Risk Factors for Chronic Liver Disease in Blacks, Mexican... : Official journal of the American College of Gastroenterology | ACG (original) (raw)

ORIGINAL CONTRIBUTION: LIVER AND BILIARY TRACT

Risk Factors for Chronic Liver Disease in Blacks, Mexican Americans, and Whites in the United States

Results From NHANES IV, 1999–2004

Flores, Yvonne N. Ph.D.1,2; Yee, Hal F. Jr M.D., Ph.D.3; Leng, Mei M.S.4; Escarce, José J. M.D., Ph.D.4; Bastani, Roshan Ph.D.1; Salmerón, Jorge M.D., Dr.Sc.2; Morales, Leo S. M.D., Ph.D.4

1UCLA Department of Health Services, School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, 2Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Morelos, Mexico, 3UCSF Department of Medicine and Rice Liver Center Laboratory, San Francisco, California, 4UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, California

Reprint requests and correspondence: Leo S. Morales, M.D., Ph.D., 650 Charles Young Drive South, Mailbox 951772, Los Angeles, CA 90095-1772.

CONFLICT OF INTEREST

Guarantor of the article: Leo S. Morales, M.D., Ph.D.

Specific author contributions: Yvonne N. Flores and Leo S. Morales originated the study and lead the analyses, interpretation of the findings, and writing of the article; Hal F. Yee and José Escarce assisted with the study design; Mei Leng conducted all the data management and statistical analyses; and Roshan Bastani and Jorge Salmerón contributed to the critical revisions of the article. Each of the seven authors played a critical role in this study and made significant contributions to this manuscript. All authors have approved the final draft of this manuscript.

Financial support: This research was supported by the UCLA Cancer Education and Career Development Program (NIH/NCI R25 CA087949), a Robert Wood Johnson Foundation Health Policy Investigator Award (052743), the Russell Sage Foundation (88-06-02), and the UCLA Resource Center for Minority Aging Research (AG-02-004).

Potential competing interests: None.

Human subjects protection: NHANES IV (1999–2004) is a secondary data set without individual subject identifiers and is available to the general public.

Received October 23, 2007; accepted April 21, 2008.

Abstract

OBJECTIVES

Morbidity and mortality due to liver disease and cirrhosis vary significantly by race/ethnicity in the United States. We examined the prevalence of liver disease risk factors among blacks, Mexican Americans, and whites, including elevated aspartate aminotransferase and alanine aminotransferase activity, infection with viral hepatitis B or hepatitis C, alcohol intake, obesity, diabetes, and metabolic syndrome.

METHODS

Data were obtained from the Fourth National Health and Nutrition Examination Survey (NHANES IV). A logistic regression was used to examine the association of race/ethnicity to liver disease risk factors, controlling for the demographic and socioeconomic variables.

RESULTS

Mexican-American men and women are the most likely to have elevated aminotransferase activity. Among men, Mexican Americans are more likely than whites to be heavy/binge drinkers, and blacks are more likely to have hepatitis B or hepatitis C. Among women, Mexican Americans are more likely than whites to be obese and diabetic, and less likely to be heavy/binge drinkers; blacks are more likely than whites to have hepatitis B or hepatitis C, be obese or diabetic, and less likely to be heavy/binge drinkers.

CONCLUSIONS

In this national sample, the prevalence of risk factors for liver disease varies by race/ethnicity. Mexican Americans and blacks have a greater risk of developing liver disease than their white counterparts. These findings are consistent with the observed racial/ethnic disparities in morbidity and mortality due to chronic liver disease and contribute to the efforts to identify the causes of these disparities. This information can be used by health professionals to tailor screening and intervention programs.