Trends in Morality Related to Chronic Liver Diseases in Patients With Diabetes Mellitus: A CDC-WONDER Based 21-Year Retrospective Analysis

Document Type

Conference Proceeding

Publication Date

10-2025

Publication Title

Journal of the Endocrine Society

Abstract

Background: Chronic liver diseases (CLDs) are a significant cause of morbidity and mortality, particularly among individuals with diabetes mellitus (DM). DM increases the risk of complications such as cirrhosis and hepatocellular carcinoma, contributing to an increase in mortality. This study aims to explore the trends in CLD mortality in DM patients from 1999 to 2020. Methods: We used the CDC WONDER database to retrieve the age-adjusted mortality rates (AAMRs) and crude rates (CRs) per 100,000 individuals aged 45 and above. Mortality data for CLDs (hepatic cirrhosis, sclerosis, fibrosis, chronic hepatitis, hepatocellular carcinoma, alcoholic and non-alcoholic fatty liver, and portal hypertension and its complications) related mortality was obtained for patients with DM. Joinpoint Regression Program was used to calculate the annual percentage change (APC) and average APC (AAPC). Results: From 1999 to 2020, CLDs caused a total of 75,054 deaths in middle-aged and older adults with DM, with an AAMR of 2.86 (2.84 - 2.88) and an AAPC of 2.21% (1.81 - 2.68), demonstrating an increasing trend. Males experienced twice the mortality than females (AAMRs: 1.99 vs 3.83) and also showed a significantly greater increase in mortality than females [AAPCs: 2.44% (2.05 - 2.81) vs 1.55% (1.14 - 1.81)]. Among the racial and ethnic groups, non-Hispanic (NH) American Indians or Alaska Natives showed the highest AAMRs (8.26), followed by Hispanics or Latinos (6.1), NH Blacks or African Americans (2.49), NH Whites (2.49), and NH Asians or Pacific Islanders (2.42). Despite having the highest mortality, NH American Indians also showed the highest rise in mortality [AAPC: 2.59% (1.78 - 3.74)], followed by NH Whites [2.53% (2.29 - 2.77)], and Hispanics [0.62% (0.07 - 1.38)]. NH Blacks and NH Asians showed decreasing mortality trends, lacking statistical significance [-0.41% (-1.08 - 0.35) and -0.78 (-1.42 - 0.02) respectively]. Regionally, the West showed the highest AAMRs (3.69), followed by the South (2.88), the Midwest (2.47), and the Northeast (2.13). Only the Northeast showed a nonsignificant declining trend, while the other regions showed significant rising trends. Non-metropolitan areas (AAMR: 3.16) exhibited more than twice the rise in mortality as in metropolitan areas (2.76) [AAPCs: 3.72% (3.40 - 4.09) vs 1.76% (1.40 - 2.10)]. The 75-84-year age group experienced the greatest mortality burden (CR: 5.36), and the 45-54-year experienced the lowest (1.15). Conclusion: CLD mortality in DM patients has significantly increased over the past two decades, with the highest burden observed in males, NH American Indians or Alaska Natives, the Western region, and non-metropolitan areas. These findings highlight the need for targeted interventions to mitigate these disparities.

Volume

9

Issue

Suppl 1

First Page

A664

Comments

ENDO 2025 Endocrine Society Annual Meeting, July 12-15, 2025, San Francisco, CA

Last Page

A665

DOI

10.1210/jendso/bvaf149.1256

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