{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:13:52Z","timestamp":1787163232468,"version":"build-2736575974"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Metabolic dysfunction\u2010associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease and 10%\u201320% occurs in lean individuals. There is little data in the literature regarding outcomes in an ethnically\u2010diverse patient populations with MASLD. Thus, we aim to investigate the natural history and ethnic disparities of MASLD patients in a diverse population, and stratified by body mass index categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective multicenter study on patients with MASLD at the Banner Health System from 2012 to 2022. Main outcomes included mortality and incidence of cirrhosis, cardiovascular disease, diabetes mellitus (DM), liver\u2010related events (LREs), and cancer. We used competing risk and Cox proportional hazard regression analysis for outcome modelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 51\u2009452 (cross\u2010sectional cohort) and 37\u2009027 (longitudinal cohort) patients were identified with 9.6% lean. The cohort was 63.33% European ancestry, 27.96% Hispanic ancestry, 3.45% African ancestry, and 2.31% Native American\/Alaskan ancestry. Median follow\u2010up was 45.8\u2009months. After adjusting for confounders, compared to European individuals, Hispanic and Native American\/Alaskan patients had higher prevalence of cirrhosis and DM, and individuals of Hispanic, African, and Native American\/Alaskan ancestry had higher mortality and incidence of LREs and DM. Lean patients had higher mortality and incidence of LREs compared with non\u2010lean patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Native American\/Alaskan, Hispanic, and African patients had higher mortality and incidence of LREs and DM compared with European patients. Further studies to explore the underlying disparities and intervention to prevent LREs in lean patients, particularly several ethnic groups, may improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.15880","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T06:34:30Z","timestamp":1708929270000},"page":"1316-1328","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Disparities among ethnic groups in mortality and outcomes among adults with\n                    <scp>MASLD<\/scp>\n                    : A multicenter study"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5533-8987","authenticated-orcid":false,"given":"Majd B.","family":"Aboona","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University of Arizona College of Medicine  Phoenix Arizona 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