P2367 - Increasing Mortality of Non-Alcoholic Fatty Liver Disease in Women: A Population-Based Time-Trend Analysis Using the Global Burden of Disease Database, 1990-2019

Saqr Alsakarneh, MD¹, Fouad Jaber, MD¹, Yassine Kilani, MD², Mohammad Aldiabat, MD³, Yazan Abboud, MD⁴, Umnia Shnawa, MD⁵, Mohammad Almeqdadi, MD⁶, Nikki duong, MD⁷, Leen Al-Sayyed, MD⁸, Wendell Clarkston, MD⁹, John Helzberg, MD¹, Fadi Francis, MD^10
1University of Missouri-Kansas City, Kansas City, MO; ²Lincoln Medical Center, New York, NY; ³New York University, New York, NY; ⁴Rutgers New Jersey Medical School, Newark, NJ; ⁵Jordan University of Science and Technology, Irbid, Irbid, Jordan; ⁶Lahey Medical Center, Boston, MA; ⁷Virginia Commonwealth University, Richmond, VA; ⁸Saint Louis University, St. Louis, MO; ⁹University of Missouri-Kansas City School of Medicine, Saint Luke’s Hospital of Kansas City, Kansas City, MO; ¹⁰University of Pittsburgh, Pittsburgh, PA

Introduction: Non-Alcoholic Fatty Liver Disease (NAFLD) patients have an increased risk of mortality compared to the general population. However, population-level NAFLD mortality rate data are limited. This study aimed to conduct a time-trend analysis of age and gender-specific NAFLD mortality rates in the US using the Global Burden Diseases (GBD) 2019 database.

Methods: Data was obtained from the GBD 2019 database, an international database that covers ~100% of NAFLD diagnosed cases in the US. NAFLD mortality rates, age-adjusted to the standard US population, were calculated using SEER*Stat software (v.8.4.0.1, National Cancer Institute “NCI”) and were stratified by gender, as reported in the database. Time-trends were estimated as annual percentage change (APC) and average APC (AAPC) using Joinpoint Regression Software (v.4.9.0.1, NCI) utilizing Monte Carlo permutation analysis to generate the simplest trend. Pairwise comparison was conducted between gender-specific trends using the tests of parallelism and coincidence. Age-specific trends were also assessed in two age sub-groups: younger adults aged 15-49 years and older adults aged 50-74 years. A two-sided P-value cut-off of 0.05 was utilized for statistical significance.

Results: 182,365 deaths were attributed to NAFLD in the US between 1990-2019. Overall, mortality rates have been increasing significantly in older adults but not younger adults (AAPC= 1.0 vs 0.0, AAPC difference= 1.0, P< 0.001). Age-specific trends were not identical (P< 0.001) nor parallel (P< 0.001) suggesting that NAFLD mortality rates are different and increasing in older adults at a greater rate compared to younger adults. Similarly, female (98,702) incidence rates have been increasing significantly greater than males (84,663) (AAPC= 0.9 vs 0.7, respectively) with an AAPC difference between females and males of 0.2 (P< 0.001), suggesting that the disparity in NAFLD incidence trends between age-specific groups arises from women.

Discussion: Our results suggest that NAFLD mortality trends have been increasing in older adults while remaining stable in younger adults over the last three decades. The greatest difference between older and younger adults seemed to arise from older women. Reasons for this observed difference are multi-factorial, but obesity, environmental and genetic factors could play a role. Future studies are warranted to investigate and address risk factors associated with the increasing mortality in older adults, especially in older women.



Disclosures:


Saqr Alsakarneh, MD¹, Fouad Jaber, MD¹, Yassine Kilani, MD², Mohammad Aldiabat, MD³, Yazan Abboud, MD⁴, Umnia Shnawa, MD⁵, Mohammad Almeqdadi, MD⁶, Nikki duong, MD⁷, Leen Al-Sayyed, MD⁸, Wendell Clarkston, MD⁹, John Helzberg, MD¹, Fadi Francis, MD¹⁰. P2367 - Increasing Mortality of Non-Alcoholic Fatty Liver Disease in Women: A Population-Based Time-Trend Analysis Using the Global Burden of Disease Database, 1990-2019, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.