S1368 Gender and Racial Disparities in NAFLD With Outcomes in the United States

Introduction: Different races and genders have been known to have a different prevalence of Non-alcohol fattyliver disease (NAFLD). We conducted a nationwide study with National Inpatient Sample (NIS) database to identify the prevalence of NAFLD among races and gender, along with their associated mortality. Methods: We used the 2019 NIS database to identify all adults ( >18 years) diagnosed with NAFLDusing the relevant ICD-10-CM codes. Gender and racial distribution amongst NAFLD patients were obtained using the variables available within the database. We conducted univariate screen and multivariate logistic regression to adjust for potential patient and hospital level confounders to evaluate if there is any association of racial or gender groups with mortality. All statistical analyses were carried out using Stata 17.0 software. Results: A total of 532,485 adult NAFLD patients were identified in the study. The racial distributionamongst this NAFLD group included: Whites (68.3%), Blacks (9.4%), Hispanics (16%), Asian/pacific islanders (2.3%), Native Americans (1%), and others (3.1%). NAFLD patients within our study were predominantly female with 54.5% and 45.6% males. On multivariate analysis, we found that the odds of mortality in blacks were lower as compared to whites [OR 0.75 (0.63-0.89); p=0.001]. Whereas there was no difference in odds of mortality among different genders. Conclusion: Our study shows a significantly higher prevalence of NAFLD in Whites followed by Hispanicsand Blacks respectively. Interestingly, in our study, blacks were found to have lower odds of mortality compared to whites. Studies have found a higher rate of rs738409 SNP (G-allele) mutation in whites compared to blacks. This has been linked to severe fibrosis and increased mortality in whites with NAFLD possibly due to the development of cirrhosis and hepatocellular carcinoma. Also, we found more females with NAFLD in 2019. Our study findings of higher NAFLD prevalence in females and lower odds of mortality in blacks compared to white are based on a one-year analysis and needs more extensive studies to identify potential causes for the observed differences.