ArticlePloS one2018
Steatosis in South African women: How much and why?
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Prevalence and risk factors of metabolic-associated fatty liver disease in sub-Saharan Africa: a systematic review and meta-analysis.Frontiers in gastroenterology (Lausanne, Switzerland) · 2025Pooled it
- Ectopic fat deposition in populations of black African ancestry: A systematic review and meta-analysis.Acta diabetologica · 2022Pooled it
- Frequency and risk factors of metabolic associated fatty liver disease among medical students in Egypt.Scientific reports · 2025Article
- Hepatic steatosis is associated with anthropometry, cardio-metabolic disease risk, sex, age and urbanisation, but not with ethnicity in adult Kenyans.Tropical medicine & international health : TM & IH · 2022Article
- A Matter of Fat: Body Fat Distribution and Cardiometabolic Disease in Africa.Methods in molecular biology (Clifton, N.J.) · 2022Article
- Branched-chain and aromatic amino acids and cardiometabolic risk in Black African and Asian Indian populations.Metabolomics : Official journal of the Metabolomic Society · 2020Article
- Non-alcoholic fatty liver disease in Africa: a hidden danger.Global health, epidemiology and genomics · 2019Article
- Expression patterns of STAT3, ERK and estrogen-receptor α are associated with development and histologic severity of hepatic steatosis: a retrospective study.Diagnostic pathology · 2018Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGlobally, steatosis is the commonest type of liver pathology and is closely associated with obesity and the metabolic syndrome. Obesity is common in urban African females but no data is available on hepatic fat content in this population group when compared to other ethnic groups. The aim of this study was therefore to compare hepatic fat content in woman from different ethnic groups in South Africa and to characterise the principle determinants of liver fat. MATERIALS AND
methodsA convenience sample of 106 (48 Indian, 29 African and 29 Caucasian) female volunteers aged 20-60 years and having no history of cardiometabolic disorders were recruited. Hepatic fat was determined from CT scans using the liver-spleen attenuation ratio (LAR), which decreases with increasing levels of hepatic fat. Anthropometric and cardiometabolic parameters were measured with insulin resistance determined using the HOMA index and dysglycaemia defined as fasting glucose ≥5.60 mmol/L.
resultsThe African subjects had significantly lower hepatic fat content (LAR as median [interquartile range]: 1.35 [1.28, 1.41]) than the Indian (1.22 [1.10, 1.35]; p<0.005) and Caucasian (1.27 [1.16, 1.33]; p<0.05) females even though they had significantly higher BMIs than both groups (p<0.0005 and p<0.05, respectively). Linear regression showed that: subcutaneous abdominal fat was a significant (unstandardised β = 0.007; p = 0.03) negative, whilst insulin resistance (β = -0.97; p = 0.01) and dysglycaemia (β = -3.58; p = 0.01) were significant positive determinants of liver fat; higher hepatic fat levels in subjects with the metabolic syndrome were explained by insulin resistance and dysglycaemia. DISCUSSION: African ethnicity is associated with low liver fat content. Subcutaneous abdominal fat protects against steatosis, possibly by acting as a triglyceride reservoir. Insulin resistance and dysglycaemia lead to greater hepatic fat deposition and explain higher liver fat levels in subjects with the metabolic syndrome. These observations must be further investigated in longitudinal surveys.
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