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Miyagi S, Takamura T, Nguyen TTT, Tsujiguchi H, Hara A, Nakamura H, Suzuki K, Tajima A, Kannon T, Toyama T, Kambayashi Y, Nakamura H. Moderate alcohol consumption is associated with impaired insulin secretion and fasting glucose in non-obese non-diabetic men. J Diabetes Investig 2021; 12:869-876. [PMID: 32910554 PMCID: PMC8089003 DOI: 10.1111/jdi.13402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/28/2020] [Accepted: 09/03/2020] [Indexed: 12/22/2022] Open
Abstract
AIMS/INTRODUCTION A low insulin secretion capacity has been implicated in the high prevalence of non-obese diabetes in East Asians. As alcohol consumption alters insulin and glucose metabolism, we tested the hypothesis that alcohol consumption contributes to impaired insulin secretion and glucose intolerance in lean/normal-weight non-diabetic Japanese men. MATERIALS AND METHODS This cross-sectional study was undertaken among the residents of Shika town, Japan, between 2011 and 2017. A total of 402 non-diabetic men, including participants with normal fasting plasma glucose (FPG) and impaired FPG (FPG 5.6-6.9 mmol/L), and aged ≥40 years, were examined. FPG, the homeostasis model assessment of insulin secretion capacity (HOMA-B) and alcohol consumption were evaluated and compared between the body mass index (BMI) <25 and BMI ≥25 groups. RESULTS HOMA-B levels were lower in the BMI <25 group than in the BMI ≥25 group. Alcohol consumption correlated with a low HOMA-B level regardless of BMI, and, thus, the HOMA-B levels of alcohol drinkers were significantly lower in the BMI <25 group. A multivariable logistic regression analysis showed that alcohol consumption, even light-to-moderate consumption (1-25 g/day), was associated with significantly low levels of HOMA-B and impaired FPG in the BMI <25 group. Among participants with impaired FPG, a low level of HOMA-B was observed in alcohol drinkers, but not in non-drinkers. In contrast, light-to-moderate alcohol consumption was not related to HOMA-B or FPG in the BMI ≥25-group. CONCLUSION Alcohol consumption, even a small amount, might contribute to reductions in HOMA-B levels and impaired FPG in lean/normal-weight Japanese men.
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Affiliation(s)
- Sakae Miyagi
- Department of Environmental and Preventive MedicineGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaJapan
- Innovative Clinical Research CenterKanazawa UniversityKanazawaJapan
| | - Toshinari Takamura
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawa UniversityKanazawaJapan
| | - Thao Thi Thu Nguyen
- Department of Environmental and Preventive MedicineGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaJapan
| | - Hiromasa Tsujiguchi
- Department of Environmental and Preventive MedicineGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaJapan
| | - Akinori Hara
- Department of Environmental and Preventive MedicineGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaJapan
| | - Haruki Nakamura
- Department of Environmental and Preventive MedicineGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaJapan
| | - Keita Suzuki
- Department of Environmental and Preventive MedicineGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaJapan
| | - Atsushi Tajima
- Department of Bioinformatics and GenomicsGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaJapan
| | - Takayuki Kannon
- Department of Bioinformatics and GenomicsGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaJapan
| | - Tadashi Toyama
- Innovative Clinical Research CenterKanazawa UniversityKanazawaJapan
| | - Yasuhiro Kambayashi
- Department of Public HealthFaculty of VeterinaryOkayama University of ScienceOkayamaJapan
| | - Hiroyuki Nakamura
- Department of Environmental and Preventive MedicineGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaJapan
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Edwards AC, Heron J, Hibbeln J, Schuckit MA, Webb BT, Hickman M, Davies AG, Bettinger JC. Long-Chain ω-3 Levels Are Associated With Increased Alcohol Sensitivity in a Population-Based Sample of Adolescents. Alcohol Clin Exp Res 2019; 43:2620-2626. [PMID: 31589770 PMCID: PMC6904498 DOI: 10.1111/acer.14212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 10/01/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND The levels of the ω-3 long-chain polyunsaturated fatty acids (ω-3 LC-PUFAs), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been associated with alcohol sensitivity in vertebrate and invertebrate model systems, but prior studies have not examined this association in human samples despite evidence of associations between ω-3 LC-PUFA levels and alcohol-related phenotypes. Both alcohol sensitivity and ω-3 LC-PUFA levels are impacted by genetic factors, and these influences may contribute to observed associations between phenotypes. Given the potential for using EPA and DHA supplementation in adjuvant care for alcohol misuse and other outcomes, it is important to clarify how ω-3 LC-PUFA levels relate to alcohol sensitivity. METHODS Analyses were conducted using data from the Avon Longitudinal Study of Parents and Children. Plasma ω-3 LC-PUFA levels were measured at ages 15.5 and 17.5. Participants reported on their initial alcohol sensitivity using the early drinking Self-Rating of the Effects of Alcohol (SRE-5) scale, for which more drinks needed for effects indicates lower levels of response per drink, at ages 15.5, 16.5, and 17.5. Polygenic liability for alcohol consumption, alcohol problems, EPA levels, and DHA levels was derived using summary statistics from large, publicly available datasets. Linear regressions were used to examine the cross-sectional and longitudinal associations between ω-3 LC-PUFA levels and SRE scores. RESULTS Age 15.5 ω-3 LC-PUFA levels were negatively associated with contemporaneous SRE scores and with age 17.5 SRE scores. One modest association (p = 0.02) between polygenic liability and SRE scores was observed, between alcohol problems-based polygenic risk scores (PRS) and age 16.5 SRE scores. Tests of moderation by genetic liability were not warranted. CONCLUSIONS Plasma ω-3 LC-PUFA levels may be related to initial sensitivity to alcohol during adolescence. These data indicate that diet-related factors have the potential to impact humans' earliest responses to alcohol exposure.
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Affiliation(s)
- Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, US
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Joseph Hibbeln
- Section on Nutritional Neurosciences, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, US
| | - Marc A. Schuckit
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, US
| | - Bradley T. Webb
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, US
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Andrew G. Davies
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, US
| | - Jill C. Bettinger
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, US
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Abstract
INTRODUCTION: The Federal Aviation Administration Office of Aerospace Medicine (AAM) is required by law to identify pilots who have driving under the influence (DUI) convictions. It is the responsibility of AAM to determine, based on the DUI, if the pilot has a drinking problem and needs follow-up treatment. Pilots with alcohol problems are at risk to themselves and the public and need to have treatment to reduce the extent of the risk. It has been suggested by some that a blood alcohol concentration (BAC) of 0.15 g · dL-1 is evidence of tolerance and the pilot should be placed in an alcohol treatment program.METHOD: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) Clinician's Guide considers a person at risk for a drinking problem when a man drinks 5 or more drinks or a woman drinks 4 or more drinks in a day and reaches a 0.08 g · dL-1 of ethanol in the blood. It is possible to estimate from a BAC or breath alcohol concentration (BrAC) the number of drinks consumed using the volume of distribution for ethanol and the weight of the individual. A spread sheet tool was developed to estimate the number of drinks consumed.RESULTS: It was determined that DUI/DWI concentrations could be used to determine the minimum number of drinks consumed. Overweight people reach binge drinking levels and higher Hingson levels at lower DUI/DWI concentrations than people with an average weight or lower.DISCUSSION: Using this tool there is a high probability (99.7%) of identifying a true binge drinker.Canfield DV, Forster EM, Cheong Z-I, Cowan JM. Breath/blood alcohol concentration as an indicator of alcohol use problems. Aerosp Med Hum Perform. 2019; 90(5):488-491.
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García-Marchena N, Silva-Peña D, Martín-Velasco AI, Villanúa MÁ, Araos P, Pedraz M, Maza-Quiroga R, Romero-Sanchiz P, Rubio G, Castilla-Ortega E, Suárez J, Rodríguez de Fonseca F, Serrano A, Pavón FJ. Decreased plasma concentrations of BDNF and IGF-1 in abstinent patients with alcohol use disorders. PLoS One 2017; 12:e0187634. [PMID: 29108028 PMCID: PMC5673472 DOI: 10.1371/journal.pone.0187634] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/23/2017] [Indexed: 12/27/2022] Open
Abstract
The identification of growth factors as potential biomarkers in alcohol addiction may help to understand underlying mechanisms associated with the pathogenesis of alcohol use disorders (AUDs). Previous studies have linked growth factors to neural plasticity in neurocognitive impairment and mental disorders. In order to further clarify the impact of chronic alcohol consumption on circulating growth factors, a cross-sectional study was performed in abstinent AUD patients (alcohol group, N = 91) and healthy control subjects (control group, N = 55) to examine plasma concentrations of brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1) and IGF-1 binding protein-3 (IGFBP-3). The association of these plasma peptides with relevant AUD-related variables and psychiatric comorbidity was explored. The alcohol group was diagnosed with severe AUD and showed an average of 13 years of problematic use and 10 months of abstinence at the moment of participating in the study. Regarding common medical conditions associated with AUD, we observed an elevated incidence of alcohol-induced liver and pancreas diseases (18.7%) and psychiatric comorbidity (76.9%). Thus, AUD patients displayed a high prevalence of dual diagnosis (39.3%) [mainly depression (19.9%)] and comorbid substance use disorders (40.7%). Plasma BDNF and IGF-1 concentrations were significantly lower in the alcohol group than in the control group (p<0.001). Remarkably, there was a negative association between IGF-1 concentrations and age in the control group (r = -0.52, p<0.001) that was not found in the alcohol group. Concerning AUD-related variables, AUD patients with liver and pancreas diseases showed even lower concentrations of BDNF (p<0.05). In contrast, the changes in plasma concentrations of these peptides were not associated with abstinence, problematic use, AUD severity or lifetime psychiatric comorbidity. These results suggest that further research is necessary to elucidate the role of BDNF in alcohol-induced toxicity and the biological significance of the lack of correlation between age and plasma IGF-1 levels in abstinent AUD patients.
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Affiliation(s)
- Nuria García-Marchena
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Daniel Silva-Peña
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | | | - María Ángeles Villanúa
- Departamento de Fisiología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Pedro Araos
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - María Pedraz
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Rosa Maza-Quiroga
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Pablo Romero-Sanchiz
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Gabriel Rubio
- Instituto i+12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Estela Castilla-Ortega
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Juan Suárez
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Fernando Rodríguez de Fonseca
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
- * E-mail: (FRF); (AS); (FJP)
| | - Antonia Serrano
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
- * E-mail: (FRF); (AS); (FJP)
| | - Francisco Javier Pavón
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
- * E-mail: (FRF); (AS); (FJP)
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Gordon A, Jaffe A, McLellan AT, Richardson G, Skipper G, Sucher M, Tirado CF, Urschel HC. How Should Remote Clinical Monitoring Be Used to Treat Alcohol Use Disorders?: Initial Findings From an Expert Round Table Discussion. J Addict Med 2017; 11:145-153. [PMID: 28157829 PMCID: PMC5367507 DOI: 10.1097/adm.0000000000000288] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 11/12/2016] [Indexed: 01/12/2023]
Abstract
Scientific evidence combined with new health insurance coverage now enable a chronic illness management approach to the treatment of alcohol use disorders (AUDs), including regular monitoring of blood alcohol content (BAC), as a useful indicator of disease control. Recent technical advances now permit many different types of remote, real-time monitoring of BAC. However, there is no body of research to empirically guide clinicians in how to maximize the clinical potential of remote BAC monitoring.As an initial step in guiding and supporting such research, the manufacturer of one remote BAC monitoring system sponsored a group of experienced clinicians and clinical researchers to discuss 8 issues that generally affect remote, clinical BAC monitoring of "adults in outpatient AUD treatment."The expert panel unanimously agreed that remote BAC monitoring for at least 12 months during and after the outpatient treatment of AUD was a clinically viable deterrent to relapse. There was also consensus that positive test results (ie, recent alcohol use) should lead to intensified care and monitoring. However, there was no agreement on specific types of clinical intensification after a positive test. The panel agreed that sharing positive and negative test results with members of the patient support group was helpful in reinforcing abstinence, yet they noted many practical issues regarding information sharing that remain concerning. Significant differences within the panel on several important clinical issues underline the need for more clinical and implementation research to produce empirically-supported guidelines for the use of remote BAC monitoring in AUD treatment.
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Affiliation(s)
- Alan Gordon
- Treatment Research Institute (ATM), Philadelphia, PA; Butler Hospital (AG), Providence, RI; Alternatives Behavioral Health (AJ), LLC, Los Angeles, CA; Edgewood Health Network (GR), British Columbia, Canada; Promises Professionals Treatment Program (GS), Santa Monica, CA; Greenberg & Sucher PC (MS), Scottsdale, AZ; ABRI Integrated Health, LLC (CT), Austin; Enterhealth LLC (HCU), Dallas, TX
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Mackus M, van de Loo AJAE, Raasveld SJ, Hogewoning A, Sastre Toraño J, Flesch FM, Korte‐Bouws GAH, van Neer RHP, Wang X, Nguyen TT, Brookhuis KA, Kraneveld AD, Garssen J, Verster JC. Biomarkers of the alcohol hangover state: Ethyl glucuronide (EtG) and ethyl sulfate (EtS). Hum Psychopharmacol 2017; 32:e2624. [PMID: 28685869 PMCID: PMC5637917 DOI: 10.1002/hup.2624] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 05/23/2017] [Accepted: 06/08/2017] [Indexed: 12/02/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the usefulness of ethyl glucuronide (EtG) and ethyl sulfate (EtS) as biomarkers of the hangover state. METHODS Thirty-sixhealthy social drinkers participated in this study, being of naturalistic design. Eighteen participants experience regular hangovers (the hangover group), whereas the other 18 claim to not experience a hangover (the hangover-immune group). On a control day (alcohol-free) day and a post-alcohol day, urine EtG and EtS concentrations were determined and hangover severity assessed. RESULTS Urinary EtG and EtS concentrations were significantly increased on post-alcohol day compared to the control day (p = .0001). Both EtG and EtS concentrations did not significantly correlate with the overall hangover score, nor with the estimated peak blood alcohol concentrations and number of alcoholic drinks. EtG correlated significantly only with the individual hangover symptom "headache" (p = .033; r = .403). No significant correlations were found with the EtG to EtS ratio. EtG and EtS concentrations significantly correlated with urine ethanol concentrations. CONCLUSIONS Although urine EtG and EtS concentration did not significantly correlate to estimated peak blood alcohol concentrations or the number of alcoholic drinks consumed, a significant correlation was found with urine ethanol concentration. However, urine EtG and EtS concentrations did not significantly correlate with overall hangover severity.
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Affiliation(s)
- Marlou Mackus
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
| | - Aurora J. A. E. van de Loo
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
- Institute for Risk Assessment Sciences (IRAS)Utrecht UniversityUtrechtThe Netherlands
| | - S. Jorinde Raasveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
| | - Anna Hogewoning
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
| | - Javier Sastre Toraño
- Division of Chemical Biology and Drug Discovery, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
| | - Frits M. Flesch
- Division of Chemical Biology and Drug Discovery, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
| | - Gerdien A. H. Korte‐Bouws
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
| | - Renier H. P. van Neer
- Division of Chemical Biology and Drug Discovery, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
| | - Xiaochun Wang
- Division of Chemical Biology and Drug Discovery, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
| | - Thomas T. Nguyen
- Division of Chemical Biology and Drug Discovery, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
| | - Karel A. Brookhuis
- Faculty of Behavioral and Social SciencesGroningen UniversityGroningenThe Netherlands
| | - Aletta D. Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
- Institute for Risk Assessment Sciences (IRAS)Utrecht UniversityUtrechtThe Netherlands
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
- Nutricia ResearchUtrechtThe Netherlands
| | - Joris C. Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS)Utrecht UniversityUtrechtThe Netherlands
- Institute for Risk Assessment Sciences (IRAS)Utrecht UniversityUtrechtThe Netherlands
- Centre for Human PsychopharmacologySwinburne UniversityMelbourneVICAustralia
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Saissi F, Caflisch C. [Not Available]. Praxis (Bern 1994) 2017; 106:503-510. [PMID: 28488530 DOI: 10.1024/1661-8157/a002682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Zusammenfassung. Alkoholkonsum ist in der Schweiz weit verbreitet; nur ein geringer Teil der Bevölkerung lebt abstinent, rund 250 000 Personen sind alkoholabhängig. Der gesundheitliche und wirtschaftliche Schaden durch Alkohol ist signifikant. Gleichzeitig stellen Erkennung und Behandlung alkoholbedingter Störungen eine grosse Herausforderung für die Grundversorger dar. Das ärztliche Gespräch bleibt dabei wichtigstes diagnostisches und therapeutisches Instrument, Laborwerte und Fragebögen können eine ergänzende Rolle spielen. In der sich traditionell in akut und postakut untergliedernden Behandlung stellt die wichtigste Neuerung der vergangenen Jahre die Anerkennung der Trinkmengenreduktion als zumindest intermediäres Behandlungsziel dar. In Prävention und Erkennung alkoholbezogener Störungen kommt den Grundversorgern eine Schlüsselrolle zu, weshalb die Kenntnis möglicher Interventionsmöglichkeiten essentiell ist.
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Affiliation(s)
| | - Carlo Caflisch
- 2 Zentrum für Abhängigkeitserkrankungen, Psychiatrische Universitätsklinik Zürich
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Hirata T, Higashiyama A, Kubota Y, Sugiyama D, Kuwabara K, Tatsumi Y, Hirata A, Nishida Y, Kadota A, Imano H, Nishikawa T, Miyamatsu N, Miyamoto Y, Okamura T. Impact of Flushing Response on the Relationship between Alcohol Consumption and Gamma-glutamyl Transpeptidase: the KOBE study. Nihon Arukoru Yakubutsu Igakkai Zasshi 2016; 51:173-183. [PMID: 30480903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Individuals with an inactive acetaldehyde dehydrogenase 2 have an. elevated level of serum acetaldehyde after drinking alcohol, and this may cause an alcohol flushing response with symptoms such as facial flushing, tachycardia, headache, and nausea. Recent studies have suggested that the flushing response influences the association between alcohol consumption and various health-related outcomes. In the present study, we investigated the impact of the flushing response on the relationship between alcohol consumption and serum y -GTP levels in Japanese drinkers. We conducted a cross-sectional study of 521 Japanese drinkers (260 men and 261 'vomen) to examine the impact of the alcohol flushing response on the relationship between alcohol consumption and serum y -GTP levels. The subjects were divided into three groups according to the amount .of daily alcohol consumption. (low, <20 g; moderate, 20-39 g;. and high, >40 g). Multiple adjustments were performed with linear regression models to examine the association between daily alcohol consumption and serum y-GTP levels, adjusting for potential con- founders including the flushing response. We found that the proportion of flushers was significantly lower in the high alcohol consumption group than in the low consumption group. The results of a multivariable analysis showed that,serum y -GTP levels were significantly higher in the moderate and high consumption groups than in the low consumption group after. adjusting for all potential confounders other than the flushing response. In addition, the association between serum y -GTP levels and alcohol consumption was unchanged after adjusting for the presence of the flushing response. In conclusion, serum y -GTP levels increased with increasing alcohol-consumption regardless of the flushing response. Screening for heavy drinkers using serum y-GTP levels was very important to prevent alcohol-related diseases or health problems in health examination.
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Niemelä O. Biomarker-Based Approaches for Assessing Alcohol Use Disorders. Int J Environ Res Public Health 2016; 13:166. [PMID: 26828506 PMCID: PMC4772186 DOI: 10.3390/ijerph13020166] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/14/2016] [Accepted: 01/20/2016] [Indexed: 12/11/2022]
Abstract
Although alcohol use disorders rank among the leading public health problems worldwide, hazardous drinking practices and associated morbidity continue to remain underdiagnosed. It is postulated here that a more systematic use of biomarkers improves the detection of the specific role of alcohol abuse behind poor health. Interventions should be initiated by obtaining information on the actual amounts of recent alcohol consumption through questionnaires and measurements of ethanol and its specific metabolites, such as ethyl glucuronide. Carbohydrate-deficient transferrin is a valuable tool for assessing chronic heavy drinking. Activities of common liver enzymes can be used for screening ethanol-induced liver dysfunction and to provide information on the risk of co-morbidities including insulin resistance, metabolic syndrome and vascular diseases. Conventional biomarkers supplemented with indices of immune activation and fibrogenesis can help to assess the severity and prognosis of ethanol-induced tissue damage. Many ethanol-sensitive biomarkers respond to the status of oxidative stress, and their levels are modulated by factors of life style, including weight gain, physical exercise or coffee consumption in an age- and gender-dependent manner. Therefore, further attention should be paid to defining safe limits of ethanol intake in various demographic categories and establishing common reference intervals for biomarkers of alcohol use disorders.
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Affiliation(s)
- Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, Seinäjoki 60220, Finland.
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Neupane SP, Lien L, Ueland T, Mollnes TE, Aukrust P, Bramness JG. Serum brain-derived neurotrophic factor levels in relation to comorbid depression and cytokine levels in Nepalese men with alcohol-use disorders. Alcohol 2015; 49:471-8. [PMID: 25873205 DOI: 10.1016/j.alcohol.2015.01.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/29/2015] [Accepted: 01/29/2015] [Indexed: 12/20/2022]
Abstract
Neurodegenerative and inflammatory processes are involved separately in major depression (MD) and alcohol-use disorders (AUD). Little is known about the nature of this relationship in the context of comorbid AUD and depression disorders. In this study, we determined brain-derived neurotrophic factor (BDNF) serum levels in patients with AUD and tested whether BDNF levels were related to history of major depression, recent depressive symptoms, AUD severity, and TNF-α and IL-6 levels. Nepalese male AUD inpatients (N=152) abstinent from alcohol for an average of 34 days were administered structured interviews to assess depression symptoms and pattern and extent of alcohol use, and to generate research diagnoses for AUD and MD. AUD severity was assessed by scores on the Alcohol Use Disorder Identification Test. Serum BDNF and cytokines were measured using ELISA and multiplex technology, respectively. Although serum BDNF levels were unrelated to MD history, patients with recent depressive symptoms (n=42) had lower (mean±SD) BDNF serum levels compared to those without (n=110) (21.6±8.1 ng/mL vs. 26.0±9.6 ng/mL; p=0.010), and patients with higher AUD severity and binge-drinking patterns had higher mean serum BDNF levels compared to lower AUD severity and non-binging (25.9±9.7 ng/mL vs. 22.1±8.7 ng/mL; p=0.022 and 25.7±9.3 vs. 21.8±9.7 ng/mL; p=0.029, respectively). Positive correlations were present between BDNF and TNF-α (r=0.39, p<0.001) and IL-6 (r=0.2, p=0.027). In particular, TNF-α levels were predictive of BDNF levels after controlling for confounders (B=0.3 [95% CI=0.2-0.5], p<0.001). These findings show that in alcohol-using populations, peripheral BDNF levels are related to severity of AUD as well as presence of depressive symptoms. The significant associations between inflammatory and neurotrophic factors may have implications for neuroadaptive changes during recovery from AUD.
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Affiliation(s)
| | - Lars Lien
- SERAF-Norwegian Centre for Addiction Research, University of Oslo, Norway; Innlandet Hospital Trust, Hamar, Norway; Department of Public Health, Hedmark University College, Elverum, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Norway; KG. Jebsen Inflammatory Research Center, University of Oslo, Norway
| | - Tom Eirik Mollnes
- KG. Jebsen Inflammatory Research Center, University of Oslo, Norway; Department of Immunology, Oslo University Hospital Rikshospitalet, Norway; Research Laboratory, Nordland Hospital, Bodø, Norway; Faculty of Health Sciences, K.G. Jebsen TREC, University of Tromsø, Norway; Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Norway; KG. Jebsen Inflammatory Research Center, University of Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Norway
| | - Jørgen G Bramness
- SERAF-Norwegian Centre for Addiction Research, University of Oslo, Norway
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11
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Qu B, Su J, Wang Z, Wang Y, Han X, Wang H, Liu Y, Jia Y, Pan J, Ren G. Effect of H. pylori Infection on Cytokine Profiles and Oxidative Balance in Subjects with Chronic Alcohol Ingestion. PLoS One 2015; 10:e0129352. [PMID: 26087062 PMCID: PMC4472927 DOI: 10.1371/journal.pone.0129352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 05/07/2015] [Indexed: 02/06/2023] Open
Abstract
Different amounts of ingested alcohol can have distinct effects on the human body. However, there is limited research on chronic alcohol consumption with Helicobacter pylori infection. We sought to investigate the relationship between the cytokine profile, oxidative balance and H. pylori infection in subjects with chronic alcohol consumption. A total of 142 subjects were divided into three groups: 59 subjects with chronic alcohol ingestion and H. pylori infection (group A); 53 subjects with chronic alcohol ingestion without H. pylori infection (group B); and 30 control subjects (group C). The serum levels of CagA, interleukin (IL)-10, E-selectin, TNF-α, malondialdehyde (MDA) and superoxide dismutase (SOD) activity were measured by enzyme-linked immunosorbent assay (ELISA). We found that the ages and serum H. pylori CagA levels among the three groups, as well as both the mean drinking age and the mean daily alcohol consumption between groups A and B, were matched and comparable. Comparing the BMIs among the three groups, the BMI differences were found to be statistically significant (F=3.921, P<0.05). Compared with group C, the BMIs in groups A and B were significantly higher (P<0.001 and P<0.01, respectively); however, the BMI differences between group A and group B were not statistically significant (P>0.05). Additionally, no differences in the serum CagA levels were found in comparisons among the groups (all P>0.05). The serum IL-10 and E-selectin levels in group A were significantly lower than those in group B (serum IL-10: P<0.05; E-selectin: P<0.05). The serum IL-10 in group A was significantly higher than that in group C (P<0.01); the serum E-selectin levels in group A did not significantly differ compared with those in group C (P>0.05). Furthermore, the serum IL-10 and E-selectin levels in group B were significantly higher than those in group C (serum IL-10: P<0.001; E-selectin: P<0.05); however, the serum TNF-α levels did not differ among groups (all P>0.05). Although the serum levels of MDA and SOD in groups A and B were slightly lower than those in group C, there were no significant differences among groups (all P>0.05). In conclusion, we believe that H. pylori infection might cause a significant inhibition of certain cytokine profiles in subjects with chronic alcohol ingestion. Moreover, chronically ingested alcohol may exert an adjusted inflammatory effect, but there was no association between H. pylori infection, chronic alcohol consumption and oxidative balance.
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Affiliation(s)
- Baoge Qu
- Department of Gastroenterology, Taishan Hospital, Taian, Shandong 271000, P. R. China
- * E-mail:
| | - Jiliang Su
- Department of Gastroenterology, Taishan Hospital, Taian, Shandong 271000, P. R. China
| | - Zhongdong Wang
- Department of Gastroenterology, Taishan Hospital, Taian, Shandong 271000, P. R. China
| | - Yafei Wang
- Department of Gastroenterology, Taishan Hospital, Taian, Shandong 271000, P. R. China
| | - Xinghai Han
- Department of Gastroenterology, Taishan Hospital, Taian, Shandong 271000, P. R. China
| | - Hui Wang
- Department of Gastroenterology, Taishan Hospital, Taian, Shandong 271000, P. R. China
- Taishan Medical College, Taian, Shandong, 271000, P. R. China
| | - Yuanxun Liu
- Department of Gastroenterology, Taishan Hospital, Taian, Shandong 271000, P. R. China
- Taishan Medical College, Taian, Shandong, 271000, P. R. China
| | - Yiguo Jia
- Department of Gastroenterology, Taishan Hospital, Taian, Shandong 271000, P. R. China
- Taishan Medical College, Taian, Shandong, 271000, P. R. China
| | - Jindun Pan
- Department of Gastroenterology, Taishan Hospital, Taian, Shandong 271000, P. R. China
| | - Guangying Ren
- Department of Gastroenterology, Taishan Hospital, Taian, Shandong 271000, P. R. China
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12
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Vonghia L, Michielsen P, Dom G, Francque S. Diagnostic challenges in alcohol use disorder and alcoholic liver disease. World J Gastroenterol 2014; 20:8024-8032. [PMID: 25009373 PMCID: PMC4081672 DOI: 10.3748/wjg.v20.i25.8024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/07/2014] [Accepted: 02/17/2014] [Indexed: 02/06/2023] Open
Abstract
Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of various organs, including the liver. Alcoholic liver disease includes different injuries ranging from steatosis to cirrhosis and implicates a diagnostic assessment of the liver disease and of its possible complications. There is growing interest in the possible different tools for assessing previous alcohol consumption and for establishing the severity of liver injury, especially by non-invasive methods.
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13
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Kalapatapu RK, Neylan TC, Regan MC, Cohen BE. Association of alcohol use biomarkers and cognitive performance in veterans with problematic alcohol use and posttraumatic stress disorder: data from the mind your heart study. J Addict Dis 2014; 33:67-76. [PMID: 24717141 PMCID: PMC4071132 DOI: 10.1080/10550887.2014.909701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The authors conducted a study of alcohol use biomarkers and cognitive performance among 85 veterans with problematic alcohol use and posttraumatic stress disorder (PTSD). All analyses were adjusted for demographics, depression, anxiety, and PTSD symptoms. Elevated levels of aspartate aminotransferase were associated with worse performance on the Trail Making Test Part A and Hopkins Verbal Learning Test. Two other biomarkers were not associated with any neurocognitive measures. Indirect alcohol use biomarkers (e.g., aspartate aminotransferase) may have a specific role in identifying veterans with problematic alcohol use and PTSD who show a change in psychomotor speed and immediate verbal memory performance.
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Affiliation(s)
- Raj K. Kalapatapu
- Department of Psychiatry, University of California, San Francisco, CA, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Thomas C. Neylan
- Department of Psychiatry, University of California, San Francisco, CA, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
- Northern California Institute for Research and Education, San Francisco, CA, USA
| | - Mathilda C. Regan
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Beth E. Cohen
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
- Northern California Institute for Research and Education, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, CA, USA
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14
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Wurst FM, Thon N, Weinmann W, Yegles M, Preuss U. [What ethanol metabolites as biological markers tell us about alcohol use]. Wien Med Wochenschr 2013; 164:25-33. [PMID: 24322386 DOI: 10.1007/s10354-013-0254-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 11/12/2013] [Indexed: 01/12/2023]
Abstract
Alcohol and tobacco related disorders are the two leading and most expensive causes of illness in central Europe. In addition to self reports and questionnaires, biomarkers are of relevance in diagnosis and therapy of alcohol use disorders. Traditional biomarkers such as gamma glutamyl transpeptidase or mean corpuscular volume are indirect biomarkers and are subject to influence of age, gender and non alcohol related diseases, among others.Direct ethanol metabolites such as ethyl glucuronide (EtG), ethyl sulphate (EtS) and phosphatidylethanol (PEth) are direct metabolites of ethanol, that are positive after intake of ethyl alcohol. They represent useful diagnostic tools for identifying alcohol use even more accurately than traditional biomarkers. Each of these drinking indicators remains positive in serum and urine for a characteristic time spectrum after the cessation of ethanol intake--EtG and EtS in urine up to 7 days, EtG in hair for months after ethanol has left the body. Applications include clinical routine use, emergency room settings, proof of abstinence in alcohol rehabilitation programs, driving under influence offenders, workplace testing, assessment of alcohol intake in the context of liver transplantation and fetal alcohol syndrome.
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Affiliation(s)
- Friedrich Martin Wurst
- Universitätsklinik für Psychiatrie und Psychotherapie II, Christian-Doppler-Klinik, Salzburger Landeskliniken, Paracelsus Medical University (PMU), Ignaz-Harrer-Straße 79, 5020, Salzburg, Österreich,
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15
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Leventsova AE, Makarov VK. [Serum phospholipids in differential diagnostics of acute alcohol and salmonella gastroenteritis]. Klin Med (Mosk) 2013; 91:56-58. [PMID: 23879056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The aim of the study was to estimate the possibility of using the serum phospholipid spectrum for differential diagnostics of acute alcoholic and salmonella gastroenteritis. It included 50 patients and 50 healthy subjects. The following fractions were measured: total lipophospholipids (LPL), sphyngomyelin (SM), phosphatitylcholine, (PC) and phosphatidylethanolamine (PE). The serum phospholipid composition in patients of the two groups was significantly different. Salmonella gastroenteritis was characterized by reduced LPL and increased PC levels. Acute alcohol gastroenteritis was associated with elevated LPL, PE levels and reduced PC level. Relative LPL, PE levels in salmonella gastroenteritis were significantly higher and PC levels lower than in alcohol gastroenteritis. In the latter the LPL level was twice that in salmonella gastroenteritis whereas PC level was 1.5 times lower
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16
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Naude CE, Bouic P, Senekal M, Kidd M, Ferrett HL, Fein G, Carey PD. Lymphocyte measures in treatment-naïve 13-15-year old adolescents with alcohol use disorders. Alcohol 2011; 45:507-14. [PMID: 21624786 PMCID: PMC3153431 DOI: 10.1016/j.alcohol.2011.02.307] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Revised: 01/18/2011] [Accepted: 02/12/2011] [Indexed: 12/13/2022]
Abstract
Many adolescents have chronic exposure to hazardous levels of alcohol. This is likely to be a significant predictor of health outcomes, including those related to immunity. We assessed substance use and biochemical immunological parameters in heavy drinking adolescents (meeting DSM-IV criteria for alcohol dependence) and light/nondrinking control adolescents in Cape Town. Lifetime alcohol dose, measured in standard units of alcohol, was orders of magnitude higher in alcohol-dependent (AD) participants than controls. All adolescent AD had a "weekends-only" style of alcohol consumption. The AD group was chosen to represent relatively "pure" AD, with minimal other drug use and no psychiatric diagnoses. With these narrow parameters in place, we found that AD adolescents were lymphopenic compared with controls, with significantly lower mean numbers of absolute circulating CD3+, CD4+, and CD8+ T-lymphocytes. On conclusion, we found that adolescent AD individuals with excessive alcohol intake, in a weekend binge-drinking style but without comorbid drug or psychiatric disorders, may be at increased risk of lymphopenia. This alcohol misuse may increase infectious disease susceptibility (including TB and HIV) by reducing immune system capabilities. Complex interactions of alcohol with other documented high-risk activities may further compound health risks.
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17
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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18
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de Wit M, Wiaterek GK, Gray ND, Goulet KE, Best AM, Clore JN, Sweeney LB. Relationship between alcohol use disorders, cortisol concentrations, and cytokine levels in patients with sepsis. Crit Care 2010; 14:R230. [PMID: 21176217 PMCID: PMC3219986 DOI: 10.1186/cc9385] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 09/13/2010] [Accepted: 12/22/2010] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Patients with alcohol use disorders (AUD) are at increased risk of developing sepsis and have higher mortality. AUD are associated with higher cortisol and anti-inflammatory cytokine profile. Higher cortisol increases risk of death in septic patients. The relationship between AUD and cortisol in septic patients is unknown. We aimed to study this relationship and postulated that AUD would be associated with higher cortisol and anti-inflammatory cytokine profile. METHODS This was a prospective cohort study of 40 medical intensive care unit (ICU) patients admitted with sepsis. Cortisol, anti-inflammatory interleukin (IL) 10, and pro-inflammatory IL1β, IL6, tumor necrosis factor (TNF) α were measured. RESULTS Thirteen (32%) out of 40 patients had AUD. AUD patients had higher cortisol by univariate (39 microg/dl versus 24, P = 0.04) and multivariable analyses (44 microg/dl versus 23, P = 0.004). By univariate analyses, AUD patients had higher IL10 (198 picog/dl versus 47, P = 0.02) and IL6 (527 picog/ml versus 156, P = 0.048), but similar IL1β and TNFα. By multivariable analyses, AUD patients had higher IL10 (182 picog/dl versus 23, P = 0.049) but similar IL1β, IL6, and TNFα. AUD patients had lower IL1β/IL10 (univariate 0.01 versus 0.10, P = 0.04; multivariable 0.01 versus 0.03, P = 0.04), lower TNFα/IL10 (univariate 0.15 versus 0.52, P = 0.03; multivariable 0.11 versus 0.63, P = 0.01), but similar IL6/IL10. CONCLUSIONS AUD are common diagnoses among medical ICU patients with sepsis. Patients with AUD have higher cortisol concentrations and have differences in cytokine expression. Future studies should seek to determine if these differences may explain the higher severity of illness seen in patients with sepsis and AUD. TRIAL REGISTRATION ClinicalTrials.gov: NCT00615862.
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Affiliation(s)
- Marjolein de Wit
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, 1200 East Broad Street, Richmond, VA 23298-0050, USA
| | - Gregory K Wiaterek
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, 1200 East Broad Street, Richmond, VA 23298-0050, USA
| | - Nicole D Gray
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, 1200 East Broad Street, Richmond, VA 23298-0050, USA
| | - Keith E Goulet
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, 1200 East Broad Street, Richmond, VA 23298-0050, USA
| | - Al M Best
- Department of Biostatistics, Virginia Commonwealth University, 730 East Broad Street, Richmond, VA 23298-0032, USA
| | - John N Clore
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Virginia Commonwealth University, 1101 E. Marshall Street, Richmond, VA 23298-0111, USA
| | - Lori B Sweeney
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Virginia Commonwealth University, 1101 E. Marshall Street, Richmond, VA 23298-0111, USA
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Polednak AP. Documentation of Alcohol Use in Hospital Records of Newly Diagnosed Cancer Patients: A Population-Based Study. The American Journal of Drug and Alcohol Abuse 2009; 33:403-9. [PMID: 17613967 DOI: 10.1080/00952990701315236] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Alcohol use has been associated with increased risk and poorer prognosis of various types of cancer, but the extent of actual screening for alcohol use in hospitalized cancer patients has received limited attention. In a random sample of 618 Connecticut patients diagnosed in 2002 with invasive cancer at age 20 + years, ascertained from a population-based registry, some information on usual frequency of drinking was found in hospital records for 478 (77.3%), but 143 (57.2%) of the 250 current drinkers were poorly described (e.g., "social," "occasional"). Alcohol use disorders were rarely mentioned. Gamma glutamyl transpeptidase was found for only 21 (3.4%). Mean corpuscular volume (MCV) was found for 434 (70.2%) and was associated with heavier drinking, independent of other predictors of MCV. Better screening is needed for all hospitalized cancer patients, to plan for interventions and conduct follow-up studies of prognosis.
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Affiliation(s)
- Anthony P Polednak
- Connecticut Department of Public Health, Hartford, Connecticut 06134-0308, USA.
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Coccini T, Crevani A, Acerbi D, Roda E, Castoldi AF, Crespi V, Manzo L. Comparative HPLC and ELISA studies for CDT isoform characterization in subjects with alcohol related problems. Prospective application in workplace risk-prevention policy. G Ital Med Lav Ergon 2008; 30:119-127. [PMID: 19068859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Serum carbohydrate-deficient transferrin (CDT) is the most specific marker of chronic alcohol abuse so far. The performance of commercial HPLC over the ELISA method for measurement of CDT was evaluated on a series of 105 serum samples obtained from subjects referred to the Toxicology Laboratory of Salvatore Maugeri Hospital for alcohol-related problems. Compared to ELISA, HPLC analysis was more valuable for determining alcohol-related patterns of CDT isoforms and quantifying serum levels of disialotransferrin that better reflect chronic heavy drinking. Other significant advantages of the HPLC method included reproducible separation and easier detection of glycoform types and genetic transferrin variants that are known to cause falsely high or low results in sera examined by immunoassay. Current scientific evidence indicates that disialotransferrin is the target analyte for CDT determination and HPLC the current CDT analysis reference method. Systematic studies for early assessment of excessive alcohol intake or abuse of alcoholic substances in workers are recommended by the Italian legislation in accordance with the European Alcohol Action Plan (EAAP) launched by the WHO Regional Committee for Europe. These studies are advisable given their potential role in preventing negative effects of alcohol abuse in workplace. A research strategy combining CDT and other laboratory markers with questionnaire and physician interview is recommended for examining subjects with alcohol related problems and the diagnosis of alcoholism. This approach can be applied for alcohol abuse in workplace surveillance.
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Affiliation(s)
- T Coccini
- IRCCS Salvatore Maugeri Foundation, Toxicology Division, Institute of Pavia, Italy.
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21
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Brady M, Nicholls R, Henderson G, Byrne J. The role of a rural sobering-up centre in managing alcohol-related harm to Aboriginal people in South Australia. Drug Alcohol Rev 2007; 25:201-6. [PMID: 16753642 DOI: 10.1080/09595230600644657] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
There is a paucity of literature on the topic of sobering-up centres (non-custodial safe overnight accommodation for the publicly intoxicated). This paper presents findings of a retrospective longitudinal case study of a sobering-up centre in regional South Australia over the ten years 1991 to 2000. There were 6,486 admissions during this period, 97.1% of which were of Aboriginal people. We collated and analysed primary data including demographic details of admissions and re-admissions, and qualitative and quantitative measures of intoxication. The findings from this case study, considered together with contextual understandings from a wider social study in this region by three of the authors, provide supporting evidence of the important role of sobering-up centres in averting the known harms of a custodial response to public drunkenness, as well as avoiding the potential harm of alcohol-related injury among vulnerable Aboriginal people.
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Affiliation(s)
- Maggie Brady
- Centre for Aboriginal Economic Policy Research, Australian National University, Canberra, Australia.
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Abstract
AIM To determine the extent to which the recommendations of the alcohol harm reduction strategy for England and the Choosing Health white paper for the provision of screening and brief interventions for hazardous and harmful drinkers have been adopted by accident and emergency departments. METHOD Telephone/postal survey of all 191 Type 1 departments in England. The survey was part of a larger study investigating the impact of the changes in the licensing act (2004) on alcohol-related attendances. RESULTS 4 departments use formal screening tools and 24 ask general questions about consumption (98.9% response rate). Blood alcohol levels were measured as required by 100 departments. No departments routinely measure blood alcohol, and 84 departments never assess blood alcohol levels. Alcohol-related attendances were formally recorded by 131 departments. Access to an alcohol health worker or a clinical nurse specialist was reported by 32 departments. DISCUSSION Although departments may be willing to address hazardous alcohol consumption, the low numbers of departments utilising formal screening tools suggests that patients who may benefit from help or advice remain undetected.
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Affiliation(s)
- R Patton
- National Addiction Centre, Kings College London & SLaM NHS Trust, London, UK.
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Csipke E, Touquet R, Patel T, Franklin J, Brown A, Holloway P, Batrick N, Crawford MJ. Use of blood alcohol concentration in resuscitation room patients. Emerg Med J 2007; 24:535-8. [PMID: 17652671 PMCID: PMC2660072 DOI: 10.1136/emj.2006.045583] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2007] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To clarify the use of blood alcohol concentration (BAC) in the emergency department resuscitation room, by comparing it with a subsequent alcohol questionnaire and by surveying patients' attitudes to BAC testing. DESIGN Observational study. PARTICIPANTS 273 resuscitation room patients at St Mary's Hospital, Paddington between August 2005 and February 2006. MAIN OUTCOME MEASURES BAC comparison to questionnaire results, and attitudes to BAC testing. RESULTS The level of agreement between positive screening by questionnaire and a BAC of >80 mg/100 ml was low (kappa = 0.29, 95% confidence interval 0.12 to 0.46) because each test measures different aspects of drinking. Patients accepted the use of BAC tests in detecting alcohol use, though a small minority reported concerns over confidentiality. CONCLUSION Use of BAC testing complements later questionnaire screening to identify alcohol misuse in patients initially brought to the emergency department resuscitation room, providing results are fed back to the patient. Potential ethical, judicial and insurance concerns should not prevent the use of BAC when judged to be in the patient's best interest.
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Affiliation(s)
- Emese Csipke
- Accident and Emergency Department, St Mary's Hospital, Praed Street, London, UK
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Jockers-Scherübl MC, Bauer A, Kuhn S, Reischies F, Danker-Hopfe H, Schmidt LG, Rentzsch J, Hellweg R. Nerve growth factor in serum is a marker of the stage of alcohol disease. Neurosci Lett 2007; 419:78-82. [PMID: 17434673 DOI: 10.1016/j.neulet.2007.03.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Revised: 03/15/2007] [Accepted: 03/27/2007] [Indexed: 01/21/2023]
Abstract
Long-term alcohol abuse has deleterious effects on the peripheral and central nervous system. Nerve growth factor (NGF) is a pleiotropic neurotrophic protein involved in development, maintenance of function and regeneration of nerve cells. We examined patients in different stages of alcohol disease and measured their NGF serum concentrations based on the hypothesis that these reflect the state of disease. We examined 57 patients suffering from alcohol-dependence for more than 2 years (DSM IV) on day 8 of a qualified withdrawal, 18 patients with Korsakoff's syndrome and 40 healthy controls. In addition to clinical examination, careful history taking and a standard neuropsychological test battery, serum NGF concentrations were measured by a highly sensitive enzyme-immunoassay. Of the 57 patients 9 had suffered from severe withdrawal delirium in the past, other clinical parameters were alike. Cognitive test performance did not differ from the control group. Mean NGF levels of controls amounted to 42.1pg/ml (S.D. 68.0); mean levels of patients with alcohol dependence were raised significantly to 401.5pg/ml (S.D. 932.6) without delirium in the past and even further to 3292.5pg/ml (S.D. 4879.6) with former withdrawal delirium. By contrast, patients with persistent amnestic disorder (Korsakoff's syndrome) showed values identical to the controls. NGF serum levels were significantly elevated in alcohol-dependent patients, more so in those with prior delirium. Their cognitive tests being normal, this possibly reflects the activity of NGF as an endogenous repair mechanism for damaged neurons. In accordance with this hypothesis, NGF values are "normal" in patients with persistent alcohol-related cognitive decline.
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Affiliation(s)
- Maria C Jockers-Scherübl
- Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Benjamin Franklin, Eschenallee 3, 14050 Berlin, Germany.
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25
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Reis AD, Figlie NB, Laranjeira R. Prevalence of substance use among trauma patients treated in a Brazilian emergency room. Rev Bras Psiquiatr 2006; 28:191-5. [PMID: 17063218 DOI: 10.1590/s1516-44462006000300009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2006] [Accepted: 04/11/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: Although there is a considerable amount of data in the literature regarding the association between alcohol consumption and injuries treated in emergency rooms, little is known about the relationship between such injury and the use of other substances. The objective of this study was to estimate the prevalence of substance use in patients admitted to the emergency room for non-fatal injuries. METHOD: A prospective cross-sectional study assessing all patients admitted to the emergency room within 6 hours after a non-fatal injury was conducted over a three-month period. The following were used as measures of alcohol and drug use: a standardized World Health Organization questionnaire; a self-administered questionnaire related to drug consumption within the 24 hours preceding contact; the Drug Abuse Screening Test; urine screens for cannabis, cocaine and benzodiazepines; and determination of blood alcohol concentration. Descriptive analyses were performed and the confidence interval used was 95%. RESULTS: A total of 353 patients were included. Cannabis and cocaine screens were conducted for 242 patients and benzodiazepine screens were conducted for 166. Blood alcohol concentrations reached the level of positivity in 11% (n = 39), and 10% (n = 33) presented some degree of intoxication. Among the 242 patients screened, 13.6% (n = 33) tested positive for cannabis, and 3.3% (n = 8) tested positive for cocaine, whereas 4.2% (n = 7) of the 166 patients screened tested positive for benzodiazepines. CONCLUSIONS: Substance use was highly prevalent among these individuals. In this sample, the frequency for the use of cannabis (an illicit drug) was comparable to that of alcohol. More studies are needed in order to characterize such use among Brazilians and to develop proper approaches to such cases, with the aim of reducing substance use and its consequences.
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Affiliation(s)
- Alessandra Diehl Reis
- Alcohol and Drugs Research Unit, Universidade Federal de São Paulo, Rua Botucatu 394, Vila Clementino, 04038-001 São Paulo, SP, Brazil.
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Hietala J, Koivisto H, Anttila P, Niemelä O. Comparison of the combined marker GGT-CDT and the conventional laboratory markers of alcohol abuse in heavy drinkers, moderate drinkers and abstainers. Alcohol Alcohol 2006; 41:528-33. [PMID: 16799164 DOI: 10.1093/alcalc/agl050] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS A combined index based on gamma-glutamyltransferase (GGT) and carbohydrate-deficient transferrin (CDT) measurements (GGT-CDT) has been recently suggested to improve the detection of excessive ethanol consumption. The aim of this work was to compare GGT-CDT with the conventional markers of alcohol abuse in individuals with a wide variety of alcohol consumption. METHODS A cross-sectional and follow-up analysis was conducted in a sample of 165 heavy drinkers, consuming 40-540 g of ethanol per day, and 86 reference individuals who were either moderate drinkers (n = 51) or abstainers (n = 35). RESULTS GGT-CDT (5.35 +/- 1.08) in the heavy drinkers was significantly higher than in the reference individuals (3.30 +/- 0.37). The sensitivity of GGT-CDT (90%) in correctly classifying heavy drinkers exceeded that of CDT (63%), GGT (58%), mean corpuscular volume (MCV) (45%), aspartate aminotransferase (AST) (47%), and alanine aminotransferase (ALT) (50%), being also essentially similar for alcoholics with (93%) or without (88%) liver disease. When comparing the data using either moderate drinkers or abstainers as reference population, the sensitivity of GGT-CDT, CDT, and ALT remained unchanged whereas the sensitivity of GGT, MCV, and AST was found to show variation. CONCLUSIONS GGT-CDT improves the sensitivity of detecting excessive ethanol consumption as compared with the traditional markers of ethanol consumption. These findings should be considered in the assessment of patients with alcohol use disorders.
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Affiliation(s)
- Johanna Hietala
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, FIN-60220 Seinäjoki, Finland
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Abstract
Alcohol dependence is a major cause of morbidity and mortality in the USA and throughout the world. Over the last 10 years there has been an intense interest in developing pharmacotherapies that address the neurochemistry of alcohol dependence. Using a novel pharmacological approach to treating alcohol dependence, topiramate (Topamax, Ortho-McNeil Pharmaceutical) has recently been shown to improve the drinking outcomes of alcohol-dependent individuals. This drug profile highlights the scientific concepts and clinical evidence in the development of topiramate for treating alcohol dependence.
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Affiliation(s)
- Bankole A Johnson
- Division of Alcohol and Drug Addiction, Department of Psychiatry, The University of Texas Health Science Center at San Antonio, 3939 Medical Drive, Suite 100, San Antonio, TX 78229 3900, USA.
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CALDWELL LISAC, SCHWEINSBURG ALECIAD, NAGEL BONNIEJ, BARLETT VALERIEC, BROWN SANDRAA, TAPERT SUSANF. Gender and adolescent alcohol use disorders on BOLD (blood oxygen level dependent) response to spatial working memory. Alcohol Alcohol 2005; 40:194-200. [PMID: 15668210 PMCID: PMC2270703 DOI: 10.1093/alcalc/agh134] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS To determine how alcohol use differentially affects brain functioning in male and female adolescents. METHODS Adolescents with alcohol use disorders (AUDs; 7 female, 11 male) and control adolescents without AUDs (9 female, 12 male), aged 14-17 years, performed spatial working memory and vigilance tasks during functional magnetic resonance imaging. RESULTS Gender, AUD and their interaction were significantly associated with brain activation patterns to the tasks. There were interactions in the superior frontal, superior temporal, cingulate and fusiform regions, in which female and male adolescents with AUDs showed a different brain response from each other and control subjects. Overall, female adolescents with AUDs showed a greater departure from normal activation patterns than male adolescents with AUD. CONCLUSIONS Adolescent alcohol involvement may affect male and female brains differently, and adolescent females may be somewhat more vulnerable to adverse alcohol effects. With continued drinking, these adolescents may be at an increased risk for behavioural deficits.
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Affiliation(s)
- LISA C. CALDWELL
- Veterans Medical Research Foundation, University of California, San Diego, USA
| | | | - BONNIE J. NAGEL
- Veterans Medical Research Foundation, University of California, San Diego, USA
- Department of Psychiatry, University of California, San Diego, USA
| | - VALERIE C. BARLETT
- Veterans Medical Research Foundation, University of California, San Diego, USA
| | - SANDRA A. BROWN
- Department of Psychology, University of California, San Diego, USA
- Department of Psychiatry, University of California, San Diego, USA
- VA San Diego Healthcare System, CA, USA
| | - SUSAN F. TAPERT
- Veterans Medical Research Foundation, University of California, San Diego, USA
- Department of Psychology, University of California, San Diego, USA
- Department of Psychiatry, University of California, San Diego, USA
- VA San Diego Healthcare System, CA, USA
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Perney P, Portalès P, Corbeau P, Roques V, Blanc F, Clot J. Specific Alteration of Peripheral Cytotoxic Cell Perforin Expression in Alcoholic Patients: A Possible Role in Alcohol-Related Diseases. Alcohol Clin Exp Res 2003; 27:1825-30. [PMID: 14634500 DOI: 10.1097/01.alc.0000093742.22787.30] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The association between chronic alcohol consumption and an increasing risk of infectious and neoplastic disease is related to an impairment of cellular immunity. However, studies of the number and activity of lymphocyte subsets show highly variable results. The aim of this study was to assess the expression of perforin, one of the main molecular agents of T and natural killer (NK) cell-mediated cytotoxicity, in alcoholic patients without cirrhosis. METHODS Eighteen patients with chronic alcoholism were prospectively included and compared with 18 age- and sex-matched healthy volunteers. Signs of hepatic insufficiency or portal hypertension, viral co-infection, other serious medical illness, and immune-related medications were exclusion criteria. Lymphocyte phenotype was assessed, and perforin expression was analyzed by flow cytometry in CD3+CD56+ T cells and NK cells. Granzyme synthesis was also evaluated in 11 of the 18 patients and compared with that of 11 age- and sex-matched controls. RESULTS The mean number of white blood cells and lymphocytes was not different between the controls and alcoholic patients, whereas the mean number of NK cells was significantly decreased in alcoholic patients (110 +/- 79/mm3 versus 271 +/- 192/mm3; p < 0.03). Perforin expression in T CD3+/CD56+ and in NK cells was significantly decreased in alcoholic patients compared with controls: 16 +/- 3% vs. 36 +/- 4% (p < 0.03) and 65 +/- 15% vs. 78 +/- 9% (p = 0.04), respectively. The percentage of cells expressing granzyme was similar in both groups. CONCLUSIONS A decrease in perforin expression by cytotoxic cells could be a major factor in explaining the physiopathologic mechanisms of several alcohol-associated diseases.
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Affiliation(s)
- Pascal Perney
- Service de Médecine Interne, Laboratoire d'Immunologie, Hôpital Saint Eloi, Montpellier, France.
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30
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Ohlin H. [Consequences of unclear GT/GGT value]. Lakartidningen 2003; 100:2626. [PMID: 12968328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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31
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Grönvall KT. [Increased GT level without known cause created problems for the patient]. Lakartidningen 2003; 100:1740. [PMID: 12800306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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32
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Abstract
The extracellular signal regulated protein kinases (ERKs), also known as mitogen-activated protein kinases (MAPK) of 42 and 44 kd, play a crucial role in the induction of various forms of neural plasticity. Ethanol induces long-lasting functional changes that are more severe following repeated exposure and may involve intracellular signal transduction mechanisms. Therefore, we investigated the regulation of the ERK signal transduction pathway in models of continuous and intermittent ethanol exposure and withdrawal. Moderate blood alcohol levels (BALs) reduced ERK activation in most of the brain regions studied. Conversely, during withdrawal, activation of ERK was increased in most areas with some regional variations in the levels and kinetics of induction. The most dramatic effects were observed in the amygdala, the cerebellum, the striatum and the hippocampus. In the amygdala and the cerebellum, the activation of ERK observed during withdrawal was significantly higher after intermittent ethanol exposure than after continuous exposure, suggesting the establishment of a form of sensitization to the effects of withdrawal on ERK regulation. Thus the dysregulation of the ERK pathway could contribute to escalation of withdrawal symptoms induced by repeated withdrawal and possibly to the neuroadaptative changes believed to underlie progression towards addiction.
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Affiliation(s)
- Pietro Paolo Sanna
- Department of Neuropharmacology, The Scripps Research Institute, 10550 N Torrey Pines Road, La Jolla, CA 92037, USA.
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Abstract
BACKGROUND A population-based study on early neurotoxic effects of environmental exposure to manganese (Mn) enabled us to investigate the relation between blood Mn levels (MnB), alcohol consumption, and risk for alcohol use disorders (AUD) on mental health. METHODS Participants were selected using a random stratified sampling procedure. Self-administered questionnaires provided data on alcohol consumption, sociodemographics, medical history, and lifestyle. Mood states were assessed with the Brief Symptom Inventory (BSI), and risk for AUD was surveyed using a behavioral screening questionnaire and categorized into no, low, and high risk. Of 297 participants, 253 current drinkers who had responded to all questions on alcohol use were retained. RESULTS Psychologic distress increased with risk for AUD and alcohol consumption > or = 420 g/week. Higher MnB levels (> or =7.5 microg/L) intensified the relation between risk for AUD and BSI scale scores. The Prevalence odd ratios for positive cases of psychologic distress with risk for AUD, 1.98 [1.13-3.46], differed when divided by MnB strata: lower MnB: 1.34 [0.64-2.85]; higher MnB: 4.22 [1.65-10.77]. CONCLUSIONS These findings suggest that higher levels of blood manganese significantly increase neuropsychiatric symptoms associated with risk for alcohol use disorders.
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Hermansson U, Helander A, Brandt L, Huss A, Rönnberg S. The Alcohol Use Disorders Identification Test and carbohydrate-deficient transferrin in alcohol-related sickness absence. Alcohol Clin Exp Res 2002; 26:28-35. [PMID: 11821651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND Previous studies have shown that elevated, risky levels of alcohol consumption may lead to higher rates of sickness absence. However, no studies have examined the Alcohol Use Disorders Identification Test (AUDIT) or serum carbohydrate-deficient transferrin (CDT) in relation to sickness absence in the workplace. The purpose of this study was to examine the relationship between sick-days, 12 months before screening, and the AUDIT and CDT (CDTect kit). Serum gamma-glutamyltransferase also was used for comparison. METHOD The study was carried out over 36 months in a large workplace and formed part of an ongoing controlled study. In conjunction with a routine health examination, employees were offered the opportunity to undergo an alcohol screening. Absence data were obtained from the company payroll system, and sickness absence was analyzed by using a three-ordinal level cumulative logistic model on the number of sick-days. Odds ratios (OR) and 95% confidence intervals (CI) are reported. RESULTS Of the 989 subjects who participated in the study, 193 (19.5%) screened positive in relation to either the AUDIT (>or=8 points) or CDT (<20 units/liter for men, and <27 units/liter for women), or both. Employees who screened positive with the AUDIT had a significantly higher proportion of sick-days (p = 0.047) compared with those who screened negative (OR = 1.4, CI 1.0-1.9). Neither long, continuous periods of sickness absence nor absence on Mondays or Fridays gave a clear indication of individuals who screened positive on the AUDIT or CDT test. CONCLUSION Our data indicate that individuals with moderately elevated or risky levels of alcohol consumption show an increase in sick-days. Accordingly, workplaces have a good reason for using a more systematic approach to alcohol screening in routine workplace health examinations.
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Affiliation(s)
- Ulric Hermansson
- Karolinska Institute, Department of Clinical Neuroscience, Center for Dependency Disorders, Karolinska Hospital, Stockholm, Sweden.
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35
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Ramskogler K, Hertling I, Riegler A, Semler B, Zoghlami A, Walter H, Lesch OM. [Possible interaction between ethanol and drugs and their significance for drug therapy in the elderly]. Wien Klin Wochenschr 2001; 113:363-70. [PMID: 11432125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Even though alcohol dependence is not often found in the elderly, alcohol consumption and alcohol abuse are both common. As the elderly also often take medication on a regular basis, this group is at particularly high risk for problems resulting from the concurrent use of these substances. Physical changes as a result of the aging process (e.g. reduction of body water, decrease of hepatic blood flow) and alcohol related diseases can influence the pharmacokinetics and pharmacodynamics of both ethanol as well as other drugs. Alcohol dehydrogenase (ADH), acetaldehydede hydrogenase (ALDH) and cytochrome P450 2E1 are the enzymes responsible for the metabolism of ethanol. These enzymes are also the sites of direct pharmacological interaction between ethanol and other drugs, however, altered effects of medication can also be caused by ethanol adding to or reducing the drug's effect. Although some of these effects result from heavy use of alcohol, others can also occur with moderate use. Interactions have most frequently been described for analgetics, psychopharmacologically active drugs, antihistamines, anticoagulants antihypertensive drugs and antibiotics.
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Affiliation(s)
- K Ramskogler
- Universitätsklinik für Psychiatrie, Wien, Osterreich
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36
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Aliev ZN. [The levels of the neuro-mediating amino acids in the blood of patients with alcoholic delirium]. Zh Nevrol Psikhiatr Im S S Korsakova 2000; 100:62-3. [PMID: 10900693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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37
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Sarkola T, Eriksson CJ, Niemelä O, Sillanaukee P, Halmesmäki E. Mean cell volume and gamma-glutamyl transferase are superior to carbohydrate-deficient transferrin and hemoglobin-acetaldehyde adducts in the follow-up of pregnant women with alcohol abuse. Acta Obstet Gynecol Scand 2000; 79:359-66. [PMID: 10830762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND AND OBJECTIVE To compare the usefulness of carbohydrate-deficient transferrin (CDT), the ratio of CDT to total transferrin, and hemoglobin-acetaldehyde adducts with mean cell volume (MCV) and gamma-glutamyl transferase (GGT) in the follow-up of alcohol abuse during pregnancy. METHODS Forty-four pregnant drug and alcohol abusing female patients attending a special outpatient clinic were followed from the 8th to 24th gestational week onwards. A population of sixty-two healthy pregnant women was recruited to assess the effect of gestation on the markers. RESULTS Eight of thirteen heavy drinking (> or =8 drinks/week) patients delivered infants with fetal alcohol effects (FAE). MCV and GGT were higher among heavy drinking patients than in moderately drinking (<8 drinks/week) patients (92+/-4 vs 90+/-3 fl and 31+/-34 vs 16+/-10 U/ L, respectively), and in patients delivering infants with FAE compared with patients delivering healthy infants (95+/-3 vs 90+/-3 fl and 34+/-26 vs 15+/-10 U/L, respectively). Hemoglobin-acetaldehyde adducts, CDT, and the ratio of CDT to total transferrin were neither associated with the reported level of alcohol consumption nor with the occurrence of FAE. In the receiver operating characteristics analysis MCV was found to be superior to CDT and the adducts, and GGT superior to the adducts, in identifying heavy drinking and in predicting FAE. In the control population, both CDT and total transferrin were found to rise during pregnancy, whereas the ratio of CDT to total transferrin was found to decline. The upper reference range of 33 U/L for CDT was considerably higher than that of non-pregnant women (26 U/L). CONCLUSION MCV and GGT appear to be the most efficient laboratory markers for detecting excessive alcohol consumption and the adverse effects of alcohol on the fetus.
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Affiliation(s)
- T Sarkola
- Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
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Abstract
It is well-known that early diagnosis in addiction leads to a better outcome and prevents psychosocial and medical illness and disability as well as costs. It would be important to have a gold standard for the diagnosis for alcoholism because of the consequences of this diagnosis for both the patient and the physician. In the last 15 years there were world-wide efforts to find biological markers for alcoholism and alcohol abuse. The results, however, were rather poor. With the exception of the relatively new and expensive CDT TEST (Carbohydrate-deficient transferrin) and some changes in established questionnaires (shortenings) we have used the same screening tests for decades. The relationship between the patient and the physician, a detailed medical history and experience of the physician cannot be replaced by tests. The Plinius Major Society recommends in its Guidelines the CAGE questionnaire. In medical settings and in primary care the MALT or AUDIT are more informative. As laboratory markers the Plinius Major Society still recommends: gamma-GT, MCV, GOT/GPT (ASAT/ALAT) and CDT. These tests are only useful if normal values of the particular laboratory are given.
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Affiliation(s)
- P I Allemann
- Psychiatrische Universitätspoliklinik, Inselspital, Bern.
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39
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Eriksson G, Spak F, Andersson C. [Risky alcohol drinking surveyed at a GP unit. Secondary prevention of alcohol problems in primary care patients]. Lakartidningen 2000; 97:1133-6, 1138-9. [PMID: 10750386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
This article describes an implementation of secondary prevention of alcohol abuse at a GP unit in southern Gothenburg, Sweden. During several periods between 1994 and 1996, screening for alcohol problems was performed using either AUDIT or a 4-item instrument called SWAG. In one part of the study, screening was simultaneously carried out using gamma-GT and MCV. The main object of screening efforts was to stimulate interest for alcohol-related conditions, and this goal was reached. The staff was trained in treatment techniques such as motivational interviewing (MI), bio-feedback using gamma-GT and delivery of concise information. Simple methods to determine level of motivation were used for treatment stratification. Some doctors reported that they had insufficient time for adequate MI treatment, and therefore a condensed model was sometimes used. A nurse-staffed treatment unit was started and successfully promoted work with alcohol problem. Attempts were made to spread these methods to other GP units in the region and this was partially successful, although support from the central primary care administration was not secured.
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Affiliation(s)
- G Eriksson
- Avdelningen, Göteborgs universitet, Vasa sjukhus
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40
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Leksowski W, Kawalaski H, Czuba Z, Krol W, Gorczyca P, Dworniczak S, Rajca M, Shani J. Immunological parameters in patients suffering from alcohol-dependence syndrome. Immunopharmacology 2000; 46:65-70. [PMID: 10665780 DOI: 10.1016/s0162-3109(99)00161-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Alcohol abuse is a major cause of abnormal liver development and activity. In addition to enzymatic malfunction, alcohol and its metabolites induce changes in the levels of some liver antigens, resulting in immunological disturbance. The purpose of the present study is to correlate the severity of liver function impairment with the length of alcohol abuse, in order to be able to use such tests as indicative of the severity of Alcohol Dependence Syndrome. Thirty-one alcohol abusers were allocated to three groups on the basis of the levels of their liver enzymes, and were tested for a variety of immunological parameters and skin reactions. The data indicate that even though not all immunological values measured differed significantly from the control values, in those that did (granulocytes, lymphocytes, CD4/CD8 ratio, C3, IgG, IgM and some skin positive reactions), the biggest difference was between the healthy volunteers and the group with the longest abuse period. It is suggested that changes in selected immunological parameters in alcohol abusers may indicate the severity of their liver dysfunction.
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Affiliation(s)
- W Leksowski
- Department of Psychiatry, Silesian Academy of Medicine, Tarnowskie Góry, Poland
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41
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Schmitt M, Gleiter CH, Nichol JL, Pralle L, Hasselblatt M, Poser W, Ehrenreich H. Haematological abnormalities in early abstinent alcoholics are closely associated with alterations in thrombopoietin and erythropoietin serum profiles. Thromb Haemost 1999; 82:1422-7. [PMID: 10595631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Numerous reports exist on haematological pathology in alcoholism. However, no data are available regarding a potential involvement of haematopoietic growth factors in the recovery from alcohol-induced haematological abnormalities upon abstinence. Therefore, thrombopoietin (TPO) and erythropoietin (EPO) serum levels along with haematological and other routine laboratory parameters were closely followed in 14 thoroughly characterized male alcoholic patients over one to five months of controlled abstention from alcohol. Haematological changes in these early abstinent alcoholics consisted predominantly of (a) the well known rebound surge of platelets, (b) an early reticulocyte peak, and (c) persistently low haematocrit levels over months without signs of recovery. Observations on EPO and TPO during early abstinence can be summarized as follows: (1) Increased TPO levels precede the rebound thrombocytosis by several days, (2) both EPO and TPO concentrations are higher in anaemic than in nonanaemic alcoholics, with (3) nonanaemic subjects exhibiting levels of TPO in the range of healthy controls but levels of EPO below controls and (4) TPO concentrations show a stronger correlation with initial haematocrit values than with thrombocyte counts. To conclude, haematological recovery in early alcohol abstinence appears to be, at least in part, growth factor-driven, involving both TPO and EPO, and may reflect an intense interaction of erythro- and thrombopoiesis.
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Affiliation(s)
- M Schmitt
- Department of Psychiatry, Georg-August-University, and Max-Planck-Institute for Experimental Medicine, Göttingen, Germany
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42
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Wick HD. [Alcohol problems in general practice--the value of biological markers]. Praxis (Bern 1994) 1999; 88:1711-1714. [PMID: 10574036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The daily practice of primary care physicians includes the frequent encounter with patients suffering from alcohol problems. Among these are the identification and treatment of the alcohol dependent patient, but also the identification of and counseling for the excessive alcohol drinker. Biological indicators such as the new marker Carbohydrate-Deficient Transferrin (CDT), can be of some help in the field. They may be used as case finding tools for suspected excessive alcohol drinking or dependence, but also as a monitoring tool for the patient under treatment. The markers may be used in this way as a bio-feedback and/or as a compliance assessment instrument.
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Affiliation(s)
- H D Wick
- Unité d'alcoologie, Policlinique médicale universitaire, Lausanne.
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Yeastedt J, La Grange L, Anton RF. Female alcoholic outpatients and female college students: a correlational study of self-reported alcohol consumption and carbohydrate-deficient transferrin levels. J Stud Alcohol 1998; 59:555-9. [PMID: 9718108 DOI: 10.15288/jsa.1998.59.555] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We sought to test the efficacy of two biochemical markers of alcohol consumption, gamma glutamyl transpeptidase and carbohydrate deficient transferrin, as indicators of heavy alcohol consumption in a female population. METHOD Using a sample of female outpatient alcoholics (n = 36) and a comparison group of female college students (n = 50), alcohol intake was monitored by self-report at approximately 90-day intervals over a period of 12 months. Gamma glutamyl transpeptidase (GGTP) and carbohydrate-deficient transferrin (CDT) values were determined for each sampling period. The criterion for heavy alcohol consumption was set at 140 g/alcohol/week for a 90-day period. Receiver operating characteristic (ROC) curves were plotted, area under the curve (Az) computed, and sensitivity and specificity calculated for both CDT and GGTP. ROC curves provide a graphical illustration of the association between the specificity and sensitivity of any diagnostic test over all possible cutpoint values. RESULTS A significant, positive correlation between the amount of alcohol consumed and GGTP activity was recorded for the outpatient alcoholic group. Among the college students, there was a significant, positive correlation between CDT levels and alcohol consumed for the second reporting period. The sensitivity of the individual biochemical markers was low but, when used in combination, sensitivity was 66% and specificity, 80%. When a more stringent criterion for heavy alcohol consumption was applied (420 g/alcohol/week), the sensitivity of CDT actually decreased. CONCLUSIONS CDT, used alone, is a poor indicator of heavy alcohol consumption in female subjects. When GGTP measures are used in conjunction with CDT, detection of heavy alcohol consumption may be enhanced to useful levels.
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Affiliation(s)
- J Yeastedt
- Department of Behavioral Sciences, New Mexico Highlands University, Las Vegas 87701, USA
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Eckardt MJ, File SE, Gessa GL, Grant KA, Guerri C, Hoffman PL, Kalant H, Koob GF, Li TK, Tabakoff B. Effects of moderate alcohol consumption on the central nervous system. Alcohol Clin Exp Res 1998; 22:998-1040. [PMID: 9726269 DOI: 10.1111/j.1530-0277.1998.tb03695.x] [Citation(s) in RCA: 464] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The concept of moderate consumption of ethanol (beverage alcohol) has evolved over time from considering this level of intake to be nonintoxicating and noninjurious, to encompassing levels defined as "statistically" normal in particular populations, and the public health-driven concepts that define moderate drinking as the level corresponding to the lowest overall rate of morbidity or mortality in a population. The various approaches to defining moderate consumption of ethanol provide for a range of intakes that can result in blood ethanol concentrations ranging from 5 to 6 mg/dl, to levels of over 90 mg/dl (i.e., approximately 20 mM). This review summarizes available information regarding the effects of moderate consumption of ethanol on the adult and the developing nervous systems. The metabolism of ethanol in the human is reviewed to allow for proper appreciation of the important variables that interact to influence the level of exposure of the brain to ethanol once ethanol is orally consumed. At the neurochemical level, the moderate consumption of ethanol selectively affects the function of GABA, glutamatergic, serotonergic, dopaminergic, cholinergic, and opioid neuronal systems. Ethanol can affect these systems directly, and/or the interactions between and among these systems become important in the expression of ethanol's actions. The behavioral consequences of ethanol's actions on brain neurochemistry, and the neurochemical effects themselves, are very much dose- and time-related, and the collage of ethanol's actions can change significantly even on the rising and falling phases of the blood ethanol curve. The behavioral effects of moderate ethanol intake can encompass events that the human or other animal can perceive as reinforcing through either positive (e.g., pleasurable, activating) or negative (e.g., anxiolysis, stress reduction) reinforcement mechanisms. Genetic factors and gender play an important role in the metabolism and behavioral actions of ethanol, and doses of ethanol producing pleasurable feelings, activation, and reduction of anxiety in some humans/animals can have aversive, sedative, or no effect in others. Research on the cognitive effects of acute and chronic moderate intake of ethanol is reviewed, and although a number of studies have noted a measurable diminution in neuropsychologic parameters in habitual consumers of moderate amounts of ethanol, others have not found such changes. Recent studies have also noted some positive effects of moderate ethanol consumption on cognitive performance in the aging human. The moderate consumption of ethanol by pregnant women can have significant consequences on the developing nervous system of the fetus. Consumption of ethanol during pregnancy at levels considered to be in the moderate range can generate fetal alcohol effects (behavioral, cognitive anomalies) in the offspring. A number of factors--including gestational period, the periodicity of the mother's drinking, genetic factors, etc.--play important roles in determining the effect of ethanol on the developing central nervous system. A series of recommendations for future research endeavors, at all levels, is included with this review as part of the assessment of the effects of moderate ethanol consumption on the central nervous system.
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Affiliation(s)
- M J Eckardt
- Office of Scientific Affairs, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, USA
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Ayaori M, Ishikawa T, Yoshida H, Suzukawa M, Nishiwaki M, Shige H, Ito T, Nakajima K, Higashi K, Yonemura A, Nakamura H. Beneficial effects of alcohol withdrawal on LDL particle size distribution and oxidative susceptibility in subjects with alcohol-induced hypertriglyceridemia. Arterioscler Thromb Vasc Biol 1997; 17:2540-7. [PMID: 9409225 DOI: 10.1161/01.atv.17.11.2540] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
LDL subclass pattern B, reported to have a higher prevalence in hypertriglyceridemics (HTGs), is considered to be associated with an increased risk for coronary artery disease, and the small dense LDL characteristic of this pattern is susceptible to oxidative modification. Alcohol is considered one of the most frequent causes of increases in plasma triglyceride (TG) levels. We investigated the effects of alcohol withdrawal on LDL subclass distribution and oxidizability in drinkers with different plasma TG levels. Thirty-seven male subjects with relatively heavy alcohol-consumption habits were divided into four groups; normotriglyceridemic (NTG)/withdrawal (n = 11), NTG/control (n = 8), hypertriglyceridemic (HTG)/withdrawal (n = 10), and HTG/control (n = 8). Both withdrawal groups abstained form alcohol for 4 weeks, while the control subjects maintained their usual intake of alcohol. Peak LDL particle diameter (PPD) was smaller in the combined HTG groups than in the combined NTG groups before abstinence, although PPD increased significantly (P < .01) from 25.5 to 26.1 nm in the HTG/withdrawal group. Before abstinence, lag times preceding LDL oxidation in the combined HTG groups were shorter than in the combined NTG groups; after withdrawal, lag time was prolonged significantly (P < .01) from 49.9 to 57.3 minutes in the HTG-withdrawal group. No significant changes in PPD and lag time were observed in the other three groups. Significant correlations (P < .05) were observed between the change (delta) in the lag time and delta TG and between delta lag time and delta PPD. We conclude that in alcohol-induced HTG subjects, alcohol withdrawal has beneficial effects on the LDL profile by shifting the particle size from smaller to larger and decreasing its susceptibility to oxidation.
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Affiliation(s)
- M Ayaori
- First Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
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Rubio Valladolid G, Martínez Ruiz M. [Usefulness of carbohydrate-deficient transferrin in alcohol-elated problems]. An Med Interna 1997; 14:473-7. [PMID: 9453759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Carbohydrate-Deficient Transferrin (CDT) is a new marker for excessive alcohol drinking. It appears to be useful to detect alcoholism, harmful consumption and relapse. It have been introduced in our country recently. METHOD Recent studies about utility of CDT have been reviewed. RESULTS Sensitivity and specificity of CDT level as a marker of alcoholism were 72-97% and 31-81% respectively. As a marker of harmful consumption its sensitivity was 15-69% and its sensitivity was higher than 82%. CDT was demonstrated to be a effective maker for evaluating alcoholic abstinence in alcoholic patients. CONCLUSIONS CDT determinations have a high specificity for screening heavy drinking in different settings. Problems related to its sensitivity are discussed.
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