Factors Associated with MASLD and Liver Fibrosis in Foreign-Born Asian-Americans with Chronic Hepatitis B Seen in Two Non-Academic Hepatology Clinics in Southern California: Impact of Metabolic Features, MASLD, and Time Spent Living in the U.S.

Summary for Medical Professionals

Title:
Authors: Michelle Gunawan BS, Brian Xu BS, Micaela Wong BS, Michel Mendler MD MS, Tse-Ling Fong MD FACP FAASLD, and Edward Mena MD MBA FAASLD
Institutions: California Liver Research Institute (Pasadena Liver Center) and Digestive Health Institute, Hoag Memorial Hospital Presbyterian, Newport Beach CA

MHM V2 CHB MASLD Poster TLM AAS… (remove?)

Background

Foreign-born Asian-Americans (FBAA) represent a population with a high prevalence of chronic hepatitis B (CHB), and increasing evidence suggests that metabolic dysfunction-associated steatotic liver disease (MASLD) can accelerate fibrosis progression in these patients. The metabolic effects of Western lifestyles—particularly after immigration—are thought to contribute to worsening liver health, yet real-world data from community-based hepatology clinics are limited.

Methods

A retrospective cohort of 115 FBAA CHB patients (non-drinkers) seen at two non-academic hepatology clinics in Southern California was analyzed between 2009 and 2023.
Testing included:

  • HBV serologies, liver biochemistry, lipid profiles, and HbA1c.

  • FibroScan® CAP and stiffness to quantify steatosis (≥ 268 dB/m) and fibrosis (≥ 6 kPa).

  • InBody™ body-composition analysis for total, visceral, and skeletal muscle mass.

  • Immigration data (country of origin, age at arrival, years in U.S.) to assess acculturation impact.
    Analyses were conducted using JMP® 17.1.0 (SAS) with non-parametric tests and multivariate logistic regression
    MHM V2 CHB MASLD Poster TLM AAS…

Results

  • MASLD prevalence: ≈ 33% of patients.

  • Fibrosis: Observed in nearly 30% of cases.

  • Metabolic associations: Patients with steatosis had higher BMI, more metabolic syndrome components, elevated HbA1c and cholesterol, and lower HDL.

  • BMI threshold: ≥ 23 kg/m² (Asian classification) was the best cut-off for increased risk of steatosis and fibrosis.

  • Fibrosis predictors: Older age, male gender, higher BMI, hypertension, and presence of MASLD.

  • Acculturation findings: Both BMI and liver steatosis increased with longer residence in the U.S. and a higher percentage of lifetime spent in the U.S.—most pronounced in men who immigrated at younger ages
    MHM V2 CHB MASLD Poster TLM AAS…
    .

  • Multivariate analysis: BMI, male gender, hypertension, and years lived in the U.S. were independently associated with steatosis and fibrosis; percent body fat was positively correlated and skeletal muscle mass inversely correlated with steatosis
    MHM V2 CHB MASLD Poster TLM AAS

Conclusions

In foreign-born Asian-Americans with CHB, metabolic factors and acculturation to Western lifestyles are significant drivers of MASLD and fibrosis.

  • A BMI ≥ 23 kg/m² should prompt metabolic and liver screening.

  • Clinicians should monitor for fatty liver and fibrosis progression even in non-obese Asian patients.

  • Public health strategies addressing nutrition and exercise among immigrant populations may mitigate the double burden of viral and metabolic liver disease.

Presented at: AASLD 2025 Annual Meeting – Washington D.C.  (perhaps put exact dates oif all the meetings for each abstract?)

Summary for General Visitors

How Western Lifestyle Affects Liver Health in Asian-American Immigrants

Doctors from the California Liver Research Institute and Hoag Memorial Hospital Presbyterian studied how moving to and living in the United States influences liver health among Asian-Americans who were born abroad and live with chronic hepatitis B (CHB).

They reviewed the records of 115 patients from Southern California clinics to see how fatty liver (MASLD) and scarring (fibrosis) develop in this community.

Key Insights

  • About one in three patients had fat build-up in the liver (MASLD), which was linked to higher body weight and features of the metabolic syndrome such as high blood pressure, cholesterol, and blood sugar.

  • Even a BMI above 23 (considered only slightly overweight by Asian standards) was enough to raise the risk for fatty liver and fibrosis.

  • Men and those who had lived in the U.S. longer were more likely to develop metabolic changes that impact the liver.

  • As people spent more years in the U.S., their BMI and liver fat levels increased—showing how lifestyle and dietary acculturation play a major role.

Why It Matters

This study reveals that foreign-born Asians with hepatitis B can develop liver fat and scarring even at lower body weights than other groups.
The findings underscore the importance of:

  • Regular liver screenings for immigrants with CHB.

  • Healthy diet and exercise education tailored to Asian communities.

  • Greater awareness of how Western habits can affect metabolic and liver health.

Presented at:American Association for the Study of Liver Diseases (AASLD) Annual Meeting, 2025 – Washington D.C.