Alcoholic Ketosis: Prevalence, Determinants, and Ketohepatitis in Japanese Alcoholic Men.

Autor: Yokoyama A; National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan a_yokoyama@kurihama1.hosp.go.jp., Yokoyama T; Department of Health Promotion, National Institute of Public Health, Saitama 351-0104, Japan., Mizukami T; National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan., Matsui T; National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan Department of Geriatric Medicine, Kyorin University Hospital, Tokyo 181-8611, Japan., Shiraishi K; Department of Gastroenterology, Tokai University School of Medicine, Kanagawa 259-1193, Japan., Kimura M; National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan., Matsushita S; National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan., Higuchi S; National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan., Maruyama K; National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan.
Jazyk: angličtina
Zdroj: Alcohol and alcoholism (Oxford, Oxfordshire) [Alcohol Alcohol] 2014 Nov; Vol. 49 (6), pp. 618-25. Date of Electronic Publication: 2014 Aug 01.
DOI: 10.1093/alcalc/agu048
Abstrakt: Aims: Alcoholic ketosis and ketoacidosis are metabolic abnormalities often diagnosed in alcoholics in emergency departments. We attempted to identify determinants or factors associated with alcoholic ketosis.
Methods: The subjects of this cross-sectional survey were 1588 Japanese alcoholic men (≥40 years) who came to an addiction center within 14 days of their last drink.
Results: The results of the dipstick urinalyses revealed a prevalence of ketosis of 34.0% (±, 21.5%; +, 8.9%; and 2+/3+; 3.6%) in the alcoholics. Higher urine ketone levels were associated with higher serum total bilirubin, aspartate transaminase (AST), alanine transaminase and gamma-glutamyl transpeptidase levels. A multivariate analysis by the proportional odds model showed that the odds ratio (95% confidence interval) for an increase in ketosis by one category was 0.94 (0.84-1.06) per 10-year increase in age, 0.93 (0.89-0.97) per 1-day increase in interval since the last drink, 1.78 (1.41-2.26) in the presence of slow-metabolizing alcohol dehydrogenase-1B (ADH1B*1/*1), 1.61 (1.10-2.36) and 1.30 (1.03-1.65) when the beverage of choice was whiskey and shochu, respectively (distilled no-carbohydrate beverages vs. the other beverages), 2.05 (1.27-3.32) in the presence of hypoglycemia <80 mg/dl, 0.91 (0.88-0.94) per 1-kg/m(2) increase in body mass index (BMI), 1.09 (1.00-1.18) per +10 cigarettes smoked, and 2.78 (2.05-3.75) when the serum total bilirubin level was ≥2.0 mg/dl, and 1.97 (1.47-2.66) when the serum AST level was ≥200 IU/l.
Conclusion: Ketosis was a very common complication and frequently accompanied by alcoholic liver injury in our Japanese male alcoholic population, in which ADH1B*1/*1 genotype, consumption of whiskey or shochu, hypoglycemia, lower BMI and smoking were significant determinants of the development of ketosis.
(© The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.)
Databáze: MEDLINE
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