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Racial and Ethnic Differences in Alcohol-Associated Aspartate Aminotransferase and  -Glutamyltransferase Elevation
Scott H. Stewart, MD, MS
Arch Intern Med. 2002;162:2236-2239.
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  -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 -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 -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.
From the Division of General Internal Medicine, School of Medicine
and Biomedical Sciences, State University of New York at Buffalo.
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