Risk for alcohol-related hospitalization fourfold higher in offspring of parents with ALD
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Children of parents with alcohol-related liver disease had up to a more than fourfold increased risk for alcohol-related hospitalization, despite a low absolute risk for developing alcohol-related liver disease.
“Patients with alcohol-related liver disease have on average been drinking heavily for 10 to 20 years before they are diagnosed, in which time they might raise children,” Gro Askgaard, MD, a clinical researcher in the department of hepatology and gastroenterology at Aarhus University Hospital in Denmark, said at EASL Congress. “Being exposed to parental alcohol abuse may increase the risk of alcohol abuse disorder for these offspring. In addition, these offspring may also have a genetic susceptibility to develop alcohol-related liver disease if they drink hazardously.”
In a nationwide registry-based study, Askgaard and colleagues identified 30,000 patients with first-time alcohol-related liver disease (ALD; median age at diagnosis, 31.8 years), who were linked to their offspring (n = 60,707) in a Danish parent-child registry from 1996 to 2018.
Researchers matched offspring with 1.2 million control individuals of the same sex and birth year and investigated the risk for adverse health outcomes among ALD offspring vs. controls, as well as the influence of a parent’s ALD diagnosis on these outcomes.
Askgaard noted that fathers were “most commonly” diagnosed with ALD (65.9%) followed by mothers (32.5%) and both parents (1.6%).
According to study results, there were 385 cases of ALD during 0.7 million person-years of follow-up among ALD offspring and 2,413 cases during 14 million person-years of follow-up among controls (incidence rate ratio = 2.7; 95% CI, 2.4-3). The 10-year risk for ALD peaked at 1.7% and 0.7%, respectively, at 55 years with “similar” rates of survival following diagnosis (adjusted HR = 1.03; 95% CI, 0.88-1.21).
Compared with controls, ALD offspring had an increased risk for hospitalization related to alcohol (IRR = 2.29; 95% CI, 2.26-2.32), other substance abuse (IRR = 2.13; 95% CI, 2.02-2.17), poisonings (IRR = 1.74; 95% CI, 1.7-1.78), psychiatric disease (IRR = 1.45; 95% CI, 1.44-1.46) and fractures or injuries (IRR = 1.23; 95% CI, 1.22-1.23). ALD offspring also had a higher risk for mortality (IRR = 1.53; 95% CI, 1.45-1.62).
“For offspring who had a father with alcohol-related liver disease, the incidence rate ratio, a measure of the relative risk, was twofold increased,” Askgaard said. “If you had a mother with ALD, it was nearly threefold increased. However, for the subgroup who had both parents with alcohol-related liver disease, it was more than fourfold increased.”
Askgaard also reported “very clear evidence” of socioeconomic inequality among offspring of parents with ALD, noting that the risk for other substance abuse increased when ALD parents had lower levels of education.
“I hope that we can be aware of these offspring: talk to them, maybe refer them to relevant help,” Askgaard concluded. “Maybe this diagnosis of alcohol-related liver disease in the parent could be an opportunity to help these offspring.”
She continued: “But of course, I also really hope that people will start research into interventions to help these offspring, because I feel quite sure that this is not only in Denmark; I think we will see similar patterns in other countries.”
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Askgaard G, et al. Abstract GS-004-YI: Adverse health outcomes in offspring of parents with alcohol-related liver disease compared to controls – a nationwide Danish cohort study. Presented at: EASL Congress; June 21-24, 2023; Vienna (hybrid meeting).
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