Racial and ethnic disparities in the natural history of alcohol-associated liver disease in the United States

IF 6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver International Pub Date : 2024-08-03 DOI:10.1111/liv.16023

Gustavo Ayares, Luis Antonio Díaz, Eduardo Fuentes-López, Francisco Idalsoaga, Thomas G. Cotter, Winston Dunn, Douglas Simonetto, Vijay H. Shah, Patrick S. Kamath, Jeffrey V. Lazarus, Ramon Bataller, Marco Arrese, Robert J. Wong, Ashwani K. Singal, Juan Pablo Arab

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引用次数: 0

Abstract

Background

Outcomes in alcohol-associated liver disease (ALD) are influenced by several race and ethnic factors, yet its natural history across the continuum of patients in different stages of the disease is unknown.

Methods

We conducted a retrospective cohort study of U.S. adults from 2011 to 2018, using three nationally representative databases to examine potential disparities in relevant outcomes among racial and ethnic groups. Our analysis included logistic and linear regressions, along with competing risk analysis.

Results

Black individuals had the highest daily alcohol consumption (12.6 g/day) while Hispanic participants had the largest prevalence of heavy episodic drinking (33.5%). In a multivariable-adjusted model, Hispanic and Asian participants were independently associated with a higher ALD prevalence compared to Non-Hispanic White interviewees (OR: 1.4, 95% CI: 1.1–1.8 and OR: 1.5 95% CI:1.1–2.0, respectively), while Blacks participants had a lower ALD prevalence (OR: .7 95% CI: .6–.9), and a lower risk of mortality during hospitalization due to ALD (OR: .83 95% CI: .73–.94). Finally, a multivariate competing-risk analysis showed that Hispanic ethnicity had a decreased probability of liver transplantation if waitlisted for ALD (SHR: .7, 95% CI: .6–.8) along with female Asian population (HR: .40, 95% CI: .26–.62).

Conclusions

After accounting for key social and biological health determinants, the Hispanic population showed an increased risk of ALD prevalence, even with lower alcohol consumption. Additionally, Hispanic and Asian female patients had reduced access to liver transplantation compared to other enlisted patients.

查看原文本刊更多论文

美国酒精相关肝病自然病史中的种族和民族差异。

背景：酒精相关性肝病（ALD）的预后受多个种族和民族因素的影响：酒精相关性肝病（ALD）的预后受多个种族和民族因素的影响，但不同阶段患者的自然病史尚不清楚：我们利用三个具有全国代表性的数据库，对 2011 年至 2018 年期间的美国成年人进行了一项回顾性队列研究，以考察种族和民族群体之间相关结果的潜在差异。我们的分析包括逻辑回归和线性回归，以及竞争风险分析：黑人的日饮酒量最高（12.6 克/天），而西班牙裔参与者的偶发性大量饮酒发生率最高（33.5%）。在多变量调整模型中，与非西班牙裔白人受访者相比，西班牙裔和亚裔受访者的 ALD 患病率更高（OR：1.4，95% CI：1.1-1.8 和 OR：1.5 95% CI：1.1-2.0），而黑人受访者的 ALD 患病率较低（OR：.7 95% CI：.6-.9），因 ALD 住院期间的死亡风险较低（OR：.83 95% CI：.73-.94）。最后，一项多变量竞争风险分析显示，西班牙裔和亚裔女性因ALD等待肝移植的概率降低（SHR：.7，95% CI：.6-.8）（HR：.40，95% CI：.26-.62）：在考虑了主要的社会和生物健康决定因素后，西班牙裔人群的 ALD 患病风险增加，即使他们的饮酒量较低。此外，与其他入伍患者相比，西班牙裔和亚裔女性患者接受肝移植的机会更少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.