Acculturative stress and pro-inflammatory markers among Mexican-Origin adults with NAFLD

ABSTRACT Non-alcoholic fatty liver disease (NAFLD), an emerging risk factor for hepatocellular carcinoma (HCC), disproportionately impacts the Mexican-origin (MO) population. This is of particular concern in the Southern Arizona U.S.-Mexico border region as liver disease and liver cancer are among the leading causes of death for

MO adults. While disparities of NAFLD prevalence have been attributed to the interplay of genetic, behavioral, and socioenvironmental factors, limited scientific efforts have been undertaken to characterize the underlying mechanisms driving the well documented NAFLD disparities in MO communities. Further, despite foreign-born

MO adults increased risk of experiencing acculturative stress, chronic stress associated with the acculturation process, it has rarely been considered in the context of NAFLD. This is a significant gap in knowledge given acculturative stress has been linked to poor lifestyle behaviors (e.g., diet) and stress-related inflammation;

thereby driving aberrant liver pathologies and ultimately cancer carcinogenesis. In fact, it has been hypothesized that elevated levels of pro-inflammatory markers may be the primary pathophysiological pathway linking chronic stress and NAFLD. However, this remains to be determined. Thus, informed by the Lifespan Biopsychosocial

Model of Cumulative Vulnerability and Minority, in the proposed project we will combine complementary quantitative and qualitative approaches in a mixed-methods project to (1) investigate the relationship between acculturative stress and NAFLD severity among a sample of 150 MO adults with known NAFLD; (2) the

relationship between acculturative stress and pro-inflammatory markers among a sample of 150 MO adults with known NAFLD; and (3) qualitatively asess the impact of acculturative stress on MO adults’ modifiable behaviors that drive inflammatory response and are central to NAFLD management. The proposed project, led by an

experienced multidisciplinary team of investigators, is a critical step to develop effective stress management strategies to reduce NAFLD and liver cancer risk among MO individuals in Southern Arizona.