P3707 - Impact of Comorbid Diabetes on Chronic Liver Disease Mortality in US Adults Aged 55 and Older: A 25-Year Nationwide Analysis

Simran Joshi, MD¹, Muhammad Faizan Ali, MD², Sampada Bhasker, MBBS³, Sudharsan Arul Sivakumar, MBBS⁴, Sneha Balaji, MBBS⁵, Husnain Ahmad, MBBS⁶, Saman Javaid, MBBS⁷, Thu Thi Anh Tran, ⁸, Mohammad Islam, MD⁹, Cheng-Hung Tai, MD¹, Corinne Caissie, MD¹, Preethi Jagannath, MBBS¹⁰, Marquise Soto, MD¹¹, Matthew Antony. Manoj, MBBS¹²
1Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT; 2Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan; 3Punjab Institute of Medical Sciences, Jalandhar, Punjab, India; 4Nangtong University, Nantong, Chongqing, China; 5Nangtong University, Nangtong, Chongqing, China; 6Shalamar Institute of Health Sciences, Lahore, Punjab, Pakistan; 7CMH Kharian, Sarghoda, Punjab, Pakistan; 8Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Ho Chi Minh, Vietnam; 9Yale New Haven Health, Bridgeport, CT; 10Mount Auburn Hospital, Cambridge, MA; 11Massachusetts General Hospital, Chelsea, MA; 12Beth Israel Deaconess Medical Center, Boston, MA

Introduction: Chronic liver disease (CLD) in patients with diabetes is a growing public health concern in the United States, particularly among older adults. Hyperglycemia contributes to hepatic inflammation and fibrosis, accelerating liver dysfunction and increasing the risk of cirrhosis and liver-related mortality. These conditions commonly coexist and pose significant challenges in management due to overlapping pathophysiology and complex clinical trajectories. This study assesses long-term mortality trends and demographic disparities in CLD-related deaths among U.S. adults aged ≥55 with diabetes from 1999 to 2023.

Methods: Mortality data was extracted from CDC WONDER using ICD-10 codes for CLD and diabetes among adults aged 55 and older. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Trends were stratified by sex, age, race/ethnicity, region, urbanization, and state. Joinpoint regression estimated the average annual percent change (AAPC) with 95% confidence intervals (CI). Significance was defined as p < 0.05.

Results: From 1999 to 2023, 148,072 deaths were attributed to CLD in individuals with diabetes. The overall AAMR more than doubled, rising from 5.17 to 11.84 per 100,000 (AAPC: 3.45; 95% CI: 3.22–3.66; p < 0.000001). Men had higher mortality than women (AAMR: 9.12 vs 5.73) and a steeper upward trend (AAPC: 3.76 vs 2.95, both p < 0.000001). Non-Hispanic (NH) American Indian/Alaskan Native individuals had the highest AAMR (21.4), followed by Hispanic populations (15.0), while NH Whites showed the sharpest rise (AAPC: 3.74), closely followed by NH American Indians (AAPC: 2.99). Regionally, the South had the steepest increase (AAPC: 4.13), followed by the West (AAPC: 3.33), both p < 0.000001. States with the highest AAMRs included Oklahoma (12.27), Texas (11.35), and Kentucky (10.68). Rural areas had higher mortality (AAMR: 7.41 vs 6.49) and faster growth (AAPC: 4.57 vs 3.14) as compared to urban areas. Adults aged ≥75 had a greater mortality burden and higher AAPC (3.93 vs 3.30).

Discussion: Mortality due to CLD among older adults with diabetes has more than doubled over the past 25 years, with pronounced increases in males, NH White, the South region, and rural areas. These findings underscore the urgent need for targeted interventions and equitable access to preventive care and liver disease management in high-risk groups.


Figure: Trends of comorbid diabetes on chronic liver disease mortality in U.S adults aged 55 and older


Figure: Impact of comorbid diabetes on chronic liver disease mortality in U.S adults aged 55 and older

Disclosures:
Simran Joshi indicated no relevant financial relationships.
Muhammad Faizan Ali indicated no relevant financial relationships.
Sampada Bhasker indicated no relevant financial relationships.
Sudharsan Arul Sivakumar indicated no relevant financial relationships.
Sneha Balaji indicated no relevant financial relationships.
Husnain Ahmad indicated no relevant financial relationships.
Saman Javaid indicated no relevant financial relationships.
Thu Thi Anh Tran indicated no relevant financial relationships.
Mohammad Islam indicated no relevant financial relationships.
Cheng-Hung Tai indicated no relevant financial relationships.
Corinne Caissie indicated no relevant financial relationships.
Preethi Jagannath indicated no relevant financial relationships.
Marquise Soto indicated no relevant financial relationships.
Matthew Manoj indicated no relevant financial relationships.

Simran Joshi, MD¹, Muhammad Faizan Ali, MD², Sampada Bhasker, MBBS³, Sudharsan Arul Sivakumar, MBBS⁴, Sneha Balaji, MBBS⁵, Husnain Ahmad, MBBS⁶, Saman Javaid, MBBS⁷, Thu Thi Anh Tran, ⁸, Mohammad Islam, MD⁹, Cheng-Hung Tai, MD¹, Corinne Caissie, MD¹, Preethi Jagannath, MBBS¹⁰, Marquise Soto, MD¹¹, Matthew Antony. Manoj, MBBS¹². P3707 - Impact of Comorbid Diabetes on Chronic Liver Disease Mortality in US Adults Aged 55 and Older: A 25-Year Nationwide Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.