Published online Oct 7, 2018. doi: 10.3748/wjg.v24.i37.4281
Peer-review started: June 20, 2018
First decision: July 4, 2018
Revised: August 1, 2018
Accepted: August 24, 2018
Article in press: August 24, 2018
Published online: October 7, 2018
To compare the prevalence of chronic liver disease (CLD) risk factors in a representative sample of Mexican-Americans born in the United States (US) or Mexico, to a sample of adults in Mexico.
Data for Mexican-Americans in the US were obtained from the 1999-2014 National Health and Nutrition Examination Survey (NHANES), which includes persons of Mexican origin living in the US (n = 4274). The NHANES sample was restricted to Mexican-American participants who were 20 years and older, born in the US or Mexico, not pregnant or breastfeeding, and with medical insurance. The data in Mexico were obtained from the 2004-2013 Health Worker Cohort Study in Cuernavaca, Mexico (n = 9485). The following known risk factors for liver disease/cancer were evaluated: elevated aminotransferase levels (elevated alanine aminotransferase was defined as > 40 IU/L for males and females; elevated aspartate aminotransferase was defined as > 40 IU/L for males and females), infection with hepatitis B or hepatitis C, metabolic syndrome, high total cholesterol, diabetes, obesity, abdominal obesity, and heavy alcohol use. The main independent variables for this study classified individuals by country of residence (i.e., Mexico vs the US) and place of birth (i.e., US-born vs Mexico-born). Regression analyses were used to investigate CLD risk factors.
After adjusting for socio-demographic characteristics, Mexican-American males were more likely to be obese, diabetic, heavy/binge drinkers or have abdominal obesity than males in Mexico. The adjusted multivariate results for females also indicate that Mexican-American females were significantly more likely to be obese, diabetic, be heavy/binge drinkers or have abdominal obesity than Mexican females. The prevalence ratios and prevalence differences mirror the multivariate analysis findings for the aforementioned risk factors, showing a greater risk among US-born as compared to Mexico-born Mexican-Americans.
In this study, Mexican-Americans in the US had more risk factors for CLD than their counterparts in Mexico. These findings can be used to design and implement more effective health promotion policies and programs to address the specific factors that put Mexicans at higher risk of developing CLD in both countries.
Core tip: United States (US) Latinos have greater morbidity and mortality from liver disease than non-Hispanic whites, and liver disease is the fifth leading cause of death in Mexico. Known risk factors for chronic liver disease include hepatitis B or C infection, heavy/binge drinking, obesity, diabetes, and metabolic syndrome. We found that Mexican-Americans in the US have a greater risk of obesity, diabetes and heavy/binge drinking than their counterparts in Mexico. The prevalence of heavy/binge drinking was alarmingly high among Mexican-Americans, with over 70% among males and over 50% among US-born females. Our results identify a high prevalence of specific risk factors that should be targeted to reduce the high rates of liver disease-related mortality in this population.