Differences in the percentage of Native American ancestry in Latin American people are linked with the chances of them developing severe liver failure and associated high risk of short-term mortality, a study co-authored by UCL has found.
The ACLARA study, published in Gastroenterology, is the first of its kind to indicate that ancestry and race may determine the outcome of advanced liver disease (decompensated cirrhosis) in patients.
The large prospective observational study, co-authored by Professor Rajiv Jalan (UCL Division of Medicine), found a high prevalence of severe acute-on-chronic liver failure (ACLF) and high risk of 28-day mortality in liver disease patients that had a greater percentage of Native American ancestry and reported race than those of European and African descent.
The study also found socio-economic factors are associated with the probability of developing ACLF in the Latin American population, with those able to afford private treatment less likely to develop the condition.
Co-author Professor Rajiv Jalan (UCL Division of Medicine) said: "The data generated in the ACLARA study provides the first indication for the important association of Native American race and ancestry in the development of liver failure and its associated mortality.
"It appears that the mechanism of this susceptibility is markedly higher systemic inflammation, which is a central operative mechanism of liver failure. These data have implications for initiating more intense screening programmes for liver disease in this population and further research to understand their susceptibility to other diseases and the mechanisms underlying increased inflammation."
According to a recent study (Global burden of liver disease: 2023 update), liver disease accounts for more than two million deaths annually (cirrhosis, viral hepatitis, and liver cancer) and for 4% of all deaths worldwide (one out of every 25 deaths). One in three liver-related deaths occurs among females.
Liver cirrhosis mortality in Mexico was the highest in Latin America in 2010, with a mortality rate of 38.3 per 100,000.
A previous large study in Europe, CANONIC, identified ACLF as a distinct syndrome that develops in 30% of patients with acute decompensation of cirrhosis.
Clinical features of ACLF are failure of multiple organs including the liver, kidneys, brain, heart, lungs, blood clotting and a high risk of infection. Recovery from ACLF, either using intensive care or liver transplantation, can normalise the function of these organs.
