Epidemiology and clinical features of alcoholic liver disease in Hainan Province, China

Alcohol can cause alcoholic fatty liver, alcoholic steatohepatitis, alcoholic liver cirrhosis (ALC), and hepatocellular carcinoma. China has become the second-largest country in the world in terms of alcohol consumption, lacking national epidemiological data on alcoholic liver disease (ALD).

To understand the incidence and characteristics of ALD in Hainan Province of China.

From October 2022 to April 2023, a stratified proportional multi-stage whole population sampling method was adopted to select permanent residents of Haikou, Sanya, Qionghai, Dongfang, and Wuzhishan in Hainan Province to carry out questionnaire surveys, blood tests, and ultrasound examinations of the liver.

A total of 2704 valid questionnaires were obtained from residents aged 15-93 years old. The rates of drinking, hazardous drinking, and harmful drinking were 31.73%, 14.53%, and 5.03%, respectively. The above rates were higher for males than for females, increasing with income, and the rates for ethnic minorities, such as Li, were higher than for Han Chinese (P < 0.05). Drinking rates increased with literacy (P < 0.05). Drinking rate and hazardous drinking rate decreased with age, were higher for residents of agricultural households than non-agricultural households, and higher for married than unmarried individuals (P < 0.05). The total number of patients with ALD was 142, with a detection rate of 5.25%. ALD detection rate was higher for males than females, decreased with age, and higher with income (P < 0.05). Patients with ALD included 48 (33.8%) cases of mild ALD, 64 (45.1%) cases of alcoholic fatty liver, 18 (12.7%) cases of alcoholic steatohepatitis, and 12 (8.5%) cases of ALC. The proportion of those who consumed more than 80 g of alcohol per day increased as they progressed from mild ALD to ALC stage. Diabetes mellitus and hyperlipidemia were easily combined in some cases, accounting for 25 (17.6%) and 80 (56.3%), respectively. The average daily alcohol consumption of ALD patients of Li ethnicity ≥ 80 g was significantly more than that of Han ethnicity (χ ² = 5.652, P = 0.02), and was predominantly among those who drank large amounts of alcohol intermittently (χ ² = 89.093, P < 0.001).

The rates of drinking, hazardous drinking, harmful drinking, and detection of ALD in Hainan Province need to be paid attention to by advocating a healthy lifestyle, such as abstinence and limiting alcohol consumption.