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Journal of Hepatology Feb 2019
Topics: Adult; Alcoholism; Animals; Binge Drinking; Humans; Liver Diseases, Alcoholic; Liver Transplantation; Molecular Targeted Therapy; Prevalence; Young Adult
PubMed: 30658723
DOI: 10.1016/j.jhep.2018.12.007 -
Journal of Hepatology Oct 2022Non-alcoholic fatty liver disease (NAFLD) and alcohol-related liver disease (ALD) cannot reliably be distinguished by routine diagnostics, and the role of alcohol... (Observational Study)
Observational Study
BACKGROUND & AIMS
Non-alcoholic fatty liver disease (NAFLD) and alcohol-related liver disease (ALD) cannot reliably be distinguished by routine diagnostics, and the role of alcohol consumption in metabolic dysfunction-associated fatty liver disease (MAFLD) remains unclear. We investigated alcohol consumption in patients with presumed NAFLD and ALD using novel objective alcohol markers.
METHODS
In total, 184 consecutive patients were included in this prospective observational study. Alcohol intake was assessed by ethylglucuronide in hair (hEtG) and urine (uEtG); the utility of these measures for alcohol detection was compared to Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), carbohydrate deficient transferrin (CDT), mean corpuscular volume (MCV), gamma-glutamyltransferase (GGT), and ALD/NAFLD index (ANI). Clinical characteristics of patients with NAFLD and ALD were re-assessed after reclassification based on repeated moderate (≥10 g <60 g EtOH/day) and excessive (≥60 g EtOH/day) alcohol consumption, and patients were retrospectively reclassified based on MAFLD criteria.
RESULTS
Repeated moderate to excessive alcohol consumption was detected in 28.6%, 28.5%, and 25.0% of patients with presumed NAFLD, ALD or MAFLD, respectively. ANI score, AUDIT-C, uEtG, and hEtG showed AUCs of 0.628, 0.733, 0.754, and 0.927 for the detection of repeated moderate to excessive alcohol consumption, respectively. The indirect markers CDT, MCV and GGT were not reliable. Patients with repeated moderate or excessive alcohol consumption were significantly more often male, had a significantly lower BMI, and suffered significantly less often from type 2 diabetes or impaired glucose tolerance.
CONCLUSIONS
In total, 28.6% of patients with presumed NAFLD, and 25.0% with MAFLD are at risk of alcohol-related liver damage. AUDIT-C, uEtG and hEtG should be used to screen for alcohol consumption in patients with fatty liver disease.
LAY SUMMARY
Fatty liver disease can be caused by metabolic factors and/or alcohol consumption. The diagnosis of non-alcoholic fatty liver disease (NAFLD) is based on the exclusion of harmful alcohol consumption, while metabolic dysfunction-associated fatty liver disease (MAFLD), which has been proposed as a new name for NAFLD, is based on the presence of metabolic comorbidities and allows for alcohol consumption. Herein, we show that up to 29% of patients diagnosed with NAFLD and 25% with MAFLD are at risk of alcohol-related liver damage. We show that ethyl glucuronide (a metabolite of alcohol) in the hair and urine can accurately detect potentially harmful alcohol consumption in these patients - as such, these tests should be integrated into routine diagnostic work-up for patients with fatty liver disease.
Topics: Alcohol Drinking; Alcoholism; Biomarkers; Diabetes Mellitus, Type 2; Ethanol; Glucuronates; Hair; Humans; Liver Diseases, Alcoholic; Male; Non-alcoholic Fatty Liver Disease; Retrospective Studies; gamma-Glutamyltransferase
PubMed: 35605744
DOI: 10.1016/j.jhep.2022.04.040 -
Neuropharmacology Aug 2017Incentive salience, negative emotionality, and executive function are functional domains that are etiologic in the initiation and progression of addictive disorders,... (Review)
Review
Incentive salience, negative emotionality, and executive function are functional domains that are etiologic in the initiation and progression of addictive disorders, having been implicated in humans with addictive disorders and in animal models of addictions. Measures of these three neuroscience-based functional domains can capture much of the effects of inheritance and early exposures that lead to trait vulnerability shared across different addictive disorders. For specific addictive disorders, these measures can be supplemented by agent specific measures such as those that access pharmacodynamic and pharmacokinetic variation attributable to agent-specific gatekeeper molecules including receptors and drug-metabolizing enzymes. Herein, we focus on the translation and reverse translation of knowledge derived from animal models of addiction to the human condition via measures of neurobiological processes that are orthologous in animals and humans, and that are shared in addictions to different agents. Based on preclinical data and human studies, measures of these domains in a general framework of an Addictions Neuroclinical Assessment (ANA) can transform the assessment and nosology of addictive disorders, and can be informative for staging disease progression. We consider next steps and challenges for implementation of ANA in clinical care and research. This article is part of the Special Issue entitled "Alcoholism".
Topics: Alcoholism; Animals; Behavior, Addictive; Disease Models, Animal; Disease Progression; Emotions; Executive Function; Humans; Motivation; Translational Research, Biomedical
PubMed: 28283392
DOI: 10.1016/j.neuropharm.2017.03.006 -
Clinical and Molecular Hepatology Oct 2020A 3-month alcoholism rehabilitation program at psychiatric hospitals is common in Japan for patients with alcohol use disorder (AUD). However, many AUD patients are...
A 3-month alcoholism rehabilitation program at psychiatric hospitals is common in Japan for patients with alcohol use disorder (AUD). However, many AUD patients are often hospitalized for the treatment of digestive disorders due to alcohol-related liver diseases and pancreatitis. In this sense, AUD patients need to be better supported by professionals and departments in general hospitals. Here we analyzed the problems in alcohol-related medical care in Japan and examined the measures to be taken at general hospitals.
Topics: Alcoholism; Humans
PubMed: 33053935
DOI: 10.3350/cmh.2020.0151 -
Alcohol (Fayetteville, N.Y.) Feb 2019Alcohol Use Disorder (AUD) is a multifarious psychiatric condition resulting from complex relationships between genetics, gene expression, neuroadaptations, and... (Review)
Review
Alcohol Use Disorder (AUD) is a multifarious psychiatric condition resulting from complex relationships between genetics, gene expression, neuroadaptations, and environmental influences. Understanding these complex relationships is essential to uncovering the mechanisms involved in the development and progression of AUD, with the ultimate goal of devising effective behavioral and therapeutic interventions. Technical advances in the fields of omics-based research and bioinformatics have yielded insights into gene interactions, biological networks, and cellular responses across humans and animal models. This review highlights several of the newly developed sequencing methodologies and resultant discoveries in neuroscience, as well as the importance of a multi-faceted and integrative approach for determining causal factors in AUD.
Topics: Alcoholism; Animals; Computational Biology; Humans; Sequence Analysis, RNA; Single-Cell Analysis
PubMed: 30144960
DOI: 10.1016/j.alcohol.2018.05.004 -
Lakartidningen Oct 2018
Topics: Alcohol Drinking; Alcoholism; Humans; Patient Acceptance of Health Care; Physician-Patient Relations; Primary Health Care
PubMed: 30325478
DOI: No ID Found -
Lakartidningen Oct 2018
Topics: Alcoholism; Counseling; Humans; Patient Acceptance of Health Care; Primary Health Care; Social Stigma
PubMed: 30325471
DOI: No ID Found -
Clinical Medicine (London, England) Jan 2019Age-standardised mortality from liver disease in the United Kingdom has risen by 400% since 1970, with three-quarters of deaths from alcohol-related liver disease... (Review)
Review
Age-standardised mortality from liver disease in the United Kingdom has risen by 400% since 1970, with three-quarters of deaths from alcohol-related liver disease (ARLD). The 2013 National Confidential Enquiry into Patient Outcome and Death report found that only 47% of the patients dying in hospital from liver disease experienced 'good' care. We discuss common complications in the care of patients with ARLD and the evidence-based best practice that can improve patient outcomes, with a focus on the initial management of patients presenting acutely to the medical take.
Topics: Alcoholism; Hepatitis, Alcoholic; Humans; Liver Diseases, Alcoholic
PubMed: 30651244
DOI: 10.7861/clinmedicine.19-1-43 -
Alcohol (Fayetteville, N.Y.) Dec 2015Long-term alcohol use leads to persistent cognitive deficits that may be associated with maladaptive changes in the neurocircuitry that mediates executive functions.... (Review)
Review
Long-term alcohol use leads to persistent cognitive deficits that may be associated with maladaptive changes in the neurocircuitry that mediates executive functions. Impairments caused by these changes can persist well into abstinence and have a negative impact on quality of life and job performance, and can increase the probability of relapse. Many of the changes that affect cognitive function appear to involve dysregulation of the mesocortical dopamine system. This includes changes in dopamine release and alterations in dopamine receptor expression and function in the medial prefrontal cortex (PFC). This review summarizes the cellular effects of acute and chronic ethanol exposure on dopamine release and dopamine receptor function in the PFC with the goal of providing greater understanding of the effects of alcohol-use disorders on the dopamine system and how this relates to deficits in the executive function of the PFC.
Topics: Alcoholic Intoxication; Alcoholism; Animals; Central Nervous System Depressants; Cognition Disorders; Dopamine; Ethanol; Humans; Neostriatum; Neural Pathways; Prefrontal Cortex; Receptors, Dopamine; Synaptic Transmission
PubMed: 26558348
DOI: 10.1016/j.alcohol.2015.09.001 -
World Journal of Gastroenterology Oct 2014Excessive ethanol consumption affects virtually any organ, both by indirect and direct mechanisms. Considerable research in the last two decades has widened the... (Review)
Review
Excessive ethanol consumption affects virtually any organ, both by indirect and direct mechanisms. Considerable research in the last two decades has widened the knowledge about the paramount importance of proinflammatory cytokines and oxidative damage in the pathogenesis of many of the systemic manifestations of alcoholism. These cytokines derive primarily from activated Kupffer cells exposed to Gram-negative intestinal bacteria, which reach the liver in supra-physiological amounts due to ethanol-mediated increased gut permeability. Reactive oxygen species (ROS) that enhance the inflammatory response are generated both by activation of Kupffer cells and by the direct metabolic effects of ethanol. The effects of this increased cytokine secretion and ROS generation lie far beyond liver damage. In addition to the classic consequences of endotoxemia associated with liver cirrhosis that were described several decades ago, important research in the last ten years has shown that cytokines may also induce damage in remote organs such as brain, bone, muscle, heart, lung, gonads, peripheral nerve, and pancreas. These effects are even seen in alcoholics without significant liver disease. Therefore, alcoholism can be viewed as an inflammatory condition, a concept which opens the possibility of using new therapeutic weapons to treat some of the complications of this devastating and frequent disease. In this review we examine some of the most outstanding consequences of the altered cytokine regulation that occurs in alcoholics in organs other than the liver.
Topics: Alcohol Drinking; Alcoholism; Animals; Cytokines; Ethanol; Humans; Inflammation; Inflammation Mediators; Liver; Liver Diseases, Alcoholic; Oxidative Stress; Prognosis; Reactive Oxygen Species; Risk Assessment; Risk Factors
PubMed: 25356029
DOI: 10.3748/wjg.v20.i40.14660