In the present study, we analyzed racial differences in the most commonly used biomarkers of hepatic damage—AST, ALT, and GGT—and the extent to which alcohol consumption can explain racial differences. The findings show that hepatic enzyme mean values (especially GGT) may increase more markedly among African Americans than in whites in relation both to drinking status and amount of alcohol consumed. For GGT, racial differences exist even in non-drinkers. The most important differences were found for GGT: in all categories of drinking status (lifetime abstainers, former and current drinkers), average levels were significantly higher in African Americans compared to whites. Furthermore, among current drinkers differences in GGT mean values were larger than those observed either in lifetime abstainers or in former drinkers. In analyses based on tertiles of recent (past 30 days) alcohol consumption, differences in GGT mean values between the two ethnic groups tended to amplify with increasing tertiles of consumption.

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Table 1 shows the selected characteristics of the study participants stratified by gender and race. In this sample, for both men and women, the African Americans were significantly older, less educated, and had a significantly higher mean value of GGT than the whites. The other two enzymes were not significantly different between the two racial groups, except for ALT, which was significantly higher among white men than among African-American men. With regard to drinking status in both sexes, whites showed a higher prevalence of current drinkers compared with African Americans, whereas for beverage-specific recent (past 30 days) consumption of alcohol, we found that, on the average, white men consumed significantly more wine and beer than African-American men. For liquor consumption, while both between-race comparisons did not reach statistical significance, in both sexes African Americans reported higher consumption than whites. For women, the only significant difference was detected for wine consumption with white women reporting higher intake than African-American counterparts. The two racial groups did not significantly differ for total alcohol use and for the usual consumption of alcohol per drinking day (measure of intensity of consumption).

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Population

The present study focuses on data obtained from a sample of residents of Erie and Niagara counties in New York State, enrolled as part of a series of studies conducted between September 1995 and May 2001. A detailed report of the study design, participant enrollment, and methodology has been described previously. Potential participants were randomly identified from lists of those holding a New York State driving license from the Department of Motor Vehicles of New York for people aged 35-64 and Health Care Financing Administration rolls for people aged 65-80. Of the 6,837 potential participants identified, contacted, and found to be eligible for our study, a total of 4,065 (participation rate=59.5%) agreed to participate and were invited to the Center for Preventive Medicine at the University at Buffalo for an interview and physical examination. The exclusion criteria applied to the present analyses were race different from Caucasian or African-American (n=53); a self-reported history of chronic or acute hepatitis, cirrhosis or noncirrhotic liver disease (n=171); missing information on education, BMI, smoking status, life pack years of smoking (n=169) or on drinking habits (n=32); outliers for enzyme levels (n=3, for GGT >800; n=l, for ALT=324) or missing blood determination of liver enzymes (n=332). The remaining 3,304 participants (3,063 Caucasians and 241 African Americans, 92.7% vs. 7.3%) are included in this analysis. Excluded participants for whom information was available were different from included participants with respect to the distribution of gender (women: 45.9% vs. 53.1%, p<0.05) and race (African-American: 11.4% vs. 7.3%, p<0.05); they were also significantly older, less educated, and characterized by higher body mass index (BMI) compared to included participants (age: 61.7 vs. 58.6, p<0.01; education: 13.2 vs. 13.5, p<0.05; BMI: 28.7 vs. 28.2, p<0.05). For smoking status and total pack-years of smoking, we did not find significant differences between the two groups of participants. With regard to drinking status, the excluded participants were significantly more likely to be lifetime abstainers (13.0 vs. 9.3, p<0.01) and less likely to be current drinkers than included participants (57.9 vs. 65.8, p<0.01). For total and beverage-specific alcohol intake in the past 30 days, the two groups did not significantly differ, except for wine consumption that was significantly higher among included individuals. Finally, excluded individuals had higher average levels of all three hepatic enzymes (p<0.05) compared with included participants.

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