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Vera MA, Koch CD, Liapakis A, Lim JK, El-Khoury JM. The ALT upper reference interval debate: Blame it on the alcohol. Clin Chim Acta 2021; 526:62-65. [PMID: 34973184 DOI: 10.1016/j.cca.2021.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/20/2021] [Accepted: 12/27/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND In 2017, the American College of Gastroenterology (ACG) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition published clinical guidelines recommending the use of alanine aminotransferase (ALT) upper reference limits (URL) of 33, 25, 26, and 22 U/l for men, women, boys, and girls, respectively. This was opposed by laboratory experts who advocated for the use of higher URL of 59, 41, 33, and 24 U/l instead. We suspected that the variable inclusion of individuals who consumed alcohol to be a major contributing source of URL variability and debate. METHODS Outpatient ALT data (n = 7379) were collected from unique individuals ≥13 y with BMIs of ≥19 and ≤25. A total of 222 (3%) were excluded due to suspected liver disease. Patients were split into a pediatric group (age 13-17 y), an alcohol-restricted adult group (age 18-20 y), and adults with access to alcohol by decade (i.e., age 21-29, 30-39, 40-49, 50-59, 60-69, 70-79, and ≥ 80 y). All ALT values were measured on Roche Cobas 8000 with pyridoxal phosphate and traceable to the IFCC-reference measurement procedure. RESULTS We derived URL similar to CALIPER for our pediatric population, but closer to ACG-proposed URL in our alcohol-restricted adult group. The URL increased significantly in men and women for all other age groups. CONCLUSIONS The discrepancy in ALT URL in clinical laboratories may be attributable in part due to the variable inclusion of individuals who recently consumed alcohol in local population derivation studies.
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Affiliation(s)
- Michael A Vera
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Christopher D Koch
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Joseph K Lim
- Yale Liver Center and Section of Digestive Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Joe M El-Khoury
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA.
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Sanvisens A, Zuluaga P, Short A, Rubio G, Gual A, Torrens M, Fuster D, Bolao F, Rodríguez de Fonseca F, Muga R. Sex-specific Associations of Alcohol Withdrawal in Patients Admitted for the Treatment of Alcohol Use Disorder. J Addict Med 2021; 15:68-73. [PMID: 32769772 DOI: 10.1097/adm.0000000000000704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES There are sex differences in the pattern of alcohol consumption and in the complications of alcohol use disorder (AUD). We aimed to identify sex-specific differences in the factors associated with alcohol withdrawal syndrome (AWS) among patients that requested a first treatment for AUD. METHODS We enrolled 313 patients (75% men) with a Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) AUD diagnosis that started treatment between 2014 and 2016. We collected socio-demographics, the type and amount of alcohol and other substances consumed, and clinical and laboratory parameters. According to Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) AUD criteria, AWS occurred when patients experienced 2 or more clinical signs/symptoms and/or consumed alcohol to relieve symptoms. Logistic regression models were used to determine factors associated with AWS according to sex. RESULTS The median age of participants was 50 years (interquartile range [IQR]: 43-54 years). The median age of starting alcohol consumption was 16 years (IQR: 14-18 years). Notably, 69% of participants smoked tobacco, and 61% had a family history of AUD; 18% currently used cannabis, and 7.7% used cocaine. Overall, 73% of patients exhibited AWS criteria, and men (76.5%) were more likely than women (64.6%) to report AWS (P = 0.038). In the adjusted analysis, factors associated with AWS were the age at starting alcohol consumption (odds ratio [OR] for every 5 years = 1.89, 95% confidence interval [CI]: 1.69-2.08), and cannabis use (OR = 2.8, 95% CI: 1.04-7.7) in men, and a family history of AUD in women (OR = 2.85 95% CI: 1.07-7.54). CONCLUSIONS factors associated with AWS differ by sex which may have clinical implications for proactive management of AWS during treatment for AUD.
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Affiliation(s)
- Arantza Sanvisens
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol - IGTP, Universitat Autònoma de Barcelona, Spain (AS, PZ, DF, RM); Alcohol Unit, Hospital Universitari Son Espases - IdISPa, Palma de Mallorca, Spain (AS); Department of Psychiatry, Hospital Universitario 12 de Octubre - Instituto i+12, Universidad Complutense de Madrid, Spain (GR); Department of Psychiatry, Hospital Clínic de Barcelona - IDIBAPS, Universitat de Barcelona, Spain (AG); Department of Neuropsychiatry and Addictions, Hospital del Mar - IMIM, Universitat Autònoma de Barcelona, Spain (MT); Department of Internal Medicine, Hospital Universitari de Bellvitge- IDIBELL, L'Hospitalet de Llobregat, Spain (FB); IBIMA Biomedical Research Institut - Málaga, Spain (FRdF)
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3
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Karatayli E, Hall RA, Weber SN, Dooley S, Lammert F. Effect of alcohol on the interleukin 6-mediated inflammatory response in a new mouse model of acute-on-chronic liver injury. Biochim Biophys Acta Mol Basis Dis 2018; 1865:298-307. [PMID: 30447270 DOI: 10.1016/j.bbadis.2018.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 11/09/2018] [Accepted: 11/13/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS ACLF is usually associated with a precipitant in the setting of a chronically damaged liver. We aim to combine a mouse model with a pre-injured liver (Abcb4/Mdr2-/-) with a recently standardized ethanol feeding model to dissect alcohol-related inflammatory responses in this model. METHOD Ten (n = 64) and 15 (n = 64) week old wild-type (WT) C57BL/6 J and Abcb4-/- knock-out (KO) mice were either fed control (WT/Cont and KO/Cont groups) or liquid ethanol diet (5% v/v) followed by an ethanol binge (4 mg/kg) (WT/EtOH and KO/EtOH groups). Hepatic mRNA levels of IL6, IFN-G, IL-1B, TGFB1, TNF-A, CCL2, HGF, CRP, RANTES, PNPLA3 and COL3A1 were evaluated using the 2-ΔΔCt method. IL6 and HGF plasma levels were quantified by ELISA. RESULTS Older mice in KO/EtOH group displayed higher IL6 expressions compared to KO/Cont, WT/EtOH and WT/Cont groups of the same age, whereas HGF did not differ. Significant over-expression of CCL2 also corresponded to the same group. Males in KO/EtOH group exhibited higher IL6 expression than females. Lipid droplets were observed in about 80% of mice challenged with ethanol. There was a profound downregulation in PNPLA3 and RANTES levels after ethanol exposure. Mean size of the LDs was inversely correlated with hepatic PNPLA3 levels. CONCLUSION We propose a novel promising approach to model alcohol-related ACLI. Acute inflammatory IL6-driven response might help transition from a stable chronic state to a progressive liver damage in Abcb4-/- mice. Repression of PNPLA3 resulted in a notable expansion in size of lipid droplets, indicating lipid remodeling in this model.
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Affiliation(s)
- Ersin Karatayli
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany.
| | - Rabea A Hall
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Susanne N Weber
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Steven Dooley
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Frank Lammert
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
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4
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Ulwelling W, Smith K. The PEth Blood Test in the Security Environment: What it is; Why it is Important; and Interpretative Guidelines. J Forensic Sci 2018; 63:1634-1640. [DOI: 10.1111/1556-4029.13874] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/06/2018] [Accepted: 06/26/2018] [Indexed: 12/29/2022]
Affiliation(s)
- William Ulwelling
- National Security Psychological Services; 2155 Louisiana Blvd, Suite 6500 Albuquerque NM 87110
| | - Kim Smith
- National Security Psychological Services; 2155 Louisiana Blvd, Suite 6500 Albuquerque NM 87110
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Yaya I, Costa M, Marcellin F, Miailhes P, Wittkop L, Salmon-Ceron D, Carrieri MP. Gender, Alcohol Use, and Fibrosis in Human Immunodeficiency Virus/Hepatitis C Virus-Coinfected Individuals. Clin Infect Dis 2018; 66:983-984. [PMID: 29088334 DOI: 10.1093/cid/cix927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Issifou Yaya
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale.,Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille
| | - Marie Costa
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale.,Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille
| | - Fabienne Marcellin
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale.,Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille
| | - Patrick Miailhes
- Service des Maladies Infectieuses et Tropicales, CHU Lyon, Hôpital de la Croix Rousse
| | - Linda Wittkop
- Université Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, Team MORPH3EUS.,CHU de Bordeaux, Pole de sante publique, Service d'information medicale, Bordeaux
| | - Dominique Salmon-Ceron
- Université Paris Descartes.,Service Maladies infectieuses et tropicales, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Maria-Patrizia Carrieri
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale.,Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille
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Morales-González JA, Sernas-Morales MDL, Morales-González Á, González-López LL, Madrigal-Santillán EO, Vargas-Mendoza N, Fregoso-Aguilar TA, Anguiano-Robledo L, Madrigal-Bujaidar E, Álvarez-González I, Chamorro-Cevallos G. Morphological and biochemical effects of weekend alcohol consumption in rats: Role of concentration and gender. World J Hepatol 2018; 10:297-307. [PMID: 29527265 PMCID: PMC5838448 DOI: 10.4254/wjh.v10.i2.297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 01/13/2018] [Accepted: 01/24/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To examine the association between weekend alcohol consumption and the biochemical and histological alterations at two different concentrations of alcohol in both genders in rats.
METHODS Wistar rats weighing 170-200 g were divided into groups as follows: (1) Control groups; and (2) weekend alcohol-consumption group: 2 d/weekly per 12 wk, at two different concentrations: (1) Group of males or females with a consumption of a solution of alcohol at 40%; and (2) group of males or females with a consumption of a solution of alcohol at 5%. At the end of the experiment, serum and liver samples were obtained. The following enzymes and metabolites were determined in serum: Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Lactate Dehydrogenase, and Gamma-Glutamyltransferase, and glucose, triglycerides, cholesterol, bilirubin, and albumin. Liver samples from each group were employed to analyze morphological abnormalities by light microscopy.
RESULTS In all of the weekend alcohol-consumption groups, AST activity presented a significant, 10-fold rise. Regarding ALT activity, the groups with weekend alcohol consumption presented a significant increase that was six times greater. Bilirubin levels increased significantly in both groups of females. We observed a significant increase in the parameters of fatty change and inflammation due to weekend alcohol consumption. Only the group of females that consumed alcohol at 40% presented slight hepatocellular disorganization
CONCLUSION The results obtained herein provide solid evidence that weekend alcohol consumption gives rise to liver damage, demonstrated by biochemical and histological alterations, first manifested acutely, and prolonged weekend alcohol consumption can cause greater, irreversible damage.
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Affiliation(s)
- José A Morales-González
- Laboratorio de Medicina de Conservación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
| | - María de Lourdes Sernas-Morales
- Laboratorio de Medicina de Conservación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
| | - Ángel Morales-González
- Escuela Superior de Cómputo, Instituto Politécnico Nacional, Ciudad de México 07738, Mexico
| | - Laura Ligía González-López
- Laboratorio de Medicina de Conservación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
| | - Eduardo Osiris Madrigal-Santillán
- Laboratorio de Medicina de Conservación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
| | - Nancy Vargas-Mendoza
- Área Académica de Nutrición, ICSa, Universidad Autónoma del Estado de Hidalgo, Pachuca de Soto 42000, Mexico
| | - Tomás Alejandro Fregoso-Aguilar
- Depto. de Fisiología, Laboratorio de Hormonas y Conducta, ENCB campus Zacatenco, Instituto Politécnico Nacional, Ciudad de México 07700, Mexico
| | - Liliana Anguiano-Robledo
- Laboratorio de Farmacología Molecular, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina-Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
| | - Eduardo Madrigal-Bujaidar
- Laboratorio de Genética, Escuela Nacional de Ciencias Biológicas, IPN, Ciudad de México 07738, Mexico
| | - Isela Álvarez-González
- Laboratorio de Genética, Escuela Nacional de Ciencias Biológicas, IPN, Ciudad de México 07738, Mexico
| | - Germán Chamorro-Cevallos
- Departamento de Farmacia, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México 07738, Mexico
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Ghosh Dastidar S, Warner JB, Warner DR, McClain CJ, Kirpich IA. Rodent Models of Alcoholic Liver Disease: Role of Binge Ethanol Administration. Biomolecules 2018; 8:biom8010003. [PMID: 29342874 PMCID: PMC5871972 DOI: 10.3390/biom8010003] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/09/2018] [Accepted: 01/11/2018] [Indexed: 12/14/2022] Open
Abstract
Both chronic and acute (binge) alcohol drinking are important health and economic concerns worldwide and prominent risk factors for the development of alcoholic liver disease (ALD). There are no FDA-approved medications to prevent or to treat any stage of ALD. Therefore, discovery of novel therapeutic strategies remains a critical need for patients with ALD. Relevant experimental animal models that simulate human drinking patterns and mimic the spectrum and severity of alcohol-induced liver pathology in humans are critical to our ability to identify new mechanisms and therapeutic targets. There are several animal models currently in use, including the most widely utilized chronic ad libitum ethanol (EtOH) feeding (Lieber–DeCarli liquid diet model), chronic intragastric EtOH administration (Tsukamoto–French model), and chronic-plus-binge EtOH challenge (Bin Gao—National Institute on Alcohol Abuse and Alcoholism (NIAAA) model). This review provides an overview of recent advances in rodent models of binge EtOH administration which help to recapitulate different features and etiologies of progressive ALD. These models include EtOH binge alone, and EtOH binge coupled with chronic EtOH intake, a high fat diet, or endotoxin challenge. We analyze the strengths, limitations, and translational relevance of these models, as well as summarize the liver injury outcomes and mechanistic insights. We further discuss the application(s) of binge EtOH models in examining alcohol-induced multi-organ pathology, sex- and age-related differences, as well as circadian rhythm disruption.
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Affiliation(s)
- Shubha Ghosh Dastidar
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA.
| | - Jeffrey B Warner
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA.
| | - Dennis R Warner
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA.
| | - Craig J McClain
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA.
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA.
- Robley Rex Veterans Medical Center, Louisville, KY 40202, USA.
- University of Louisville Alcohol Research Center and Hepatobiology & Toxicology COBRE, University of Louisville, Louisville, KY 40202, USA.
| | - Irina A Kirpich
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA.
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA.
- University of Louisville Alcohol Research Center and Hepatobiology & Toxicology COBRE, University of Louisville, Louisville, KY 40202, USA.
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Cheng SQ. Influence of non-pathological factors on ALT measurements. Shijie Huaren Xiaohua Zazhi 2017; 25:3005-3020. [DOI: 10.11569/wcjd.v25.i34.3005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Alanine transaminase (ALT) is still the most sensitive marker for evaluating the damage of liver cells. ALT measurements may be affected by common non-pathological factors such as gender, age, pregnancy, different physiological conditions, circadian rhythm, diet, drinking, smoking, strenuous exercise, metabolic factors, drugs, blood collection methods, and specimen collection, transmission, and preservation. It is important to emphasize the definition of limits of normal ALT and the influence of the above-mentioned non-pathological factors on its test results.
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Affiliation(s)
- Shu-Quan Cheng
- Department of Hepatology, the Third People's Hospital of Guilin, Guilin 541002, Guangxi Zhuang Autonomous Region, China
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Tsui JI, Mirzazadeh A, Hahn JA, Maher L, Bruneau J, Grebely J, Hellard M, Kim AY, Shoukry NH, Cox AL, Prins M, Dore G, Lauer G, Lloyd A, Page K. The effects of alcohol on spontaneous clearance of acute hepatitis C virus infection in females versus males. Drug Alcohol Depend 2016; 169:156-162. [PMID: 27816863 PMCID: PMC5328754 DOI: 10.1016/j.drugalcdep.2016.10.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Approximately one quarter of persons exposed to hepatitis C virus (HCV) will spontaneously clear infection. We undertook this study to investigate the impact of alcohol on likelihood of HCV spontaneous viral clearance stratified by sex groups. METHODS Pooled data from an international collaboration of prospective observational studies of incident HIV and HCV infection in high-risk cohorts (the InC3 Study) was restricted to 411 persons (or 560.7 person-years of observation) with documented acute HCV infection and data regarding alcohol use. The predictor of interest was self-reported alcohol use at or after estimated date of incident HCV infection and the outcome was HCV spontaneous clearance. Sex stratified Cox proportional hazards models were used to evaluate the association between alcohol and spontaneous clearance, adjusting for age, race/ethnicity, and IFNL4 genotype. RESULTS The median age was 28.5 years, 30.4% were women, 87.2% were white, and 71.8% reported alcohol use at or after incident infection. There were 89 (21.6%) cases of spontaneous clearance observed, 39 (31.2%) among women and 50 (17.5%) in men (p<0.01). Overall, spontaneous clearance occurred less frequently among participants who drank alcohol compared to those who did not drink (18.9% v. 28.5%, p=0.03). After adjustment for other covariates, alcohol was significantly and independently associated with lower relative hazards for spontaneous clearance of HCV in women (AHR=0.35; 95% CI: 0.19-0.66; p=0.001) but not in men (AHR=0.63; 95% CI: 0.36-1.09; p=0.10). CONCLUSION Results indicate that abstaining from drinking alcohol may increase the likelihood of spontaneous clearance among women.
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Affiliation(s)
- Judith I. Tsui
- Division of General Internal Medicine, Department of Medicine, University of Washington, 325 9th Avenue Seattle, WA 98104, USA,Corresponding author (JT)
| | - Ali Mirzazadeh
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, Second Floor, San Francisco, CA 94158, USA
| | - Judith A. Hahn
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, Second Floor, San Francisco, CA 94158, USA, Department of Medicine, University of California, San Francisco, 3333 California Street, Suite 430, San Francisco, CA 94118, USA
| | - Lisa Maher
- The Kirby Institute, University of New South Wales, Wallace Wurth Building, UNSW Australia, Sydney NSW 2052, Australia
| | - Julie Bruneau
- Centre de Recherche du CHUM, Université de Montréal, 900 Rue Saint-Denis, Montréal, QC H2X 0A9, Canada
| | - Jason Grebely
- The Kirby Institute, University of New South Wales, Wallace Wurth Building, UNSW Australia, Sydney NSW 2052, Australia
| | - Margaret Hellard
- Burnet Institute, 85 Commercial Rd, Melbourne VIC 3004, Australia
| | - Arthur Y. Kim
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Naglaa H. Shoukry
- Centre de Recherche du CHUM, Université de Montréal, 900 Rue Saint-Denis, Montréal, QC H2X 0A9, Canada
| | - Andrea L. Cox
- Department of Medicine, Johns Hopkins Medical Institutions, 1830 E. Monument Street, Baltimore, MD 21287, USA
| | - Maria Prins
- Cluster Infectious Diseases, GGD Public Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, Postbus 2200, 1000 CE Amsterdam, The Netherlands
| | - Gregory Dore
- The Kirby Institute, University of New South Wales, Wallace Wurth Building, UNSW Australia, Sydney NSW 2052, Australia
| | - Georg Lauer
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Andrew Lloyd
- University of New South Wales, School of Medical Sciences, Wallace Wurth Building, UNSW Australia, Sydney NSW 2052, Australia
| | - Kimberly Page
- Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, New Mexico 87131 USA
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Ren Z, Yang F, Wang X, Wang Y, Xu M, Frank JA, Ke ZJ, Zhang Z, Shi X, Luo J. Chronic plus binge ethanol exposure causes more severe pancreatic injury and inflammation. Toxicol Appl Pharmacol 2016; 308:11-19. [PMID: 27538709 DOI: 10.1016/j.taap.2016.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/12/2016] [Accepted: 08/13/2016] [Indexed: 02/06/2023]
Abstract
Alcohol abuse increases the risk for pancreatitis. The pattern of alcohol drinking may impact its effect. We tested a hypothesis that chronic ethanol consumption in combination with binge exposure imposes more severe damage to the pancreas. C57BL/6 mice were divided into four groups: control, chronic ethanol exposure, binge ethanol exposure and chronic plus binge ethanol exposure. For the control group, mice were fed with a liquid diet for two weeks. For the chronic ethanol exposure group, mice were fed with a liquid diet containing 5% ethanol for two weeks. In the binge ethanol exposure group, mice were treated with ethanol by gavage (5g/kg, 25% ethanol w/v) daily for 3days. For the chronic plus binge exposure group, mice were fed with a liquid diet containing 5% ethanol for two weeks and exposed to ethanol by gavage during the last 3days. Chronic and binge exposure alone caused minimal pancreatic injury. However, chronic plus binge ethanol exposure induced significant apoptotic cell death. Chronic plus binge ethanol exposure altered the levels of alpha-amylase, glucose and insulin. Chronic plus binge ethanol exposure caused pancreatic inflammation which was shown by the macrophages infiltration and the increase of cytokines and chemokines. Chronic plus binge ethanol exposure increased the expression of ADH1 and CYP2E1. It also induced endoplasmic reticulum stress which was demonstrated by the unfolded protein response. In addition, chronic plus binge ethanol exposure increased protein oxidation and lipid peroxidation, indicating oxidative stress. Therefore, chronic plus binge ethanol exposure is more detrimental to the pancreas.
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Affiliation(s)
- Zhenhua Ren
- Department of Anatomy, School of Basic Medicine, Anhui Medical University, Hefei, Anhui, China 230032; Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY 40536, United States
| | - Fanmuyi Yang
- Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY 40536, United States
| | - Xin Wang
- Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY 40536, United States
| | - Yongchao Wang
- Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY 40536, United States
| | - Mei Xu
- Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY 40536, United States
| | - Jacqueline A Frank
- Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY 40536, United States
| | - Zun-Ji Ke
- Department of Biochemistry, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Zhuo Zhang
- Department of Toxicology and Cancer Biology, University of Kentucky College of Medicine, Lexington, KY 40536, United States
| | - Xianglin Shi
- Department of Toxicology and Cancer Biology, University of Kentucky College of Medicine, Lexington, KY 40536, United States
| | - Jia Luo
- Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY 40536, United States.
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Agarwal S, Fulgoni VL, Lieberman HR. Assessing alcohol intake & its dose-dependent effects on liver enzymes by 24-h recall and questionnaire using NHANES 2001-2010 data. Nutr J 2016; 15:62. [PMID: 27334005 PMCID: PMC4917983 DOI: 10.1186/s12937-016-0180-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 06/07/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Alcohol is a significant component of the diet with dose-dependent risks and benefits. High doses of alcohol damage the liver and early symptoms of liver disease include changes in routinely assessed liver enzymes. Less is known regarding the mechanisms responsible for the benefits of moderate alcohol consumption, including their effects on the liver. The objectives of this study were to examine alcohol's dose-dependent effects on markers of liver function (alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), and bilirubin), as well as to compare the different methods of assessing alcohol intake using NHANES 2001-2010 adult data (N = 24,807). METHODS Three methods were used to estimate alcohol intake from all volunteers: 24-h recall; the National Cancer Institute (NCI) method of usual intake; and a specific alcohol intake questionnaire. RESULTS Mean alcohol intake by 24-h recall, NCI method and questionnaire was 41.0 ± 0.8 g/d, 10.9 ± 0.2 g/d and 11.0 ± 0.2 g/d, respectively. Alcohol consumers had significantly lower levels of ALP and higher levels of AST, GGT and bilirubin compared to non-consumers (P < 0.01) and activities of ALT, AST, and GGT increased and of ALP decreased as alcohol intake increased, regardless of intake assessment method used. The most sensitive measure of alcohol consumption was GGT. CONCLUSIONS Since alcohol had a graded linear effect on several liver enzymes, including at low and moderate doses, benefits as well as risks of alcohol intake may be related to liver function. Since the NCI method and alcohol questionnaire yielded very similar alcohol intake estimates, this study cross-validated these methods and demonstrated the robustness of the NCI method for estimating intake of irregularly consumed foods.
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Affiliation(s)
- Sanjiv Agarwal
- Oak Ridge Institute for Science and Education, Belcamp, MD, 21017, USA
| | - Victor L Fulgoni
- Oak Ridge Institute for Science and Education, Belcamp, MD, 21017, USA
- Henry M. Jackson Foundation, Bethesda, MD, 20817, USA
| | - Harris R Lieberman
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, 01760-5007, USA.
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13
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de Gaetano G, Costanzo S, Di Castelnuovo A, Badimon L, Bejko D, Alkerwi A, Chiva-Blanch G, Estruch R, La Vecchia C, Panico S, Pounis G, Sofi F, Stranges S, Trevisan M, Ursini F, Cerletti C, Donati MB, Iacoviello L. Effects of moderate beer consumption on health and disease: A consensus document. Nutr Metab Cardiovasc Dis 2016; 26:443-467. [PMID: 27118108 DOI: 10.1016/j.numecd.2016.03.007] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/26/2016] [Accepted: 03/14/2016] [Indexed: 01/09/2023]
Abstract
A large evidence-based review on the effects of a moderate consumption of beer on human health has been conducted by an international panel of experts who reached a full consensus on the present document. Low-moderate (up to 1 drink per day in women, up to 2 in men), non-bingeing beer consumption, reduces the risk of cardiovascular disease. This effect is similar to that of wine, at comparable alcohol amounts. Epidemiological studies suggest that moderate consumption of either beer or wine may confer greater cardiovascular protection than spirits. Although specific data on beer are not conclusive, observational studies seem to indicate that low-moderate alcohol consumption is associated with a reduced risk of developing neurodegenerative disease. There is no evidence that beer drinking is different from other types of alcoholic beverages in respect to risk for some cancers. Evidence consistently suggests a J-shaped relationship between alcohol consumption (including beer) and all-cause mortality, with lower risk for moderate alcohol consumers than for abstainers or heavy drinkers. Unless they are at high risk for alcohol-related cancers or alcohol dependency, there is no reason to discourage healthy adults who are already regular light-moderate beer consumers from continuing. Consumption of beer, at any dosage, is not recommended for children, adolescents, pregnant women, individuals at risk to develop alcoholism, those with cardiomyopathy, cardiac arrhythmias, depression, liver and pancreatic diseases, or anyone engaged in actions that require concentration, skill or coordination. In conclusion, although heavy and excessive beer consumption exerts deleterious effects on the human body, with increased disease risks on many organs and is associated to significant social problems such as addiction, accidents, violence and crime, data reported in this document show evidence for no harm of moderate beer consumption for major chronic conditions and some benefit against cardiovascular disease.
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Affiliation(s)
- G de Gaetano
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy.
| | - S Costanzo
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
| | - A Di Castelnuovo
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
| | - L Badimon
- Cardiovascular Research Center (CSIC-ICCC), Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de Sant Pau, Barcelona, Spain
| | - D Bejko
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - A Alkerwi
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - G Chiva-Blanch
- Cardiovascular Research Center (CSIC-ICCC), Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de Sant Pau, Barcelona, Spain
| | - R Estruch
- Department of Internal Medicine, Hospital Clinic, University of Barcelona, Spain
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - S Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - G Pounis
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
| | - F Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Don Carlo Gnocchi Foundation, ONLUS IRCCS, Florence, Italy
| | - S Stranges
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - F Ursini
- Dipartimento di Medicina Molecolare, Università di Padova, Italy
| | - C Cerletti
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
| | - M B Donati
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
| | - L Iacoviello
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy
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14
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Rehm J, Greenfield TK, Kerr W. Patterns of Drinking and Mortality from Different Diseases—An Overview. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/009145090603300203] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alcohol has been linked to a considerable burden of disease worldwide. Recent epidemiological research has shown that dimensions of alcohol exposure other than average volume are causal in the etiology of disease. Based on a systematic, computer-assisted search, this article attempts a qualitative review of this literature. Results show that cardiovascular disease, especially ischaemic heart disease, is linked to patterns of drinking: regular and light to moderate drinking, and drinking with meals are cardioprotective; heavy drinking occasions have been associated with detrimental outcomes and increases in disease risk. For cancers, consumption of spirits is linked to higher risk of cancers of the upper digestive tract. Spirits also may play a particular role in causing liver cirrhosis in addition to heavy drinking occasions. Finally, injuries are especially related to high blood alcohol concentration and to the frequency of heavy drinking occasions. Overall, these findings strongly indicate that alcohol epidemiology should include adequate pattern measures into future research.
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15
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Mathews S, Feng D, Maricic I, Ju C, Kumar V, Gao B. Invariant natural killer T cells contribute to chronic-plus-binge ethanol-mediated liver injury by promoting hepatic neutrophil infiltration. Cell Mol Immunol 2016; 13:206-16. [PMID: 25661730 PMCID: PMC4786627 DOI: 10.1038/cmi.2015.06] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 01/10/2015] [Indexed: 12/12/2022] Open
Abstract
Neutrophil infiltration is a hallmark of alcoholic steatohepatitis; however, the underlying mechanisms remain unclear. We previously reported that chronic-plus-binge ethanol feeding synergistically induces hepatic recruitment of neutrophils, which contributes to liver injury. In this paper, we investigated the roles of invariant natural killer T (iNKT) cells in chronic-plus-binge ethanol feeding-induced hepatic neutrophil infiltration and liver injury. Wild-type and two strains of iNKT cell-deficient mice (CD1d- and Jα18-deficient mice) were subjected to chronic-plus-binge ethanol feeding. Liver injury and inflammation were examined. Chronic-plus-binge ethanol feeding synergistically increased the number of hepatic iNKT cells and induced their activation, compared with chronic feeding or binge alone. iNKT cell-deficient mice were protected from chronic-plus-binge ethanol-induced hepatic neutrophil infiltration and liver injury. Moreover, chronic-plus-binge ethanol feeding markedly upregulated the hepatic expression of several genes associated with inflammation and neutrophil recruitment in wild-type mice, but induction of these genes was abrogated in iNKT cell-deficient mice. Importantly, several cytokines and chemokines (e.g., MIP-2, MIP-1, IL-4, IL-6 and osteopontin) involved in neutrophil infiltration were upregulated in hepatic NKT cells isolated from chronic-plus-binge ethanol-fed mice compared to pair-fed mice. Finally, treatment with CD1d blocking antibody, which blocks iNKT cell activation, partially prevented chronic-plus-binge ethanol-induced liver injury and inflammation. Chronic-plus-binge ethanol feeding activates hepatic iNKT cells, which play a critical role in the development of early alcoholic liver injury, in part by releasing mediators that recruit neutrophils to the liver, and thus, iNKT cells represent a potential therapeutic target for the treatment of alcoholic liver disease.
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Affiliation(s)
- Stephanie Mathews
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Dechun Feng
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Igor Maricic
- Laboratory of Autoimmunity, Torrey Pines Institute for Molecular Studies, San Diego, CA, USA
| | - Cynthia Ju
- Skaggs School of Pharmacy and Pharmaceutical Sciences and Integrated Immunology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Vipin Kumar
- Laboratory of Autoimmunity, Torrey Pines Institute for Molecular Studies, San Diego, CA, USA
| | - Bin Gao
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
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Abstract
Inflammation contributes to the pathogenesis of most acute and chronic liver diseases. Inflammasomes are multiprotein complexes that can sense danger signals from damaged cells and pathogens and assemble to mediate caspase-1 activation, which proteolytically activates the cytokines IL-1β and IL-18. In contrast to other inflammatory responses, inflammasome activation uniquely requires two signals to induce inflammation, therefore setting an increased threshold. IL-1β, generated upon caspase-1 activation, provides positive feed-forward stimulation for inflammatory cytokines, thereby amplifying inflammation. Inflammasome activation has been studied in different human and experimental liver diseases and has been identified as a major contributor to hepatocyte damage, immune cell activation and amplification of liver inflammation. In this Review, we discuss the different types of inflammasomes, their activation and biological functions in the context of liver injury and disease progression. Specifically, we focus on the triggers of inflammasome activation in alcoholic steatohepatitis and NASH, chronic HCV infection, ischaemia-reperfusion injury and paracetamol-induced liver injury. The application and translation of these discoveries into therapies promises novel approaches in the treatment of inflammation in liver disease.
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Affiliation(s)
- Gyongyi Szabo
- Department of Medicine, University of Massachusetts Medical School, LRB 215, 364 Plantation Street, Worcester, MA 01605, USA
| | - Jan Petrasek
- Department of Medicine, University of Massachusetts Medical School, LRB 215, 364 Plantation Street, Worcester, MA 01605, USA
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17
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Chen YW, Barson JR, Chen A, Hoebel BG, Leibowitz SF. Hypothalamic peptides controlling alcohol intake: differential effects on microstructure of drinking bouts. Alcohol 2014; 48:657-64. [PMID: 25241055 DOI: 10.1016/j.alcohol.2014.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Different alcohol drinking patterns, involving either small and frequent drinking bouts or large and long-lasting bouts, are found to differentially affect the risk for developing alcohol-related diseases, suggesting that they have different underlying mechanisms. Such mechanisms may involve orexigenic peptides known to stimulate alcohol intake through their actions in the hypothalamic paraventricular nucleus (PVN). These include orexin (OX), which is expressed in the perifornical lateral hypothalamus, and galanin (GAL) and enkephalin (ENK), which are expressed within as well as outside the PVN. To investigate the possibility that these peptides affect different aspects of consumption, a microstructural analysis of ethanol drinking behavior was performed in male, Sprague-Dawley rats trained to drink 7% ethanol and implanted with guide shafts aimed at the PVN. While housed in specialized cages containing computerized intake monitors (BioDAQ Laboratory Intake Monitoring System, Research Diets Inc., New Brunswick, NJ) that measure bouts of ethanol drinking, these rats were given PVN injections of OX (0.9 nmol), GAL (1.0 nmol), or the ENK analog D-Ala2-met-enkephalinamide (DALA) (14.2 nmol), as compared to saline vehicle. Results revealed clear differences between the effects of these peptides. While all 3 stimulated ethanol intake, they had distinct effects on patterns of drinking, with OX increasing the number of drinking bouts, GAL increasing the size of the drinking bouts, and DALA increasing both the size and duration of the bouts. In contrast, these peptides had little impact on water or food intake. These results support the idea that different peptides can increase ethanol consumption by promoting distinct aspects of the ethanol drinking response. The stimulatory effect of OX on drinking frequency may be related to its neuronally stimulatory properties, while the stimulatory effect of GAL and ENK on bout size and duration may reflect a suppressive effect of these neuronally inhibitory peptides on the satiety-controlling PVN.
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18
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Bertola A, Park O, Gao B. Chronic plus binge ethanol feeding synergistically induces neutrophil infiltration and liver injury in mice: a critical role for E-selectin. Hepatology 2013; 58:1814-23. [PMID: 23532958 PMCID: PMC3726575 DOI: 10.1002/hep.26419] [Citation(s) in RCA: 214] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 02/20/2013] [Accepted: 03/20/2013] [Indexed: 12/12/2022]
Abstract
UNLABELLED Chronic plus binge ethanol feeding acts synergistically to induce liver injury in mice, but the mechanisms underlying this phenomenon remain unclear. Here, we show that chronic plus binge ethanol feeding synergistically up-regulated the hepatic expression of interleukin-1β and tumor necrosis factor alpha and induced neutrophil accumulation in the liver, compared with chronic or binge feeding alone. In vivo depletion of neutrophils through administration of an anti-Ly6G antibody markedly reduced chronic-binge ethanol feeding-induced liver injury. Real-time polymerase chain reaction analyses revealed that hepatic E-selectin expression was up-regulated 10-fold, whereas expression of other neutrophil infiltration-related adhesion molecules (e.g., P-selectin, intercellular adhesion molecule 1, and vascular cell adhesion molecule 1) was slightly up- or down-regulated in this chronic-binge model. The genetic deletion of E-selectin prevented chronic-binge ethanol-induced hepatic neutrophil infiltration as well as elevation of serum transaminases without affecting ethanol-induced steatosis. In addition, E-selectin-deficient mice showed reduced hepatic expression of several proinflammatory cytokines, chemokines, and adhesion molecules, compared to wild-type mice, after chronic-binge ethanol feeding. Finally, the expression of E-selectin was highly up-regulated in human alcoholic fatty livers, but not in alcoholic cirrhosis. CONCLUSIONS Chronic-binge ethanol feeding up-regulates expression of proinflammatory cytokines, followed by the induction of E-selectin. Elevated E-selectin plays an important role in hepatic neutrophil infiltration and injury induced by chronic-binge feeding in mice and may also contribute to the pathogenesis of early stages of human alcoholic liver disease.
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Affiliation(s)
- Adeline Bertola
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD
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19
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Casale T, Rosati MV, Ciarrocca M, Samperi I, Andreozzi G, Schifano MP, Capozzella A, Pimpinella B, Tomei G, Caciari T, Tomei F. Assessment of liver function in two groups of outdoor workers exposed to arsenic. Int Arch Occup Environ Health 2013; 87:745-52. [DOI: 10.1007/s00420-013-0914-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 10/02/2013] [Indexed: 01/03/2023]
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Abstract
Chronic alcohol consumption is a leading cause of chronic liver disease worldwide, leading to cirrhosis and hepatocellular carcinoma. Currently, the most widely used model for alcoholic liver injury is ad libitum feeding with the Lieber-DeCarli liquid diet containing ethanol for 4-6 weeks; however, this model, without the addition of a secondary insult, only induces mild steatosis, slight elevation of serum alanine transaminase (ALT) and little or no inflammation. Here we describe a simple mouse model of alcoholic liver injury by chronic ethanol feeding (10-d ad libitum oral feeding with the Lieber-DeCarli ethanol liquid diet) plus a single binge ethanol feeding. This protocol for chronic-plus-single-binge ethanol feeding synergistically induces liver injury, inflammation and fatty liver, which mimics acute-on-chronic alcoholic liver injury in patients. This feeding protocol can also be extended to chronic feeding for longer periods of time up to 8 weeks plus single or multiple binges. Chronic-binge ethanol feeding leads to high blood alcohol levels; thus, this simple model will be very useful for the study of alcoholic liver disease (ALD) and of other organs damaged by alcohol consumption.
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21
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Tsai J, Ford ES, Li C, Zhao G. Past and current alcohol consumption patterns and elevations in serum hepatic enzymes among US adults. Addict Behav 2012; 37:78-84. [PMID: 21975024 DOI: 10.1016/j.addbeh.2011.09.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 07/06/2011] [Accepted: 09/01/2011] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The aim of this study was to examine the association between patterns of past and current alcohol consumption and elevations in serum hepatic enzymes among a nationally representative sample of adults in the United States. METHODS We estimated the age-adjusted prevalence of elevated serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) among 8993 adults aged 20 years or older who participated in the 2005-2008 National Health and Nutrition Examination Survey (NHANES). We produced prevalence ratios by using patterns of alcohol consumption as a predictor; elevations in serum ALT, AST, and GGT were used as an outcome variable while adjusting for covariates in multivariate regression models. RESULTS The age-adjusted prevalence of elevated serum ALT, AST, and GGT in adults was 9.7%, 16.0%, and 8.6%, respectively. Male excessive current drinkers had 50%-71% and 75%-314% increased likelihoods of having elevated serum AST and GGT, respectively; female excessive drinkers with a history of consuming 5 or more drinks almost daily had a 226% increased likelihood of having elevated serum GGT, when compared to their respective counterparts who were lifetime abstainers. CONCLUSIONS The results of this study indicate that elevations in serum hepatic enzymes, especially AST and GGT, are common in adults who are excessive current drinkers. There is evidence to suggest that excessive current drinkers with a history of protracted drinking are especially vulnerable to potential liver injury. These findings lend further support to the early identification of excessive drinkers who may have an increased risk for alcohol-related morbidity and mortality in health care settings.
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22
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Tsai J, Ford ES, Zhao G, Croft JB. Multiple health behaviors and serum hepatic enzymes among US adults with obesity. Prev Med 2011; 53:278-83. [PMID: 21893086 DOI: 10.1016/j.ypmed.2011.08.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 08/20/2011] [Accepted: 08/20/2011] [Indexed: 01/01/2023]
Abstract
INTRODUCTION This study was to examine the cumulative number and clustering patterns of low-risk health behaviors (i.e., not currently smoking, not excessive drinking, and physically active) associated with elevation of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) among adults with obesity in the United States. METHODS We estimated the age-adjusted prevalence of elevated ALT, AST, and GGT from 4547 adults with obesity aged ≥ 20 years who participated in the 2005-2008 National Health and Nutrition Examination Survey. The associations between the cumulative number or clustering patterns of low-risk health behaviors and measures of serum ALT, AST, and GGT were assessed using multivariate regression models. RESULTS Adult men who reported having three low-risk health behaviors were 62%, 39%, and 48% less likely to have elevated serum ALT, AST, and GGT, respectively; adult women were 56% and 73% less likely to have elevated serum AST and GGT, respectively, when compared to their respective counterparts who reported having none of the low-risk health behaviors. CONCLUSIONS The findings of this study indicate that, among adults with obesity, having multiple low-risk health behaviors is associated with decreased likelihoods of elevated hepatic enzymes, including ALT in men, AST and GGT in both men and women.
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Affiliation(s)
- James Tsai
- National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention, Atlanta, GA, USA.
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23
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The frequency of daily ethanol consumption influences the effect of ethanol on insulin sensitivity in rats fed a high-fat diet. Br J Nutr 2011; 107:850-7. [PMID: 21892982 DOI: 10.1017/s0007114511003722] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The different effects of ethanol on insulin sensitivity may be due to complex reasons. Here, we focus on the various daily ethanol consumption frequencies in rats fed a high-fat (HF) diet and explore the possible mechanism mediated by adiponectin and AMP-activated protein kinase (AMPK). A total of thirty-six male Wistar rats were fed a HF diet and were randomly divided into three groups: those that received tap water (C); those that received ethanol via a gastric tube twice per d (E1); those that received free access to ethanol for drinking (E2). The total daily ethanol dosage in groups E1 and E2 were the same (5 g/kg per d). At the end of 18 weeks, insulin sensitivity was evaluated. Adiponectin AMPK and GLUT4 levels were determined. We found that the different administration frequencies led to markedly different plasma ethanol concentrations and there were intimate relationships between plasma ethanol concentration and insulin sensitivity. Insulin resistance was markedly improved in group E1, whereas only a slight improvement was observed in group E2. Accordingly, adiponectin, phosphorylated AMPK and GLUT4 levels were significantly increased in group E1. Based on these findings, we propose that ethanol concentration might be the major influencing factor mediating the effect of ethanol on insulin sensitivity. At a total daily dosage of 5 g/kg per d, twice daily administration of ethanol was more beneficial than continuous drinking. The protective effect of ethanol might be mediated by increased adiponectin levels, which subsequently improve the activation of AMPKα and GLUT4 expression in adipose tissue.
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Islam K, Haque A, Karim R, Fajol A, Hossain E, Salam KA, Ali N, Saud ZA, Rahman M, Rahman M, Karim R, Sultana P, Hossain M, Akhand AA, Mandal A, Miyataka H, Himeno S, Hossain K. Dose-response relationship between arsenic exposure and the serum enzymes for liver function tests in the individuals exposed to arsenic: a cross sectional study in Bangladesh. Environ Health 2011; 10:64. [PMID: 21740555 PMCID: PMC3146918 DOI: 10.1186/1476-069x-10-64] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 07/08/2011] [Indexed: 05/05/2023]
Abstract
BACKGROUND Chronic arsenic exposure has been shown to cause liver damage. However, serum hepatic enzyme activity as recognized on liver function tests (LFTs) showing a dose-response relationship with arsenic exposure has not yet been clearly documented. The aim of our study was to investigate the dose-response relationship between arsenic exposure and major serum enzyme marker activity associated with LFTs in the population living in arsenic-endemic areas in Bangladesh. METHODS A total of 200 residents living in arsenic-endemic areas in Bangladesh were selected as study subjects. Arsenic concentrations in the drinking water, hair and nails were measured by Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). The study subjects were stratified into quartile groups as follows, based on concentrations of arsenic in the drinking water, as well as in subjects' hair and nails: lowest, low, medium and high. The serum hepatic enzyme activities of alkaline phosphatase (ALP), aspartate transaminase (AST) and alanine transaminase (ALT) were then assayed. RESULTS Arsenic concentrations in the subjects' hair and nails were positively correlated with arsenic levels in the drinking water. As regards the exposure-response relationship with arsenic in the drinking water, the respective activities of ALP, AST and ALT were found to be significantly increased in the high-exposure groups compared to the lowest-exposure groups before and after adjustments were made for different covariates. With internal exposure markers (arsenic in hair and nails), the ALP, AST and ALT activity profiles assumed a similar shape of dose-response relationship, with very few differences seen in the higher groups compared to the lowest group, most likely due to the temporalities of exposure metrics. CONCLUSIONS The present study demonstrated that arsenic concentrations in the drinking water were strongly correlated with arsenic concentrations in the subjects' hair and nails. Further, this study revealed a novel exposure- and dose- response relationship between arsenic exposure metrics and serum hepatic enzyme activity. Elevated serum hepatic enzyme activities in the higher exposure gradients provided new insights into arsenic-induced liver toxicity that might be helpful for the early prognosis of arsenic-induced liver diseases.
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Affiliation(s)
- Khairul Islam
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh
| | - Abedul Haque
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh
| | - Rezaul Karim
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia-7003, Bangladesh
| | - Abul Fajol
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh
| | - Ekhtear Hossain
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh
| | - Kazi Abdus Salam
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh
| | - Nurshad Ali
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh
| | - Zahangir Alam Saud
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh
| | - Matiar Rahman
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh
| | - Mashiur Rahman
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh
| | | | - Papia Sultana
- Department of Statistics, Rajshahi University, Rajshahi-6205, Bangladesh
| | - Mostaque Hossain
- Department of Medicine, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | - Anwarul Azim Akhand
- Department of Genetic Engineering and Biotechnology, Dhaka University, Dhaka-1000, Bangladesh
| | - Abul Mandal
- System Biology Research Center, University of Skövde, P. O. Box 408, SE-541-28 Skövde, Sweden
| | - Hideki Miyataka
- Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan
| | - Seiichiro Himeno
- Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan
| | - Khaled Hossain
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh
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Tsai J, Ford ES, Zhao G, Li C, Greenlund KJ, Croft JB. Co-occurrence of obesity and patterns of alcohol use associated with elevated serum hepatic enzymes in US adults. J Behav Med 2011; 35:200-10. [PMID: 21626151 DOI: 10.1007/s10865-011-9353-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 05/12/2011] [Indexed: 12/19/2022]
Abstract
The aim of this cross-sectional study was to present nationally representative findings on the co-occurrence of obesity and specific patterns of alcohol use associated with elevated serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) among adults in the United States. We analyzed data from 8,373 adults aged ≥ 20 years who participated in the 2005-2008 National Health and Nutrition Examination Survey. We produced prevalence ratios by using the co-occurrence of obesity (i.e., body mass index ≥ 30.0 kg/m(2) or waist circumference ≥ 102 cm in men and ≥ 88 cm in women) and specific patterns of alcohol use (i.e., non-drinkers, non-excessive drinkers, and excessive drinkers) as a predictor; elevations in serum ALT, AST, and GGT were used as an outcome variable while adjusting for covariates in multivariate regression models. Approximately 34.7% of adult men and 38.6% of adult women in the United States had co-occurrence of obesity and any alcohol use, including 16.4% of men and 9.8% of women who had co-occurrence of obesity and excessive drinking during 2005-2008. When compared to male non-drinkers without obesity after multivariate adjustment, male excessive drinkers with obesity were 3.08 (95% CI: 1.80-5.28), 2.42 (95% CI: 1.80-3.26), and 3.15 (95% CI: 1.82-5.46) times more likely to exhibit elevated serum ALT, AST, and GGT, respectively. Similarly, when compared to female non-drinkers without obesity, female excessive drinkers with obesity were 2.36 (95% CI: 1.38-4.04), 3.27 (95% CI: 1.85-5.78), and 3.43 (95% CI: 2.19-5.40) times more likely to have elevated serum ALT, AST, and GGT, respectively. The co-occurrence of obesity and excessive drinking may place adults at an increased risk for potential liver injury. Our study findings provide support for evidence-based clinical and population-based interventions that integrate health behavior change among adults who have these co-occurring risk factors.
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Affiliation(s)
- James Tsai
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, Mail Stop K67, Atlanta, GA 30341, USA.
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Sung J, Lee K, Song YM. Heritabilities of Alcohol Use Disorders Identification Test (AUDIT) scores and alcohol biomarkers in Koreans: the KoGES (Korean Genome Epi Study) and Healthy Twin Study. Drug Alcohol Depend 2011; 113:104-9. [PMID: 20729011 DOI: 10.1016/j.drugalcdep.2010.07.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2009] [Revised: 03/18/2010] [Accepted: 07/03/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Both the Alcohol Use Disorders Identification Test (AUDIT) and alcohol biomarkers are used to screen for alcohol problems. The purpose of this study was to examine the genetic and environmental contributions to the AUDIT score and alcohol biomarkers in Koreans. METHODS The study included 1678 current alcohol drinkers: 818 Korean twins and 860 their families. The Korean version of AUDIT and alcohol biomarkers, i.e., gamma glutamyltransferase (GGT), alanine aminotransferase (ALT), mean corpuscular volume (MCV), and triglycerides (TG), were studied. The analyses were conducted using variance components method to estimate heritability and common environmental effects, and bivariate analyses for genetic and environmental correlations between the AUDIT score and the biomarkers after adjustment for age, gender, interaction of age and gender, smoking status, the amount of consumed alcohol, body mass index, and education. RESULTS Heritabilities for the AUDIT score were 0.35 and 0.40-0.71 for biomarkers (P<0.001). The risk of alcohol problems using AUDIT score was positively associated with the levels of biomarkers (GGT, MCV, and TG) in men, while the relationship was significant only for MCV in women. Genetic or environmental correlations between the AUDIT score and some of the biomarkers (GGT and MCV) were significant in men, but not significant in women. CONCLUSIONS We found a significant genetic contribution to the AUDIT score and the alcohol biomarkers. As there were significant genetic and environmental relationships between the AUDIT score and the alcohol biomarkers in men, future studies are warranted to identify common genes and environmental effects affecting the relationships.
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Affiliation(s)
- Joohon Sung
- Department of Epidemiology, School of Public Health and Institute of Health and Environment, Seoul National University, 28 Yeongundong, Jongrogu, Seoul 110-744, South Korea
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Haren MT, Li M, Petkov J, McDermott RA. Alcohol, metabolic risk and elevated serum gamma-glutamyl transferase (GGT) in Indigenous Australians. BMC Public Health 2010; 10:454. [PMID: 20682033 PMCID: PMC2920283 DOI: 10.1186/1471-2458-10-454] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 08/03/2010] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The interaction between overweight/obesity and alcohol intake on liver enzyme concentrations have been demonstrated. No studies have yet examined the interaction between metabolic syndrome or multiple metabolic risk factors and alcohol intake on liver enzymes. The aim of this study was to examine if alcohol consumption modifies the effect of metabolic risk on elevated serum GGT in Indigenous Australians. METHODS Data were from N = 2609 Indigenous Australians who participated in a health screening program in rural far north Queensland in 1999-2000 (44.5% response rate). The individual and interactive effects of metabolic risk and alcohol drinking on elevated serum GGT concentrations (>or=50 U/L) were analyzed using logistic regression. RESULTS Overall, 26% of the population had GGT>or=50 U/L. Elevated GGT was associated with alcohol drinking (moderate drinking: OR 2.3 [95%CI 1.6 - 3.2]; risky drinking: OR 6.0 [4.4 - 8.2]), and with abdominal obesity (OR 3.7 [2.5 - 5.6]), adverse metabolic risk cluster profile (OR 3.4 [2.6 - 4.3]) and metabolic syndrome (OR 2.7 [2.1 - 3.5]) after adjustment for age, sex, ethnicity, smoking, physical activity and BMI. The associations of obesity and metabolic syndrome with elevated GGT were similar across alcohol drinking strata, but the association of an adverse metabolic risk cluster profile with elevated GGT was larger in risky drinkers (OR 4.9 [3.7 - 6.7]) than in moderate drinkers (OR 2.8 [1.6 - 4.9]) and abstainers (OR 1.6 [0.9 - 2.8]). CONCLUSIONS In this Indigenous population, an adverse metabolic profile conferred three times the risk of elevated GGT in risky drinkers compared with abstainers, independent of sex and ethnicity. Community interventions need to target both determinants of the population's metabolic status and alcohol consumption to reduce the risk of elevated GGT.
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Affiliation(s)
- Matthew T Haren
- Spencer Gulf Rural Health School (SGRHS), University of South Australia and The University of Adelaide, Whyalla Norrie SA, Australia
- Centre for Rural Health and Community Development (CRHaCD), University of South Australia, Whyalla Norrie SA, Australia
- Sansom Institute, Division of Health Sciences, University of South Australia, Adelaide SA, Australia
| | - Ming Li
- Sansom Institute, Division of Health Sciences, University of South Australia, Adelaide SA, Australia
| | - John Petkov
- Centre for Rural Health and Community Development (CRHaCD), University of South Australia, Whyalla Norrie SA, Australia
- Applied Statistics Unit, Centre for Regional Engagement, University of South Australia, Mount Gambier SA, Australia
| | - Robyn A McDermott
- Sansom Institute, Division of Health Sciences, University of South Australia, Adelaide SA, Australia
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Wu CY, Lin HL, Chen CW, Lin JN, Kuo LC, Cheng YC, Lin TY, Lee WC. Relationship Between Blood Alcohol Concentration and Hepatic Enzymes in an Emergency Department. Tzu Chi Med J 2010. [DOI: 10.1016/s1016-3190(10)60031-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Rahmioglu N, Andrew T, Cherkas L, Surdulescu G, Swaminathan R, Spector T, Ahmadi KR. Epidemiology and genetic epidemiology of the liver function test proteins. PLoS One 2009; 4:e4435. [PMID: 19209234 PMCID: PMC2636884 DOI: 10.1371/journal.pone.0004435] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Accepted: 12/23/2008] [Indexed: 12/23/2022] Open
Abstract
Background The liver function test (LFT) is among the most commonly used clinical investigations to assess hepatic function, severity of liver diseases and the effect of therapies, as well as to detect drug-induced liver injury (DILI). Aims To determine the relative contribution of genetic and environmental factors as well as test and quantify the effects of sex, age, BMI and alcohol consumption to variation in liver function test proteins - including alanine amino transaminase (ALT), Albumin, gamma glutamyl transpeptidase (GGT), total bilirubin, total protein, total globulin, aspartate transaminase (AST), and alkaline phosphotase (ALP) - using the classical twin model. Methods Blood samples were collected from a total of 5380 twin pairs from the TwinsUK registry. We measured the expression levels of major proteins associated with the LFT, calculated BMI from measured weight and height and questionnaires were completed for alcohol consumption by the twins. The relative contribution of genetic and environmental factors to variation in the LFT proteins was assessed and quantified using a variance components model fitting approach. Results Our results show that (1) variation in all the LFTs has a significant heritable basis (h2 ranging from 20% to 77%); (2) other than GGT, the LFTs are all affected to some extent by common environmental factors (c2 ranging from 24% to 54%); and (3) a small but significant proportion of the variation in the LFTs was due to confounding effects of age, sex, BMI, and alcohol use. Conclusions Variation in the LFT proteins is under significant genetic and common environmental control although sex, alcohol use, age and BMI also contribute significantly to inter-individual variation in the LFT proteins. Understanding the underlying genetic contribution of liver function tests may help the interpretation of their results and explain wide variation among individuals.
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Affiliation(s)
- Nilufer Rahmioglu
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Toby Andrew
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Lynn Cherkas
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Gabriela Surdulescu
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | | | - Tim Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Kourosh R. Ahmadi
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- * E-mail:
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Heeb JL, Gmel G, Rehm J, Mohler-Kuo M. Exploring daily variations of drinking in the Swiss general population. A growth curve analysis. Int J Methods Psychiatr Res 2008; 17:1-11. [PMID: 18286462 PMCID: PMC6878556 DOI: 10.1002/mpr.238] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This study aims to address the underlying trajectories of weekly individual drinking patterns by growth models and to relate differences in drinking patterns to socio-demographic and drinking characteristics of respondents. Data came from a two-stage stratified random subsample of 747 persons aged 15 years or more from a Swiss study on alcohol consumption using a within-subject design conducted between March 1999 and July 1999. Beverage specific assessment of daily alcohol consumption was obtained by a weekly drinking diary and other characteristics via telephone interviews. The diary had to be filled out on seven consecutive days. The growth models accounted for up to 37.6% of the initial error variance and provided evidence for two distinct, negatively correlated underlying trajectories of drinking patterns. The first trajectory described an increase in consumption from Monday to Sunday. The second trajectory was about a specific weekend consumption culminating on Saturday with a significantly higher growth rate among young people and heavy episodic drinkers than in other subgroups. Therefore, young and heavy episodic drinkers may be exposed to sudden adverse consequences of alcohol consumption during the weekend. Prevention efforts which are targeted to this subgroup should take its specific drinking pattern into account.
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Affiliation(s)
- Jean-Luc Heeb
- Swiss Institute for the Prevention of Alcohol and other Drug Problems, Lausanne, Switzerland.
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Fan AZ, Russell M, Stranges S, Dorn J, Trevisan M. Association of lifetime alcohol drinking trajectories with cardiometabolic risk. J Clin Endocrinol Metab 2008; 93:154-61. [PMID: 18029458 PMCID: PMC2190740 DOI: 10.1210/jc.2007-1395] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT AND OBJECTIVE Alcohol intakes may vary considerably over a drinker's lifetime. This study was designed to examine whether lifetime drinking trajectories are associated with cardiovascular risk factors that are used to define the metabolic syndrome (MetS). DESIGN, SETTING, PARTICIPANTS, AND OUTCOMES: This is a population-based cross-sectional study. Participants were ever-regular drinkers (n = 2818) selected from healthy controls for the Western New York Health Study (1996-2001) in which lifetime lifestyle was ascertained retrospectively. Prevalence of the MetS and its individual components, including obesity, high triglycerides, low high-density lipoprotein cholesterol, elevated blood pressure, and high fasting glucose, were the main outcomes. RESULTS Trajectory analyses were based on estimates of total kilograms of ethanol for each age decade between 10 and 59 yr. Two groups of drinkers with distinct lifetime drinking trajectories were obtained, an early peak and a stable trajectory group. Compared with stable trajectory drinkers, early-peak drinkers were 10 yr younger on average, had earlier onset of regular drinking, drank heavily in late adolescence and early adulthood tapering off in middle age, averaged more drinks per drinking day in lifetime, and were more likely to abstain when interviewed. After controlling for age, sex, and other potential confounders, early-peak trajectories were modestly associated with high odds of the MetS [1.31; 95% confidence interval (CI) 1.00, 1.71] overall, low high-density lipoprotein cholesterol (1.62; 95% CI 1.27, 2.08), abdominal obesity (1.48; 95% CI 1.23, 1.78), and overweight (1.32; 95% CI 1.10, 1.60). CONCLUSION Early initiation of alcohol drinking and heavy drinking in adolescence and early adulthood may be associated with an adverse cardiometabolic profile.
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Affiliation(s)
- Amy Z Fan
- Pacific Institute for Research and Evaluation, Prevention Research Center, 1995 University Avenue, Suite 450, Berkeley, California 94704, USA
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Abstract
Alcoholism results from an interplay between genetic and environmental factors, and is linked to brain defects and associated cognitive, emotional, and behavioral impairments. A confluence of findings from neuroimaging, physiological, neuropathological, and neuropsychological studies of alcoholics indicate that the frontal lobes, limbic system, and cerebellum are particularly vulnerable to damage and dysfunction. An integrative approach employing a variety of neuroscientific technologies is essential for recognizing the interconnectivity of the different functional systems affected by alcoholism. In that way, relevant experimental techniques can be applied to assist in determining the degree to which abstinence and treatment contribute to the reversal of atrophy and dysfunction.
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Affiliation(s)
- Marlene Oscar-Berman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, L-815, 715 Albany Street, Boston, MA 02118, USA.
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Nasim A, Belgrave FZ, Jagers RJ, Wilson KD, Owens K. The moderating effects of culture on peer deviance and alcohol use among high-risk African-American Adolescents. JOURNAL OF DRUG EDUCATION 2007; 37:335-363. [PMID: 18047186 DOI: 10.2190/de.37.3.g] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
African-American adolescents have lower rates of alcohol consumption than White youth. However, African-American youth suffer disproportionately more adverse social, mental, and physical health outcomes related to alcohol use. Affiliating with negative peers is a risk factor for alcohol initiation and consumption. Cultural variables have shown moderating effects against other risk factors for African-American youth and therefore were the focus of this study. Specifically, we tested whether three culturally-relevant variables, Africentric beliefs, religiosity, and ethnic identity were promotive or protective for alcohol initiation and use within the context of negative peer affiliations. The sample consisted of 114 at-risk African-American adolescents whose ages ranged from 13 to 20. Participants were administered a questionnaire with measures of alcohol initiation and use, peer risk behaviors, ethnic identity, Africentric beliefs, religiosity, and demographic items. Peer risk behaviors accounted for significant percentages of the variance in age of alcohol initiation, lifetime use, and current and heavy alcohol use after adjusting for age and gender. Cultural variables showed both promotive and protective effects. Africentric beliefs were promotive of delayed alcohol initiation, whereas both Africentrism and religiosity moderated peer risk behaviors effect on alcohol initiation. Africentric beliefs were also inversely related to lifetime alcohol use revealing a promotive effect. Moreover, there were significant protective effects of ethnic identity and religiosity on heavy alcohol consumption. One implication of these findings is that prevention programs that infuse cultural values and practices such as Africentrism, ethnic identity, and religiosity may delay alcohol initiation and reduce use especially for youth with high risk peers.
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Affiliation(s)
- Aashir Nasim
- Center for Preventive Health Research on Children and Adolescents, Department of Psychology, Virginia State University, Petersburg 23806, USA.
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Blanco PG, Salem RO, Ollero M, Zaman MM, Cluette-Brown JE, Freedman SD, Laposata M. Ethanol administration to cystic fibrosis knockout mice results in increased fatty acid ethyl ester production. Alcohol Clin Exp Res 2006; 29:2039-45. [PMID: 16340462 DOI: 10.1097/01.alc.0000187593.86202.e8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Fatty acid ethyl esters (FAEE) are nonoxidative ethanol metabolites shown to produce toxic effects in the liver and pancreas in vivo and in vitro. Because alcohol-induced chronic pancreatitis is associated with mutations in the gene responsible for cystic fibrosis (CFTR), we hypothesized that CFTR dysfunction leads to increased levels of these toxic nonoxidative ethanol metabolites following alcohol administration. METHODS Cystic fibrosis (CF) and wild-type (WT) mice were injected intraperitoneally with 1, 2, or 3 g/kg of 50% ethanol. Mice were sacrificed and the liver and pancreas removed for FAEE analysis. RESULTS The mean FAEE concentration (pmol/g) detected in the liver of cftr mice following injection with 2 g/kg of ethanol was significantly greater than the amount detected in WT (p < 0.005). A similar trend in FAEE concentration was seen in the pancreas, but the difference was not statistically different. In both the liver and pancreas, analysis of individual FAEE species demonstrated a selective increase in ethyl oleate. CONCLUSION These data show an association between CFTR dysfunction and qualitative and quantitative changes in FAEE in liver and pancreas upon ethanol exposure.
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Affiliation(s)
- Paola G Blanco
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Berner MM, Bentele M, Kriston L, Mänz C, Clement HW, Härter M, Mundle G. DOVER and QUVER-new marker combinations to detect and monitor at-risk drinking. Alcohol Clin Exp Res 2006; 30:1372-80. [PMID: 16899040 DOI: 10.1111/j.1530-0277.2006.00163.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND At-risk drinking is a common medical problem. "Objective" laboratory tests are widely used, especially in situations where it might be favorable for the patient to dissimulate the existing alcohol problem. In this study, we report a new approach to combine the biological markers % carbohydrate-deficient transferrin (%CDT) and gamma-glutamyltransferase (gammaGT) to increase diagnostic properties to identify patients with at-risk drinking behavior. METHODS Fifty-eight general practitioners (GPs) participated in the study at 2 study sites in South-West Germany. Patients filled in a questionnaire that included the Alcohol Use Disorders Identification Test (AUDIT) and gave a blood sample. The GP recorded his assessment about the presence of an alcohol-related disorder in the patient. Screening results of 1 test center were used as a calculation sample. The results at the other site were used to cross-validate the study outcomes. The markers were combined by 2 methods. The first approach used the AUDIT (QUestionnaire VERified; QUVER), and the second was performed using the clinical judgment of the treating GP (DOctor VERified; DOVER). The formulas were calculated using linear and logistic regression models, respectively. RESULTS A total of 2,940 patients participated in the study, of whom 2,496 completed data sets that could be used for further analysis. In the receiver-operating characteristics (ROC) curves with the reference standard of an AUDIT> or =8, the area under the curve (AUC) of 78.8% for DOVER and 80.6% (QUVER) are in a higher range than the values for gamma-%CDT (75.4%) or gamma-GT (66.3%) and %CDT (74.3%) and suggest a clear superiority of the proposed marker combinations. Regarding the combinations DOVER and QUVER, the cross-validation results were almost identical, with 78.4/78.8% and 80.6/79.5%, respectively. CONCLUSION Our study is to date the largest practice-based trial that examines the value of the markers CDT and gamma-GT and their combinations for the screening of at-risk drinking in general practice under routine conditions. Our ROC analysis clearly demonstrated that the combination of the markers gamma-GT and %CDT under routine conditions with a behaviorally oriented reference standard leads to an improvement of diagnostic performance, more so than the use of single markers.
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Affiliation(s)
- Michael M Berner
- Department of Psychiatry and Psychotherapy, Freiburg University Hospital, Freiburg, Germany.
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Banerjee A, Burghardt RC, Johnson GA, White FJ, Ramaiah SK. The temporal expression of osteopontin (SPP-1) in the rodent model of alcoholic steatohepatitis: a potential biomarker. Toxicol Pathol 2006; 34:373-84. [PMID: 16844665 DOI: 10.1080/01926230600806543] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Previous studies from our laboratory have shown that osteopontin (OPN) mediates neutrophil infiltration into the liver in a rodent model of alcoholic steatohepatitis (ASH). The objective of this study was to investigate the temporal and spatial pattern of hepatic OPN mRNA and protein expression during the progression of alcoholic liver disease. OPN mRNA and protein expression were evaluated using real time PCR, in situ hybridization, Western blot and immunohistochemistry respectively. ASH was induced in male Sprague-Dawley rats by feeding EtOH-containing Lieber-DeCarli diet for 6 weeks, followed by a single injection of lipopolysaccharide (LPS, 10 mg/kg, ip). Rats were sacrificed 2-, 12-and 24-hour post LPS injection. A progressive induction of OPN mRNA was observed that preceded hepatic neutrophil infiltration and the increase in OPN mRNA correlated with increases in OPN protein expression. OPN mRNA was localized primarily to the biliary epithelium. The data indicates that OPN is transcribed and translated within the biliary epithelium. These findings suggest a potential role of OPN as an early biomarker in predicting inflammatory liver diseases such as ASH.
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Affiliation(s)
- Atrayee Banerjee
- Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843-4467, USA
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Affiliation(s)
- Sylvie Naveau
- Service d'Hépato-Gastroentérologie, Hôpital Antoine Béclère, Clamart.
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Affiliation(s)
- Robin Room
- Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-106 91 Stockholm, Sweden.
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Munafò MR, Johnstone EC, Welsh KI, Walton RT. Association between the DRD2 gene Taq1A (C32806T) polymorphism and alcohol consumption in social drinkers. THE PHARMACOGENOMICS JOURNAL 2005; 5:96-101. [PMID: 15668731 DOI: 10.1038/sj.tpj.6500294] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An association between the DRD2 Taq1A (C32806T) polymorphism and social alcohol consumption in the opposite direction to that reported for alcoholism has recently been reported in a male Finnish sample. We attempted to replicate these findings in two independent samples, and extend on previous work by including female participants. The DRD2 A1 allele was significantly associated with reduced alcohol consumption in sample one (P=0.004) and sample two (P=0.015). In sample two there was a significant genotype x sex interaction (P=0.016), with the association of the A1 allele and reduced alcohol consumption significant in men only. This interaction was marginally significant (P=0.042) in a meta-analysis of combined data from both samples, and the main effect of genotype highly significant (P<0.001). Age at time of data collection and cigarette consumption were entered as covariates in all analyses. These results replicate recent previous findings and suggest a possibility that this association may exist in men only, or be stronger in men.
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Affiliation(s)
- M R Munafò
- Cancer Research UK General Practice Research Group, Department of Clinical Pharmacology, University of Oxford, Oxford, UK.
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