Correlation of severity of alcohol dependence with liver dysfunction (by transient elastography) in freshly diagnosed cases of alcohol dependence syndrome.

Industrial Psychiatry Journal Pub Date : 2024-07-01 Epub Date: 2024-12-17 DOI:10.4103/ipj.ipj_264_24
Guggilla Madhusudhan, Kartikeya R Singh, Om Panda, Priyadarshee Patra
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Abstract

Background: Alcohol-related liver disease contributes significantly to global mortality and healthcare costs, underscoring the urgency of early detection and non-invasive diagnostic tools such as transient elastography.

Aim: This study aimed to investigate the correlation between the severity of alcohol dependence syndrome (ADS) and liver dysfunction assessed via transient elastography in newly diagnosed patients.

Materials and methods: From October 2019 to September 2021, a cross-sectional observational study was conducted on 58 inpatients diagnosed with ADS according to International Classification of Diseases-10 criteria. The severity of alcohol dependence was assessed using the Severity of Alcohol Dependence Questionnaire (SADQ), serum biochemical markers, and liver stiffness measured by transient elastography within 96 hours of admission and again after four weeks of enforced abstinence. Data were analyzed using Statistical Package for Social Sciences, with descriptive statistics applied to socio-demographic and clinical data. Paired t-tests compared biochemical markers, and Spearman rank correlation analyzed the relationship between SADQ scores and liver stiffness at admission and after abstinence.

Results: Initial SADQ scores indicated moderate alcohol dependence in 55% of participants. According to Alcohol Use Disorders Identification Test, 38% had a medium-to-severe risk of harmful alcohol consumption. Liver fibrosis assessment showed that 63.8% had no or mild fibrosis on day 1, increasing to 81.0% by day 28. Moderate to advanced fibrosis (measured above 7.5 kilopascal) decreased from 8.6%, 12.1%, and 15.5% on day 1 to 3.4%, 5.2%, and 10.3% on day 28, respectively. There was a statistically significant (P < 0.05) reduction in serum biochemical markers and mean liver stiffness after four weeks of abstinence.

Conclusions: The study underscores that the greater severity of alcohol dependence correlates with more pronounced liver function impairments and stiffness. Transient elastography indicated significant liver fibrosis in actively drinking patients, with notable improvement after one month of abstinence.

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新诊断的酒精依赖综合征患者酒精依赖严重程度与肝功能障碍的相关性(通过瞬时弹性成像)
背景:酒精相关肝脏疾病对全球死亡率和医疗保健费用有重大贡献,强调了早期检测和非侵入性诊断工具(如瞬变弹性成像)的紧迫性。目的:本研究旨在探讨酒精依赖综合征(ADS)严重程度与新诊断患者肝功能障碍的相关性。材料与方法:2019年10月至2021年9月,对58例按照国际疾病分类-10标准诊断为ADS的住院患者进行横断面观察研究。采用酒精依赖严重程度问卷(SADQ)、血清生化指标和入院96小时内及强制戒酒四周后用瞬时弹性成像测量的肝脏硬度来评估酒精依赖的严重程度。数据分析使用社会科学统计软件包,描述性统计应用于社会人口和临床数据。配对t检验比较生化指标,Spearman秩相关分析入院时和戒酒后SADQ评分与肝脏硬度的关系。结果:最初的SADQ分数表明55%的参与者有中度酒精依赖。根据酒精使用障碍鉴定测试,38%的人有中度到重度有害酒精消费的风险。肝纤维化评估显示,63.8%在第1天无纤维化或轻度纤维化,到第28天增加到81.0%。中度至晚期纤维化(测量值高于7.5千帕)分别从第1天的8.6%、12.1%和15.5%下降到第28天的3.4%、5.2%和10.3%。禁欲4周后血清生化指标和平均肝硬度降低,差异有统计学意义(P < 0.05)。结论:该研究强调,严重的酒精依赖与更明显的肝功能损害和僵硬相关。瞬时弹性图显示,积极饮酒的患者肝纤维化明显,戒酒一个月后明显改善。
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46
审稿时长
39 weeks
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