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

Journal: The American journal of gastroenterology

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Affiliated Institutions:  Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA. Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA. Department of Epidemiology, University of Florida, Gainesville, FL, USA. Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA, USA. Department of Internal Medicine (Section of Digestive Diseases) and Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA. Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA. VA Connecticut Healthcare System, United States Department of Veterans Affairs, West Haven, CT, USA. Department of Medicine, Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, CA, USA. First Pavlov State Medical University, St. Petersburg, Russia. Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda. Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Australia. TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Tulsa, Oklahoma, USA. Department of Family Medicine, Division of Addiction Medicine, University at Buffalo, Buffalo, NY, USA. Johns Hopkins University School of Medicine, Baltimore MD USA.

Abstract summary 

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.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.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.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.

Authors & Co-authors:  Murnane Pamela M PM Afshar Majid M Chamie Gabriel G Cook Robert L RL Ferguson Tekeda T Haque Lamia Y LY Jacobson Karen R KR Justice Amy C AC Kim Theresa W TW Khalili Mandana M Krupitsky Evgeny E McGinnis Kathleen A KA Molina Patricia P Muyindike Winnie R WR Myers Bronwyn B Richards Veronica L VL So-Armah Kaku K Stewart Scott S Sulkowski Mark S MS Tien Phyllis C PC Hahn Judith A JA

Study Outcome 

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Citations : 
Authors :  21
Identifiers
Doi : 10.14309/ajg.0000000000003178
SSN : 1572-0241
Study Population
Male,Female
Mesh Terms
Other Terms
Study Design
Study Approach
Mixed Methods
Country of Study
Uganda
Publication Country
United States