Risk of alcohol-related liver disease in the offspring of parents with alcohol-related liver disease: A nationwide cohort study

Jepsen, Peter; West, Joe; Kann, Anna Emilie; Kraglund, Frederik; Morling, Joanne; Crooks, Colin; Askgaard, Gro

Abstract

Background and aims: Offspring of patients with alcohol-related liver disease (ALD) may have higher risk of ALD. We examined their risk of ALD and survival with ALD.

Approach & Results: We used Danish nationwide registries to identify offspring of patients diagnosed with ALD in 1996–2018 and 20:1 matched comparators from the general population. They were followed for ALD diagnosis through 2018. We used landmark competing risk analysis to estimate the age-specific absolute and relative 10-year risks of ALD.

ALD was diagnosed in 385 of 60,707 offspring and 2,842 of 1,213,357 comparators during 0.7 and 14.0 million person-years of follow-up, respectively, yielding an incidence rate ratio of 2.73 (95% CI 2.44–3.03). The risk of being diagnosed with ALD within the next 10 years peaked at age 55 years for offspring and age 57 years for comparators with 10-year risks of 1.66% (95% CI 1.16–2.30) in offspring and 0.81% (95% CI 0.68–0.97) in comparators at these ages. Offspring were younger at ALD diagnosis than comparators (median age of 47.4 vs 48.9 years), yet slightly more of them had developed cirrhosis (60.3 % vs. 58.7%). Survival after ALD diagnosis was similar in offspring and comparators, adjusted hazard ratio = 1.03 (95% CI 0.88–1.21), so on average offspring died younger due to their younger age at diagnosis.

Conclusions: Offspring of patients with ALD had a low but increased risk of ALD. Screening offspring for chronic liver disease may be unnecessary, but other interventions to mitigate alcohol-related harm should be considered.

Funding: Novo Nordisk Foundation and the ‘Savværksejer Jeppe Juhl og hustru Ovita Juhls Mindelegat’ foundation.

Citation

Jepsen, P., West, J., Kann, A. E., Kraglund, F., Morling, J., Crooks, C., & Askgaard, G. (2024). Risk of alcohol-related liver disease in the offspring of parents with alcohol-related liver disease: A nationwide cohort study. Hepatology, 80(2), 418-427. https://doi.org/10.1097/hep.0000000000000747

• Journal Article Type: Article
• Acceptance Date: Nov 24, 2023
• Online Publication Date: Dec 29, 2023
• Publication Date: 2024-08
• Deposit Date: Nov 28, 2023
• Publicly Available Date: Dec 30, 2024
• Journal: Hepatology
• Print ISSN: 0270-9139
• Electronic ISSN: 1527-3350
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 80
• Issue: 2
• Pages: 418-427
• DOI: https://doi.org/10.1097/hep.0000000000000747
• Keywords: Hepatology
• Public URL: https://nottingham-repository.worktribe.com/output/27860763
• Publisher URL: https://journals.lww.com/hep/abstract/9900/risk_of_alcohol_related_liver_disease_in_the.712.aspx
• PMID: 38156979