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APHA Scientific Session and Event Listing

Ana Patricia Ortiz, PhD¹, Cynthia Pérez, PhD, MS¹, Carlos J. Romero, MD², Orville Disdier, MS³, Erik Santana¹, Margaret Torres¹, and Esther Torres, MD². (1) Department of Biostatistics and Epidemiology, University of Puerto Rico, Graduate School of Public Health, P.O. Box 365067, San Juan, PR 00936-5067, 787-758-2525, aportiz@rcm.upr.edu, (2) Department of Medicine, School of Medicine, University of Puerto Rico, PO BOX 365067, San Juan, 00936-5067, (3) Puerto Rico Department of Health, PO Box 70184, San Juan, PR 00936

Background: Although diabetes mellitus (DM) has been proposed as a risk factor for both chronic liver disease (CLD) and hepatocellular carcinoma (HCC), few studies have been performed in the US, particularly among Hispanics. According to the 2002 BRFSS, Puerto Rico (PR) had the highest prevalence of diabetes mellitus (DM) (10.5%) in the US, supporting the need for a better understanding of the public health implications associated to DM in this population. Objective: Determine the association between DM and CLD and HCC in an insured population of Puerto Rican adults. Methods: The study sample consisted of 1,037,633 persons aged >18 years covered by the government health insurance during 2002. ICD- 9 codes 250 (DM), 571 (CLD) and 155 (Malignant neoplasm of the liver and intra-hepatic bile ducts) were retrieved from the database in order to determine the prevalence of these conditions. A logistic regression model was used to determine the association between DM, CLD and HCC, adjusting for age and sex. Results: The prevalence (95% Confidence Interval) of these morbidities was 11.1% (10.9%-11.3%) for DM; 0.33% (0.29%-0.37%) for CLD; and 0.02% (0.01%-0.03%) for HCC. The prevalence of DM was higher in patients with CLD (21.6%) and those with HCC (21.4%) than the prevalence in patients without these conditions (10.7% and 9.9%, respectively). In adjusted logistic regression models DM was associated with both CLD (POR=1.9, 95%CI=1.7-2.0) and HCC (POR=1.4, 95%CI=1.0-1.9). Conclusions: DM is associated to CLD and HCC in this population. Longitudinal studies that can elucidate these associations are highly warranted.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe the prevalence of diabetes, chronic liver disease and liver cancer in the adult insured population of PR ( year 2002), and its distribution by age and sex.
• Recognize the association of diabetes with chronic liver disease and liver cancer in the adult insured population of PR (year 2002).

Keywords: Diabetes, Chronic Diseases

Presenting author's disclosure statement:

Not Answered