≥1 cardiometabolic risk factor with controlled attenuation parameter ≥294 dB/m; fibrosis was assessed by vibration-controlled transient elastography. All analyses were conducted using survey weights adjusted for the sampling design.
RESULTS: Among Mexican Americans, higher acculturation was associated with lower MASLD prevalence (53.3%, 48.1%, 30.9% for low, medium, and high acculturation, respectively; P = 0.035). Compared with low acculturation, medium and high levels conferred a 0.73-fold (95% confidence interval [CI] = 0.68-0.79) and 0.30-fold (95% CI = 0.23-0.37) lower MASLD risk, respectively (ptrend = 0.004). High acculturation was linked to a small, nonclinically significant increase in liver fibrosis (adj β = 0.18, 95% CI = 0.04-0.31). We did not find any such associations among non-Mexican Hispanic Americans, though more acculturated individuals had lower Healthy Eating Index-2020 scores (P = 0.021).
CONCLUSION: Higher acculturation was associated with lower risk of MASLD among Mexican Americans, but not among non-Mexican Hispanics. Mexican Americans with low acculturation may benefit from targeted screening and counseling.
METHODS: National Health and Nutrition Examination Survey (NHANES) 2017-2020 prepandemic data were analyzed for Hispanic adults ≥20 years without other liver diseases or significant alcohol use. The population was classified as Mexican Americans and non-Mexican Hispanic Americans. An acculturation index (scored 0-5) was adapted from prior literature. MASLD was defined as ≥1 cardiometabolic risk factor with controlled attenuation parameter ≥294 dB/m; fibrosis was assessed by vibration-controlled transient elastography. All analyses were conducted using survey weights adjusted for the sampling design.
RESULTS: Among Mexican Americans, higher acculturation was associated with lower MASLD prevalence (53.3%, 48.1%, 30.9% for low, medium, and high acculturation, respectively; P = 0.035). Compared with low acculturation, medium and high levels conferred a 0.73-fold (95% confidence interval [CI] = 0.68-0.79) and 0.30-fold (95% CI = 0.23-0.37) lower MASLD risk, respectively (ptrend = 0.004). High acculturation was linked to a small, nonclinically significant increase in liver fibrosis (adj β = 0.18, 95% CI = 0.04-0.31). We did not find any such associations among non-Mexican Hispanic Americans, though more acculturated individuals had lower Healthy Eating Index-2020 scores (P = 0.021).
CONCLUSION: Higher acculturation was associated with lower risk of MASLD among Mexican Americans, but not among non-Mexican Hispanics. Mexican Americans with low acculturation may benefit from targeted screening and counseling.