{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T18:30:12Z","timestamp":1776709812399,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Diagnosis of primary biliary cholangitis (PBC) is made using alkaline phosphatase (ALP) and positive antimitochondrial antibody (AMA), but these biomarkers may vary by race. There is also little known about changes in ALP in the years prior to PBC diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from the Fibrotic Liver Disease Consortium, we used matched pairs to evaluate racial differences in ALP for up to 5\u2009years prior to diagnosis. We also compared rates of AMA positivity by race.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>1335 confirmed PBC patients were included: 769 (58%) non\u2010Hispanic white (NHW); 110 (8%) Black; 138 (11%) Asian American Pacific Islander (AAPI); and 318 (24%) Hispanic. 774 patients had AMA test results. Black patients had significantly lower AMA positivity than NHWs. Black patients were less likely to be AMA\u2010positive compared to NHW patients (OR\u2009=\u20090.50, 95% CI 0.29\u20130.86, <jats:italic>p<\/jats:italic>\u2009=\u20090.012). There were no significant differences in rates of AMA positivity between AAPI or\u00a0 Hispanic versus NHW patients. All patient groups had elevated ALP for 2\u20135\u2009years prior to diagnosis. ALP differed between Black and NHW patients only at specific times before diagnosis. There were no significant differences in ALP between Hispanic and NHW patients. AAPI patients had significantly lower ALP compared to NHWs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a diverse sample of PBC patients, we observed significant differences in AMA positivity and pre\u2010diagnosis ALP levels by race. Future studies to better characterize PBC across racial\/ethnic groups are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.17035","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:40:01Z","timestamp":1750725601000},"page":"2209-2218","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pre\u2010Diagnosis Alkaline Phosphatase and Antimitochondrial Antibody Positivity Vary by Race\/Ethnicity Among Patients With Primary Biliary Cholangitis"],"prefix":"10.1111","volume":"40","author":[{"given":"Allyce","family":"Caines","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Henry Ford Health  Detroit Michigan USA"},{"name":"School of Medicine Michigan State University  East Lansing Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3313-6428","authenticated-orcid":false,"given":"Mei","family":"Lu","sequence":"additional","affiliation":[{"name":"School of Medicine Michigan State University  East Lansing Michigan USA"},{"name":"Department of Public Health Sciences Henry Ford Health  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trueman","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Henry Ford Health  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheri","family":"Trudeau","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Henry Ford Health  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Melkonian","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Henry Ford Health  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Humberto\u00a0C.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Henry Ford Health  Detroit Michigan USA"},{"name":"School of Medicine Wayne State University  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amandeep\u00a0K.","family":"Sahota","sequence":"additional","affiliation":[{"name":"Department of Research and Evaluation Kaiser Permanente Southern California  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark\u00a0A.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Center for Health Research Kaiser Permanente Northwest  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yihe","family":"Daida","sequence":"additional","affiliation":[{"name":"Center for Integrated Health Care Research Kaiser Permanente Hawaii  Honolulu Hawaii USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher\u00a0L.","family":"Bowlus","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of California  Davis California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8666-3849","authenticated-orcid":false,"given":"Stuart\u00a0C.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Henry Ford Health  Detroit Michigan USA"},{"name":"School of Medicine Michigan State University  East Lansing Michigan USA"},{"name":"School of Medicine Wayne State University  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000225653.07932.8f"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.456"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.10.018"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-020-06402-3"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000512"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.12.010"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.03.022"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.138.10.3525"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.161.10.5157"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.30280"},{"key":"e_1_2_8_12_1","unstructured":"E.Williams L. 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