Prevalence, Trend and Mortality Disparities in Chronic Liver Diseases in the U.S. across nativity

Background Data on the burden of chronic liver diseases(CLDs) among immigrants in the United States (U.S.) is limited. Aim This study aimed to investigate the prevalence, trends, and mortality of CLDs in immigrants compared to native residents in U.S. Design Population-based cohort. Methods Utilizing data from NHANES, we calculated age-standardized prevalence of etiology-specific CLDs. Mortality risks for CLDs individuals were compared across nativity groups. Results In 2017-2020, a significant burden of SLD was observed, with immigrants showing a higher prevalence of MASLD (36.05% vs. 31.10%, P = 0.021) but a lower MetALD (1.03% vs. 2.16%, P = 0.009). Immigrants experienced a faster increase in advanced liver fibrosis prevalence (annual percent change [APC]: 15.739 vs. 8.642), despite having a lower overall prevalence at present. A higher prevalence of HBV exposure (10.38% vs. 2.96%, P < 0.001) and a slower decline in prevalence (APC: −3.214 vs. −6.176) were observed among U.S. immigrants compared to U.S.-born residents. Mortality risk for individuals with CLDs was generally lower among immigrants compared to native residents (SLD individuals: all-cause: aHR = 0.66, 95%CI: 0.49-0.88; other-cause: aHR = 0.39, 95%CI: 0.21-0.72; all P < 0.005); however, this protection diminished among immigrants resided in the U.S. over 15 years. Conclusion Significant disparities exist in CLDs across nativity in U.S, highlighting the need for tailored public health strategies.