P1623 - Temporal Trends in Non-Alcohol Fatty Liver Disease-Related Mortality Rates from 1999 to 2020: A Sub-Stratified Analysis of Ethnicity, Census Region, and Urbanization in the United States

Muhammad Nouman. Aslam, MBBS¹, Umar Abdul Rehman Khalid, MBBS², Ijlal Akbar. Ali, MD³
1Creighton University School of Medicine, Omaha, NE; 2King Edward Medical University, Bahawalpur, Punjab, Pakistan; 3University of Oklahoma, Oklahoma City, OK

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a prevalent condition in the United States, with varying impacts across racial, ethnic, and geographic groups. Despite its growing public health significance, limited research examines associated mortality patterns within these diverse populations. This study aims to analyze longitudinal trends in NAFLD-related mortality from 1999 to 2020, stratifying outcomes by gender, ethnicity, and geographic regions. We aim to identify disparities and trends to inform targeted public health interventions and future research.

Methods: Using CDC WONDER data, we analyzed death certificates listing NAFLD as a primary or contributing cause. Age-adjusted mortality rates (AAMRs) and temporal trends were assessed with Joinpoint regression.

Results: A total of 67,939 NAFLD-related deaths were recorded among individuals aged 35 years and older in the US from 1999 to 2020, with a cumulative AAMR of 1.8. The overall AAMR rose significantly between 1999 and 2020, with an APC of 6.4 (p< 0.01). Males and females showed similar cumulative AAMRs (1.9 and 1.7). Males showed a significant decrease in mortality from 1999-2020 (APC: -2.0; p< 0.01), and then mortality increased significantly from 1999-2020 (APC: 5.8; p< 0.01). Females showed a significant increase in mortality from 1999-2020 (APC: 6.8; p< 0.01). Among ethnic groups, Non-Hispanic (NH) American Indians/Alaska Natives experienced the highest cumulative AAMR (males, 3.3; females, 5.0), followed by NH Whites (males, 2.1; females, 1.8), Hispanics (males, 1.8; females, 2.1), NH Blacks (males, 1.2; females, 0.9), and NH Asians/Pacific Islanders (males, 0.9; females, 0.7). Geographically, rural areas exhibited comparable AAMRs (males, 1.9; females, 2.0) to urban settings (males, 2.0; females, 1.6). Among regions, males in the West had the highest cumulative AAMR (2.8), followed by the Midwest (1.8), South (1.7), and Northeast (1.5). Females in the West similarly recorded the highest AAMR (2.2), with the Midwest (1.8), South (1.7), and Northeast (1.2) following.

Discussion: NAFLD-related mortality in the United States has significantly increased from 1999 to 2020, with disparities observed across gender, ethnicity, and geographic regions. NH American Indians/Alaska Natives and individuals in the Western region exhibited the highest mortality rates. These findings underscore the need for targeted interventions to address demographic and regional disparities in NAFLD outcomes


Figure: TEMPORAL TRENDS IN NON-ALCOHOL FATTY LIVER DISEASE-RELATED MORTALITY RATES FROM 1999 TO 2020

Disclosures:
Muhammad Aslam indicated no relevant financial relationships.
Umar Abdul Rehman Khalid indicated no relevant financial relationships.
Ijlal Ali indicated no relevant financial relationships.

Muhammad Nouman. Aslam, MBBS¹, Umar Abdul Rehman Khalid, MBBS², Ijlal Akbar. Ali, MD³. P1623 - Temporal Trends in Non-Alcohol Fatty Liver Disease-Related Mortality Rates from 1999 to 2020: A Sub-Stratified Analysis of Ethnicity, Census Region, and Urbanization in the United States, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.