title: Ethnic differences in presentation and severity of alcoholic liver disease.
abstract: BACKGROUND
  The frequency of alcoholic liver disease (ALD), including alcoholic steatosis, hepatitis, and cirrhosis, varies significantly by ethnicity.
  
  
  METHODS
  With the goal to assess the role of ethnicity in determining the age of onset and severity of ALD and to compare the risk factors for its progression among ethnic groups, we conducted a retrospective chart review of all patients with ALD who were admitted or were followed as outpatients at University of California Davis Medical Center between 2002 and 2010. After excluding HBsAg- and HIV-positive subjects, we reviewed the charts of 791 patients with ALD including 130 with alcoholic fatty liver, 154 with alcoholic hepatitis, and 507 with alcoholic cirrhosis.
  
  
  RESULTS
  When controlling for all variables in the model, Hispanic patients presented at significantly 4 to 10 years younger ages than White/Caucasian patients, in each of the 3 disease severity categories, and the results were confirmed after excluding HCV Ab-/RNA-positive subjects. There were more obese Hispanic patients than White/Caucasian patients, whereas the proportion of patients with hepatitis C was significantly greater in African American subjects with alcoholic hepatitis, and the proportion of patients with diabetes mellitus was significantly lower in White/Caucasian subjects than in Hispanic subjects with cirrhosis. The proportion of subjects with severe alcoholic hepatitis was similar in Hispanic and White/Caucasian patients, but lower in African American subjects.
  
  
  CONCLUSIONS
  Ethnicity is a major factor affecting the age and severity of presentation of different subtypes of ALD.
authors.affiliation: Department of Internal Medicine, University of California Davis, Division of Gastroenterology and Hepatology, University of California Davis.
authors.forename: Robert
authors.initials: R
authors.lastname: Levy
authors.affiliation: Department of Internal Medicine, University of California Davis, Division of Gastroenterology and Hepatology, University of California Davis.
authors.forename: Andreea M
authors.initials: AM
authors.lastname: Catana
authors.affiliation: Department of Public Health Sciences, Division of Biostatistics, University of California Davis.
authors.forename: Blythe
authors.initials: B
authors.lastname: Durbin-Johnson
authors.affiliation: Department of Internal Medicine, University of California Davis, Division of Gastroenterology and Hepatology, University of California Davis.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Halsted
authors.affiliation: Department of Internal Medicine, University of California Davis, Division of Gastroenterology and Hepatology, University of California Davis.
authors.forename: Valentina
authors.initials: V
authors.lastname: Medici
mesh_terms: D005006:Ethnicity / Q000208:ethnology*; D005260:Female; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis* / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Alcoholic; Alcoholic Liver Disease; Ethnicity; Hispanic