Abstract C077: Understanding the epidemiology of NAFLD in Asian Americans: A literature review and survey development
Authors: Zhu Lin , Jeong Dasam , Lavelah Yassah N. , Tan Yin , Ma Grace X. 
Published: January 2023

Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) affects about 25% of the general population in the US. Although epidemiology of NAFLD is well studied in the US, the scientific understanding of how this disease affect Asian Americans is very limited. Given that NAFLD is strongly increases the risks of liver cancer, a condition that disproportionally affect Asian Americans, it is critical that we better understand the burden of NAFLD in this population and identify protective/risk factors. The goals of this study are to (1) review the existing body of literature on the epidemiology of NAFLD in Asian Americans and (2) develop a survey based to better understand the burden of the disease. Methods: In this study we conducted a review of previous studies on NAFLD in Asian Americans and in Asia/Pacific regions. We focused on three aspects: (1) the prevalence and incidence rates of NALFD in the target populations; (2) the risk factors and protective factors of NAFLD; (3) the knowledge of and attitude towards NAFLD and its prevention, diagnosis, and treatment. We also identified limitations in previous studies with regards to study design and methodology. Findings: We have found that so far there has been there is paucity of data for NAFLD burdens in Asian Americans. The few existing studies estimated the prevalence of NAFLD to be between 18% to 43% in Asian Americans, with higher rates in men than women. Comparative studies have inconsistent findings on the prevalence of NAFLD between Asian and non-Asian American populations, likely due to differences in target population and sampling methods. However, one consistent finding so far was that Asian Americans with NAFLD have lower BMI and waist circumference, and aminotransferases and triglycerides, and similar risk factors for advanced fibrosis and atherosclerotic cardiovascular disease, than non-Asian Americans with NAFLD. Though limited, these studies suggested that Asian Americans are potentially at high risks for NAFLD and liver cancer, but the specific mechanisms remained unclear. Survey Development: Recognizing the gaps in previous literature, we designed a survey to better understand the burden of NAFLD in Asian Americans and provide foundation for behavioral and clinical interventions. We developed a survey to examine the knowledge, attitude, and behaviors related to NAFLD prevention, diagnosis, and treatment among Asian Americans. Conclusion: Despite inconsistent findings on how prevalence rates compare between Asian Americans and non-Hispanic white, increased evidence points to an elevated risks for advanced NAFLD and worsen outcomes in Asian Americans. We will discuss the implications for the prevention in Asian Americans, as well as linkage to care for early diagnosis and treatment for Asian Americans with NAFLD. We will also discuss the participant recruitment and data collection process of conducting the survey.
Citation Format: Lin Zhu, Dasam Jeong, Yassah N. Lavelah, Yin Tan, Grace X. Ma. Understanding the epidemiology of NAFLD in Asian Americans: A literature review and survey development [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C077.