Hispanic patients with alcohol use disorder face greater odds for hepatitis, cirrhosis
Key takeaways:
- Hispanic patients with AUD had higher odds of alcohol-associated hepatitis, decompensated cirrhosis and related complications.
- Asian and African American patients had lower odds of decompensated cirrhosis.
Hispanic patients hospitalized for alcohol use disorder were more likely to develop alcohol-associated hepatitis, decompensated cirrhosis and related complications compared with non-Hispanic white patients, according to published data.
“Alcohol use disorder (AUD), a major contributor to alcohol-associated liver disease (ALD), has been increasing in the United States,” Soo Young Hwang, MD, of Harvard T.H. Chan School of Public Health and Massachusetts General Hospital, and colleagues wrote in Gastro Hep Advances. “As a result, ALD, from alcohol-associated hepatitis to alcohol-associated cirrhosis and hepatocellular carcinoma, has become the leading cause of death from cirrhosis and the primary reason for liver transplantation. Therefore, it is imperative to understand the factors associated with the development of ALD in AUD patients.”
They continued, “Racial disparities and associated factors such as differing access to health care, racial discrimination and environmental factors have been suggested to play a significant role in the utilization of alcohol treatment. However, little is known about how racial disparities affect the development of ALD in AUD patients.”
To identify racial and ethnic disparities of ALD and its related complications, Hwang and colleagues retrospectively assessed adult patients with AUD hospitalized at NewYork-Presbyterian/Columbia University Irving Medical Center between January 2010 and January 2020.
Of 17,378 patients included in analysis, the racial and ethnic identities included non-Hispanic Asian (1.6%), non-Hispanic African American (11.4%) and Hispanic (19.4%), as well as non-Hispanic white (25.6%) as the reference group.
The outcomes of interest included alcohol-associated hepatitis (AAH), compensated alcoholic cirrhosis, hepatic encephalopathy and variceal bleeding, which the researchers further subcategorized under decompensated alcohol-associated cirrhosis (AAC) after the first occurrence.
The researchers noted diabetes was observed most in Hispanic patients (60.6%), whereas higher rates of myocardial infarction (18.1%) and congestive heart failure (49.5%) were observed in non-Hispanic white patients. Conversely, non-Hispanic Asian patients had the lowest rates of myocardial infarction and congestive heart failure. In addition, rates of chronic kidney disease were higher among non-Hispanic African American patients (42%).
Results from multivariate logistic regression model analysis showed Hispanic patients had a higher likelihood for AAH (OR = 1.92; 95% CI, 1.43-2.59), decompensated AAC (OR = 1.26; 95% CI, 0.97-1.64) and variceal bleeding (OR = 1.57; 95% CI, 1.08-2.27) compared with white patients. However, a lower likelihood for decompensated AAC was observed among non-Hispanic Asian patients (OR = 0.34; 95% CI, 0.1-0.82).
In addition, non-Hispanic African American patients had lower odds of decompensated AAC (OR = 0.65; 95% CI, 0.45-0.96) and hepatic encephalopathy (OR = 0.52; 95% CI, 0.36-0.73) vs. white patients.
“Differences in racial/ethnic groups have various contributory factors including differences in drinking patterns and access and utilization of AUD treatment,” Hwang and colleagues wrote. “Hispanic individuals had a higher proportion of binge drinking compared to other races, and white individuals had a higher proportion of heavy drinking, while Asian Americans had the lowest proportion in both indices.”
They added, “Among the hospitalized AUD patients, Hispanics had higher odds of AAH, decompensated cirrhosis and complications such as variceal bleeding while non-Hispanic Asians and non-Hispanic African Americans had lower odds of decompensated cirrhosis compared to non-Hispanic white patients.”
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Hwang SY, et al. Gastro Hep Adv. 2024;doi:10.1016/j.gastha.2024.100592.