Hispanic, Asian populations in US at highest risk for alcohol-associated liver disease
Click Here to Manage Email Alerts
Key takeaways:
- Hispanic and Asian populations had the highest risk for alcohol-associated liver disease.
- Black patients had the highest daily alcohol consumption but lowest risk for ALD.
Significant differences in alcohol use, alcohol-related mortality and liver transplant rate by race and ethnicity underscore the need for “tailored approaches to managing” alcohol-related liver disease in the U.S., according to a researcher.
“Previous research has highlighted that outcomes in ALD can differ significantly among racial and ethnic groups and we have experienced the same in our clinical practice,” Juan Pablo Arab, MD, FRCPC, study author and director of alcohol sciences at Stravitz-Sanyal Institute of Liver Disease and Metabolic Health at Virgina Commonwealth University, told Healio. “However, a comprehensive understanding of how these disparities affect each stage of ALD across various populations has been lacking.
“This study aimed to address these gaps using nationally representative databases, providing insights into how social and biological health determinants shape these disparities.”
Arab and colleagues conducted a retrospective study of adults from 2011 to 2018 using National Health and Nutrition Examination Survey, National Inpatient Sample (NIS) and United Network for Organ Sharing (UNOS) databases to compare alcohol use, alcohol-associated liver disease (ALD) prevalence and mortality and LT rate among patients with ALD-related cirrhosis.
Of 39,165 interviewees from NHANES (61.2% non-Hispanic white, 17.4% Hispanic, 12.1% Black, 5.4% Asian and 3.9% other), Black individuals had the highest daily alcohol consumption (11.6 g/day), while heavy episodic drinking was highest among Hispanic individuals (33.5%). From this overall population, 2,125 individuals met ALD criteria.
According to multivariate analyses, Hispanic ethnicity was independently associated with higher ALD prevalence (OR = 1.4; 95% CI, 1.1-1.8), as was Asian ethnicity (OR = 1.5; 95% CI, 1.1-2), compared with non-Hispanic white ethnicity. Black individuals had the lowest prevalence of ALD (OR = 0.7; 95% CI, 0.6-0.9), despite the highest consumption.
When analyzing 121,683 hospitalizations using NIS data, the researchers reported that Hispanic individuals had lower risk for inpatient ALD-related mortality (OR = 0.83; 95% CI, 0.73-0.94).
“Hispanic patients hospitalized for decompensated cirrhosis had a higher prevalence of hepatocellular carcinoma but a lower mortality rate per hospitalization,” Arab said.
In addition, of 98,000 patients listed for transplant in the UNOS database, there were “significant disparities in LT access,” he noted, with Hispanic patients (HR = 0.85; 95% CI, 0.78-0.92) and Asian women (HR = 0.4; 95% CI, 0.26-0.62) experiencing lower likelihood of transplant.
“These findings highlight the need for more tailored approaches to managing ALD in diverse populations,” Arab told Healio. “Recognizing that certain racial and ethnic groups are at higher risk for ALD or face barriers in accessing life-saving treatments like liver transplantation can inform public health strategies. Implementing culturally and ethnically sensitive screening, treatment interventions and policies could help reduce these disparities and improve outcomes for vulnerable populations.”
He continued: “Further research is necessary to better understand the underlying factors contributing to these disparities including genetic, socioeconomic and health care access-related influences.”
Collapse
Read more about
Click Here to Manage Email Alerts