Liver biochemistry and associations with alcohol intake, hepatitis B virus infection and Inuit ethnicity: a population-based comparative epidemiological survey in Greenland and Denmark

Abstract

Background. Hepatitis B virus (HBV) infection is common in Arctic populations and high alcohol intake has been associated with an increased risk of a number of diseases. Yet, a description of the influence of alcohol intake in persons with HBV infection on liver biochemistry is lacking. Objective. We aimed to describe the association between reported alcohol intake and liver biochemistry taking into account also HBV infection, ethnicity, Inuit diet, body mass index (BMI), gender and age in an Arctic population. Design and methods. Population-based investigation of Inuit (n 0441) and non-Inuit (94) in Greenland and Inuit living in Denmark (n 0136). Participants filled in a questionnaire on alcohol intake and other life style factors. Blood samples were tested for aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), bilirubin, albumin, hepatitis B surface antigen, hepatitis B surface antibody and hepatitis B core antibody. We also performed physical examinations. Results. Participation rate was 95% in Greenland and 52% in Denmark. An alcohol intake above the recommended level was reported by 12.9% of non-Inuit in Greenland, 9.1% of Inuit in East Greenland, 6.1% of Inuit migrants and 3.4% of Inuit in the capital of Greenland (p 00.035). Alcohol intake was associated with AST (p B0.001) and GGT (p 00.001), and HBV infection was associated with ALP (p 00.001) but not with AST, GGT, bilirubin or albumin in the adjusted analysis. Inuit had higher AST (p B0.001), GGT (p B0.001) and ALP (p 00.001) values than non-Inuit after adjustment for alcohol, diet, BMI and HBV exposure. Ethnic origin modified the association between alcohol and AST, while HBV infection did not modify the associations between alcohol and liver biochemistry. Conclusions. Non-Inuit in Greenland reported a higher alcohol intake than Inuit. Ethnic origin was more markedly associated with liver biochemistry than was alcohol intake, and Greenlandic ethnicity modified the effect of alcohol intake on AST. HBV infection was slightly associated with ALP but not with other liver biochemistry parameters.

Low serum 25-hydroxyvitamin D levels are associated with liver injury markers in the US adult population

“…Although no interaction was observed in our results, the reason may be the small number of cases (n 38, 2•8 %) in the alcoholic healthy population; however, the number of cases of abnormal levels of ALP in other populations varies from 4•4 to 4•9 %, which may induce low statistical power for inference. This phenomenon indicates that the number of people who drink alcohol with abnormal ALP levels is less than that of other subgroups, suggesting that there is a negative association between alcohol consumption and ALP, which is supported by previous studies (36,37) , although other studies have found no association between alcohol and ALP levels (38,39) . Further studies are needed with a larger sample size to demonstrate this association.…”

Forty years of research concerning children and youth in Greenland: a mapping review

“…Of the 79 studies themed Alcohol abuse , only one study focused exclusively on this subject [ 38 ]. 21 studies focused primarily on alcohol abuse, with a secondary focus on other areas such as biological and genetic issues [ 39 , 40 ], cross-addictions [ 41 – 43 ], migration [ 44 ], violence [ 45 , 46 ], relations with parents and adults outside the family [ 47 – 50 ] and children’s health behaviour [ 51 – 56 ]. In the 57 remaining studies, alcohol use and abuse were supplemented as part of larger national public health surveys or as part of cross-national public surveys.…”