P3436 - Gender, Ethnicity, and Vitamin D Deficiency as Potential Predictors of PBC-Related Short-Term and Long-Term Outcomes

Miriam Sanchez Luna, MD¹, Chris Sabillon, MSc², Angelin Raju, MD³, Carolina DeLaPorte, MD¹, Jay Yepuri, MD, FACG⁴, Marlyn J. Mayo, MD, FACG^5
1Texas Health Resources HEB/ Denton, Bedford, TX; ²University of Texas Austin, Northlake, TX; ³Texas Health Resources HEB/Denton, Lewisville, TX; ⁴Digestive Health Associates of Texas/GI Alliance, Bedford, TX; ⁵University of Texas Southwestern, Dallas, TX

Introduction: Primary biliary cholangitis (PBC), is an autoimmune disease that progressively destroys the intrahepatic bile ducts. Complications of PBC include malabsorption of fat-soluble vitamins and cirrhosis, which can lead to outcomes such as decompensated cirrhosis, LT, and death. This study aims to establish the association between gender, ethnicity, and vitamin D deficiency in short and long term outcomes for patients with PBC.

Methods: We conducted a retrospective cross-sectional analysis using 2020-2021 HCUP NIS data, including individuals aged 18 and older with PBC cirrhosis-related ICD-10 codes. Outcomes of interest included decompensated cirrhosis (short-term) and HCC, LT, and death (long-term). We used multivariable logistic regression to calculate odds ratios (OR). Significance was set at p< 0.05.

Results: Out of 4873 patients with PBC-related cirrhosis, the median age was 67 years (IQR: 57-76). The median length of stay was 4 days. Demographically, 72.60% were White, 14.53% Hispanic, 6.9% Black, and 5.97% other minorities. Regarding gender, 84.03% were female. Regarding PBC-related decompensated cirrhosis, both Hispanic (OR: 1.276, 95% CI: 1.183-1.376, p < 0.001) and Black individuals (OR: 1.261, 95% CI: 1.135-1.402, p< 0.001) were more likely to develop decompensated cirrhosis compared to White individuals. Males were more likely than females to develop decompensated cirrhosis (OR: 1.299, 95% CI: 1.208-1.397, p < 0.001). Regarding death, Black individuals had higher odds of mortality compared to White individuals (OR: 1.316, 95% CI: 1.057-1.638, p=0.014). Hispanic individuals had the highest odds of receiving liver transplantation compared to White individuals (OR: 1.574, 95% CI: 1.278-1.939, p< 0.001). Individuals with Vitamin D deficiency had higher odds of developing HRS (OR: 1.236, 95% CI: 1.041-1.469, p=0.016) and HCC (OR: 1.657, 95% CI: 1.091-2.516, p=0.018).

Discussion: Previous smaller studies have suggested that minorities (Hispanics and Blacks) and males with PBC are more likely to present with more advanced disease. This study confirms this finding in a larger, national cohort. Vitamin D deficiency was associated with higher risk of HRS, further studies are needed to determine the possible role of CKD leading to Vit D deficiency. Vit D has in vitro effects against hepatoma cell proliferation, so deficiency may create a permissive environment for HCC growth.



Disclosures:


Miriam Sanchez Luna, MD¹, Chris Sabillon, MSc², Angelin Raju, MD³, Carolina DeLaPorte, MD¹, Jay Yepuri, MD, FACG⁴, Marlyn J. Mayo, MD, FACG⁵. P3436 - Gender, Ethnicity, and Vitamin D Deficiency as Potential Predictors of PBC-Related Short-Term and Long-Term Outcomes, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.