Using phosphatidylethanol as an adjunct to self-reported alcohol use improves identification of liver fibrosis risk.

Autor:	Murnane PM; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA., Afshar M; Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA., Chamie G; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA., Cook RL; Department of Epidemiology, University of Florida, Gainesville, FL, USA., Ferguson T; Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA, USA.; Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA., Haque LY; Department of Internal Medicine (Section of Digestive Diseases) and Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA., Jacobson KR; Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA., Justice AC; VA Connecticut Healthcare System, United States Department of Veterans Affairs, West Haven, CT, USA.; Yale School of Medicine, New Haven, CT, USA.; Yale School of Public Health, New Haven, CT, USA., Kim TW; Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA., Khalili M; Department of Medicine, Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, CA, USA., Krupitsky E; First Pavlov State Medical University, St. Petersburg, Russia.; V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia., McGinnis KA; VA Connecticut Healthcare System, United States Department of Veterans Affairs, West Haven, CT, USA., Molina P; Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA, USA.; Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA., Muyindike WR; Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda., Myers B; Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Australia.; Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Tygerberg, South Africa.; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa., Richards VL; TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Tulsa, Oklahoma, USA., So-Armah K; Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA., Stewart S; Department of Family Medicine, Division of Addiction Medicine, University at Buffalo, Buffalo, NY, USA., Sulkowski MS; Johns Hopkins University School of Medicine, Baltimore MD USA., Tien PC; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.; San Francisco VA Health Care System, San Francisco, CA, USA., Hahn JA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Jazyk:	angličtina
Zdroj:	The American journal of gastroenterology [Am J Gastroenterol] 2024 Oct 31. Date of Electronic Publication: 2024 Oct 31.
DOI:	10.14309/ajg.0000000000003178
Abstrakt:	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. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)
Databáze:	MEDLINE
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