Evidence map›Paper›PMID 36937989›Full record

ArticleJHEP reports : innovation in hepatology2023

Environmental exposures are important risk factors for advanced liver fibrosis in African American adults.

Ning Ma, Rowena Yip, Sara Lewis, Amreen Dinani, Christina Wyatt, Michael Crane, Artit Jirapatnakul, Li Li, Costica Aloman, Meena B Bansal and 5 more

Open access · goldAbstract read
In one paragraph

Article in JHEP reports : innovation in hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
6.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 28 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Article
  5. Impact of Socio-Economic, Behavioural and Clinical Factors on Liver Disease Progression in Individuals With HIV and Hepatitis B.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Observational
  6. Review
  7. Review
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Review
  14. Article
  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 3 institutions in 1 country.

Ning MaDivision of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA.
Rowena YipDepartment of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Sara LewisDepartment of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Amreen DinaniDivision of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA.
Christina WyattDepartment of Medicine, Division of Nephrology, Duke University School of Medicine, Durham, NC, USA.
Michael CraneDepartment of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Artit JirapatnakulDepartment of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Li LiDivision of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA.
Costica AlomanDepartment of Medicine, Rush University Medical Center, Chicago, IL, USA.
Meena B BansalDivision of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA.
Douglas DieterichDivision of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA.
Brooke WyattDivision of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA.
David YankelevitzDepartment of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Claudia HenschkeDepartment of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Andrea D BranchDivision of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA.
Icahn School of Medicine at Mount Sinai · USDuke University · USRush University Medical Center · US

Funding

Targeting mononuclear phagocytes development in alcohol induced liver damage: pathological and immunological pathwaysR01AA024762 · NIAAA · RUSH UNIVERSITY MEDICAL CENTER · PI ALOMAN, COSTICA · 2017 to 2021
$1.7M
NIAAA NIH HHS R01 AA024762
6 · The paper itself

Abstract

Background & Aims: The prevalence and aetiology of liver fibrosis vary over time and impact racial/ethnic groups unevenly. This study measured time trends and identified factors associated with advanced liver fibrosis in the United States. Methods: Standardised methods were used to analyse data on 47,422 participants (≥20 years old) in the National Health and Nutrition Examination Survey (1999-2018). Advanced liver fibrosis was defined as Fibrosis-4 ≥2.67 and/or Forns index ≥6.9 and elevated alanine aminotransferase. Results: The estimated number of people with advanced liver fibrosis increased from 1.3 million (95% CI 0.8-1.9) to 3.5 million (95% CI 2.8-4.2), a nearly threefold increase. Prevalence was higher in non-Hispanic Black and Mexican American persons than in non-Hispanic White persons. In multivariable logistic regression analysis, cadmium was an independent risk factor in all racial/ethnic groups. Smoking and current excessive alcohol use were risk factors in most. Importantly, compared with non-Hispanic White persons, non-Hispanic Black persons had a distinctive set of risk factors that included poverty (odds ratio [OR] 2.09; 95% CI 1.44-3.03) and susceptibility to lead exposure (OR 3.25; 95% CI 1.95-5.43) but did not include diabetes (OR 0.88; 95% CI 0.61-1.27; Conclusions: The number of people with advanced liver fibrosis has increased, creating a need to expand the liver care workforce. The risk factors for advanced fibrosis vary by race/ethnicity. These differences provide useful information for designing screening programmes. Poverty and toxic exposures were associated with the high prevalence of advanced liver fibrosis in non-Hispanic Black persons and need to be addressed. Impact and Implications: Because liver disease often produces few warning signs, simple and inexpensive screening tests that can be performed by non-specialists are needed to allow timely diagnosis and linkage to care. This study shows that non-Hispanic Black persons have a distinctive set of risk factors that need to be taken into account when designing liver disease screening programs. Exposure to exogenous toxins may be especially important risk factors for advanced liver fibrosis in non-Hispanic Black persons.

Indexed as

AetiologyALD, alcohol-associated liver diseaseALT, alanine aminotransferaseAPC, annual percent changeBMI, body mass indexCI, confidence intervalEnvironmental toxinsFIB-4, Fibrosis-4HBV, hepatitis B virusHCV, hepatitis C virusHR, hazard ratioKI, kidney insufficiencyLF, liver fibrosisMA, Mexican AmericanNAFLD, non-alcoholic fatty liver diseaseNEI, no exposure identifiedNHANES, National Health and Nutrition Evaluation SurveyNHB, non-Hispanic BlackNHW, non-Hispanic WhiteNon-invasive scoresO, other racePCB, polychlorinated biphenylQ1–Q4, quartiles 1–4Racial disparitiesScreeningULN, upper limit of normalUSFLI, US Fatty Liver IndexVH, viral hepatitisWC, waist circumference

Identifiers

PMID36937989
PMCPMC10017423
OpenAlexW4319320492

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.