Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec;64(6):1969-1977.
doi: 10.1002/hep.28677. Epub 2016 Jul 17.

Prevalence of chronic liver disease and cirrhosis by underlying cause in understudied ethnic groups: The multiethnic cohort

Veronica Wendy Setiawan  1   2 , Daniel O Stram  1 , Jacqueline Porcel  2 , Shelly C Lu  3 , Loïc Le Marchand  4 , Mazen Noureddin  3   5
Affiliations

Prevalence of chronic liver disease and cirrhosis by underlying cause in understudied ethnic groups: The multiethnic cohort

Veronica Wendy Setiawan et al. Hepatology. 2016 Dec.

Abstract

Chronic liver disease (CLD) and cirrhosis are major sources of morbidity and mortality in the United States. Little is known about the epidemiology of these two diseases in ethnic minority populations in the United States. We examined the prevalence of CLD and cirrhosis by underlying etiologies among African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites in the Multiethnic Cohort. CLD and cirrhosis cases were identified using Medicare claims between 1999 and 2012 among the fee-for-service participants (n = 106,458). We used International Classification of Diseases Ninth Revision codes, body mass index, history of diabetes mellitus, and alcohol consumption from questionnaires to identify underlying etiologies. A total of 5,783 CLD (3,575 CLD without cirrhosis and 2,208 cirrhosis) cases were identified. The prevalence of CLD ranged from 3.9% in African Americans and Native Hawaiians to 4.1% in whites, 6.7% in Latinos, and 6.9% in Japanese. Nonalcoholic fatty liver disease (NAFLD) was the most common cause of CLD in all ethnic groups combined (52%), followed by alcoholic liver disease (21%). NAFLD was the most common cause of cirrhosis in the entire cohort. By ethnicity, NAFLD was the most common cause of cirrhosis in Japanese Americans, Native Hawaiians, and Latinos, accounting for 32% of cases. Alcoholic liver disease was the most common cause of cirrhosis in whites (38.2%), while hepatitis C virus was the most common cause in African Americans (29.8%).

Conclusions: We showed racial/ethnic variations in the prevalence of CLD and cirrhosis by underlying etiology; NAFLD was the most common cause of CLD and cirrhosis in the entire cohort, and the high prevalence of NAFLD among Japanese Americans and Native Hawaiians is a novel finding, warranting further studies to elucidate the causes. (Hepatology 2016;64:1969-1977).

PubMed Disclaimer

Conflict of interest statement

the authors disclose no conflicts

Figures

Figure 1
Figure 1. Identification of the cause of liver disease
Alcoholic Liver Disease: alcohol dependence (303.00–303.93), alcohol abuse (305.00–305.03), alcohol mental disorders (291.0–291.9), alcoholic polyneuropathy (357.5), cardiomyopathy (425.5), pancreatitis (577.0, 577.1), and alcoholic-related CLD (571.0–571.3); Alpha-1-Antitrypsin: 273.4; Autoimmune Hepatitis: 571.42; Cirrhosis: 571.2, 571.5, hepatic encephalopathy (572.2), hepatorenal syndrome (572.4), esophageal varices (456.0, 456.1, 456.20, 456.21), and spontaneous bacterial peritonitis (567.23); CLD: 571.0–571.9; Hemochromatosis: 275.0; Hepatitis B: 0702, 07020, 07021, 07022, 07023, 0703, 07030, 07031, 07032, 07033, V0261; Hepatitis C: 07041, 07044, 07051, 07054, 07070, 07071, V0262; HIV: 042; NAFLD: Diabetic or BMI ≥ 30 kg/m2 or 571.8. Women with NAFLD who drank >14 drinks/week and men with NAFLD who drank >21 drinks/week were reclassified to alcoholic liver disease; Primary Biliary Cirrhosis (PBC): 571.6; Primary Sclerosing Cholangitis (PSC): 576.1; Wilson’s Disease: 275.1
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. National Vital Statistics Reports 1999–2013: Centers for Disease Control and Prevention
    1. Asrani SK, Larson JJ, Yawn B, Therneau TM, Kim WR. Underestimation of liver-related mortality in the United States. Gastroenterology. 2013;145:375–382. e371–e372. - PMC - PubMed
    1. Nguyen GC, Thuluvath PJ. Racial disparity in liver disease: Biological, cultural, or socioeconomic factors. Hepatology. 2008;47:1058–1066. - PubMed
    1. Younossi ZM, Stepanova M, Afendy M, Fang Y, Younossi Y, Mir H, Srishord M. Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. Clin Gastroenterol Hepatol. 2011;9:524–530. e521. quiz e560. - PubMed
    1. Vuppalanchi R, Chalasani N. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: Selected practical issues in their evaluation and management. Hepatology. 2009;49:306–317. - PMC - PubMed
  NODES
Association 2
chat 2
INTERN 1
twitter 2