Racial and ethnic differences in alcohol-associated aspartate aminotransferase and γ-glutamyltransferase elevation

Background: Recent analyses have confirmed that Hispanic and black non-Hispanic Americans are at an increased risk for death from liver cirrhosis. The reasons for this are unknown. As a common cause of cirrhosis, differing sensitivities to alcohol-related hepatocellular injury may play a role. This study compared racial and ethnic aspartate aminotransferase and γ-glutamyltransferase level elevations within alcohol-drinking categories. Methods: A cross-sectional analysis of adult subjects from the Third National Health and Nutrition Examination Survey. Logistic regression models were used to estimate the risk for elevation of aspartate aminotransferase and γ-glutamyltransferase levels among Mexican American and black non-Hispanic subjects compared with white non-Hispanic subjects within categories of alcohol use. Adjustment was made for age, sex, exposure to hepatitis C and B, and body mass index. Results: Among current drinkers, black non-Hispanic and Mexican Americans were more likely to have a 2-fold elevation in aspartate aminotransferase levels when compared with white non-Hispanic Americans. This was most pronounced in the highest-frequency drinkers (Mexican Americans: odds ratio, 9.1 [95% confidence interval, 3.9-21.0]; and black non-Hispanic Americans: odds ratio, 3.1 [95% confidence interval, 1.4-6.8]). No racial and ethnic differences were apparent among current abstainers. A similar pattern was found for 2-fold γ-glutamyltransferase level elevations. Conclusions: Among current drinkers, Mexican and black non-Hispanic Americans may have an increased risk for hepatocellular injury. These results require confirmation in other study populations for whom validated measures of quantity and pattern of drinking exist.