将磷脂酰乙醇作为自我报告饮酒情况的辅助手段可提高肝纤维化风险的识别能力。

IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY American Journal of Gastroenterology Pub Date : 2024-10-31 DOI:10.14309/ajg.0000000000003178
Pamela M Murnane, Majid Afshar, Gabriel Chamie, Robert L Cook, Tekeda Ferguson, Lamia Y Haque, Karen R Jacobson, Amy C Justice, Theresa W Kim, Mandana Khalili, Evgeny Krupitsky, Kathleen A McGinnis, Patricia Molina, Winnie R Muyindike, Bronwyn Myers, Veronica L Richards, Kaku So-Armah, Scott Stewart, Mark S Sulkowski, Phyllis C Tien, Judith A Hahn
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引用次数: 0

摘要

导言:对饮酒情况的准确评估有助于肝病的预防和管理。我们研究了血液中磷脂酰乙醇(PEth,一种酒精代谢物)的浓度是否与肝纤维化风险相关,而与自我报告的饮酒情况无关:我们汇集了来自美国、俄罗斯、乌干达和南非的 12 项研究的个人水平数据,其中包括 PEth、AUDIT-C(酒精使用障碍识别测试-消费)和 FIB-4 测量值。我们将 PEth 与 AUDIT-C 之间的关系作为连续变量进行了混合效应逻辑回归(经线性检验),FIB-4 高(≥2.67)。我们将 PEth(范围 0-1000)除以 83.3,使其与 AUDIT-C(0-12)处于同一量表,以便直接比较几率比。调整后的模型包括性别、种族/民族、年龄、体重指数、HIV 和病毒抑制状态:在 4,644 名成年人中,年龄中位数为 49 岁(四分位数间距 [IQR]:40-55),998 人(21%)为女性,3,520 人(76%)为 HIV 感染者,其中 2,386 人(68%)病毒已被抑制。PEth的中位数为13纳克/毫升(IQR:结论:PEth与HIV感染率高密切相关:PEth与高FIB-4独立相关,其几率比与AUDIT-C相关的几率更大。使用 PEth 可提高对酒精使用的识别以及肝纤维化的预防和管理。
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Using phosphatidylethanol as an adjunct to self-reported alcohol use improves identification of liver fibrosis risk.

Introduction: Accurate assessment of alcohol use informs prevention and management of liver disease. We examined whether phosphatidylethanol (PEth, an alcohol metabolite) blood concentrations are associated with liver fibrosis risk independently of self-reported alcohol use, among persons with and without HIV.

Methods: We pooled individual-level data from 12 studies from the United States, Russia, Uganda, and South Africa with PEth, AUDIT-C (Alcohol Use Disorders Identification Test-Consumption), and FIB-4 measurements. We conducted mixed-effects logistic regression of the relationship between PEth and AUDIT-C as continuous variables (after checking linearity), with high FIB-4 (≥2.67). We divided PEth (range 0-1000) by 83.3 to put it on the same scale as AUDIT-C (0-12) to directly compare odds ratios. Adjusted models included sex, race/ethnicity, age, body mass index, HIV and virologic suppression status.

Results: Among 4,644 adults, the median age was 49 years (interquartile range [IQR]: 40-55), 998 (21%) were female, and 3,520 (76%) were living with HIV among whom 2,386 (68%) were virologically suppressed. Median PEth was 13 ng/mL (IQR: <8-132.0) and median AUDIT-C was 3 (IQR: 1-6); 554 (12%) had high FIB-4. The adjusted odds ratios per 83.3 ng/mL difference in PEth and one-unit difference in AUDIT-C with high FIB-4 were 1.15 (95%CI: 1.08-1.22) and 1.03 (95%CI: 1.00-1.07), respectively. Findings were similar when PEth and AUDIT-C were treated as categorical variables.

Conclusions: PEth was independently associated with high FIB-4, with a larger odds ratio than that of the association of AUDIT-C. Use of PEth may improve identification of alcohol use and liver fibrosis prevention and management.

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来源期刊
American Journal of Gastroenterology
American Journal of Gastroenterology 医学-胃肠肝病学
CiteScore
11.40
自引率
5.10%
发文量
458
审稿时长
12 months
期刊介绍: Published on behalf of the American College of Gastroenterology (ACG), The American Journal of Gastroenterology (AJG) stands as the foremost clinical journal in the fields of gastroenterology and hepatology. AJG offers practical and professional support to clinicians addressing the most prevalent gastroenterological disorders in patients.
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