medwireNews: Pancreatic and liver complications due to alcohol are occurring in adolescents and young adults (AYAs) at a greater rate than in other organ systems, especially in young women, a retrospective study concludes.
“These findings underscore the importance of gastroenterologists in caring for individuals with harmful alcohol use and support the integration of addiction medicine into gastroenterology training along with consideration for multidisciplinary gastroenterology-addiction medicine clinics,” write Jennifer Flemming (Queen’s University, Kingston, Ontario, Canada) and colleagues in JAMA Network Open.
While alcohol-associated liver disease (ALD) is known to be disproportionately increasing among AYAs, especially in young women, the epidemiology of alcohol-associated end-organ complications in other organ systems has not been described prior to this study, the researchers say.
The investigators used ICES administrative health service data for Ontario to identify incident emergency department or inpatient encounters for end-organ alcohol-related harm in 11,508 AYAs aged 13–39 years between 2003 and 2021. Eligible participants were considered at risk for the outcomes of interest but had no previous healthcare encounters for these outcomes.
End-organ complications as the main diagnosis secondary to alcohol use were categorized as related to the pancreas (alcohol-associated acute and chronic pancreatitis); liver (ALD, alcohol-associated hepatitis, and alcohol-associated cirrhosis); or other organs including the stomach, adrenal glands, nervous system, muscles, heart, and fetus.
The participants were a median of 28 years old, 64% were men, and 83% lived in urban areas. The participants were generally in the lowest income quintile and most encounters were in the emergency department as opposed to inpatient care, with rates of 63% versus 37%.
Overall, 3310 (29%) patients had pancreatic complications, primarily acute pancreatitis (92%), 2217 had (19%) liver complications, and 5981 (52%) had complications to other organs, note Flemming et al.
The investigators also found that those with pancreatic complications were more likely to be men (71%) than women, people living in urban areas (88%) rather than rural areas, and inpatients (77%) rather than visitors to the emergency department.
When accounting for factors including urban versus rural residences, young women saw more growth over the study period than men in complications to the pancreas, liver, and other organs. The annual increase in the age-adjusted incidence rates per 100,000 person–years of the three complications in women were 12%, 9%, and 2%, respectively. Men, in turn, had incidence increases of 7% and 6% in pancreas and liver complications, and a decrease of 1% in those of other organs.
“It is unclear what factors are associated with this rise in disease burden,” write the authors. They note that changes to administrative coding or better case definition could be contributing factors, but they saw no such changes in other end organs, such as the stomach and heart.
While Flemming and colleagues acknowledge limitations to the study, including a lack of data on alcohol consumption and the severity of the disease, they emphasize the need for further research on this topic in other age groups.
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2025 Springer Healthcare Ltd, part of the Springer Nature Group