Risk of liver damage rises when metabolic problems and drinking combine in Asian Americans
A new analysis shows that Asian American adults with metabolic problems who also drink alcohol face a higher risk of liver injury than those with either risk alone.
A team of VCU-led researchers reviewed at health data for 799 Asian American adults from the NIH “All of Us” database. They sorted participants by whether they had metabolic syndrome (the group of conditions such as high blood pressure, large waist size, high triglycerides and low “good” cholesterol) and by hazardous drinking, measured with a standard screening test. They also looked at a common blood test for alanine aminotransferase (ALT) to flag liver damage, and adjusted results for age, sex, smoking and income.
What the researchers found
Overall, about 26% participants showed signs of damage to their liver. Roughly 33% of those with metabolic syndrome only had liver damage, 22% of hazardous drinkers did, and more than 35% of people with both risks showed liver damage.
The study found that high triglycerides, large waist size and low HDL cholesterol were each linked to greater liver damage. High triglycerides worsened the effect of drinking as people with both high triglycerides and risky drinking had more than three times the odds of liver injury. High blood pressure when combined with hazardous drinking also raised the danger.
What this means for Asian Americans
Experts say the results matter for Asian Americans, which the U.S. Census Bureau defines as a person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian subcontinent.
Alcohol use varies across different Asian-American groups. Some face rising rates of heavy drinking while others may avoid seeking help because of stigma. Drinking habits differ by ethnic subgroup and by how long people have lived in the U.S. For example, genetic differences in alcohol metabolism more common in people of East Asian descent can change how alcohol affects the body. With metabolic conditions also increasing in parts of the community, health workers say screening and prevention should address both alcohol use and metabolic health together to protect liver health.
What doctors suggest
The researchers say the findings support healthcare workers should ask about both metabolic health and alcohol use together. For Asian Americans with metabolic risk factors, cutting back on alcohol, or avoiding it altogether, may help protect the liver. The authors also call for more studies that look at specific Asian-American subgroups and follow people over time to better guide prevention and care.
The VCU researchers included corresponding author Juan Pablo Arab, M.D., the Institute’s director of alcohol sciences; VCU medical students Kerry Yi Chen Lee and Ye In Christopher Kwon; Butros Fakhoury, M.D., VCU Department of Internal Medicine; Hyundam Gu, M.D., of the Institute; and Matthew Ambrosio, VCU School of Public Health. Nicole Ng, M.D., now at New York Presbyterian Hospital-Weill Cornell, was also a co-author.