Ronan Allencherril
University of Texas Medical Branch
Background: The Center for Disease Control and Prevention (CDC) reports that liver disease is a significant cause of morbidity and mortality in the US, afflicting 4.9 million people in 2016, or approximately 2% of the American adult population. Objective: To investigate the prevalence and risk factors of liver disease among older Mexican Americans. Methods: Nine-year prospective cohort study of 1,233 Mexican Americans aged 75 years from the Hispanic Established Population for the Epidemiological Study of the Elderly (2004/05-2012/13). Measures: Included socio-demographic variables (age, gender, years of formal education, nativity, marital status, and income), self-reported liver disease, medical conditions (diabetes, arthritis, hypertension, heart attack, heart failure, stroke, and cancer), hand-grip strength, the Short Physical Performance Battery (SPPB), cognitive function, depression, and body mass index. Generalized linear equation estimation was used to estimate the odds ratio of liver disease. Results: The mean age at baseline was 81.1 ± Standard Deviation (4.5) and 59.6% were female. The prevalence of liver disease was 4.5%. Over time the odds ratio (OR) of developing liver disease was 1.08 [Confidence Interval (CI) =1.03-1.14). Participants with diabetes (OR=1.67, 95% CI=1.06-2.62), heart failure (OR=2.12, 95% CI=1.36-3.32), arthritis (OR=2.01, 95% CI=1.25-3.22), and cancer (OR=1.91, 95% CI=1.09-3.32) were at increased risk of developing liver disease over time. Participants with high performance in SPPB (OR=1.14, 95% CI=1.08-1.21) and high cognitive function (OR=1.15, 95% CI=1.10-1.22) were significantly more likely to report liver disease over time. Participants with high level of education (OR=0.92, 95% CI=0.86-0.99) and high performance in hand-grip muscle strength (OR=0.96, 95% CI=0.93-0.99) were significantly less likely to develop liver disease over time. Conclusions: The prevalence of liver disease in this population is 4.5%, which is over twice as prevalent as in the general US population (2%). Diabetes, heart failure, arthritis, and cancer were risk factors for liver disease. Screening for liver function among patients with these morbidities may help prevent liver disease in this population with high rates of diabetes and obesity.