Systemic effects of excess alcohol consumption

Excess alcohol consumption is a top risk factor for death and disability. Fatty liver will likely develop and the risk of liver disease increases. We have previously demonstrated that an essential amino acid supplement (EAAS) improved protein synthesis and reduced intrahepatic lipid in the elderly. The purpose of this exploratory pilot study was to initiate the evaluation of EAAS on intrahepatic lipid (IHL), body composition, and blood lipids in individuals with mild to moderate alcohol use disorder (AUD). Following consent, determination of eligibility, and medical screening, 25 participants (18 males at 38 ± 15 years/age and 7 females at 34 ± 18 years/age) were enrolled and randomly assigned to one of two dosages: a low dose (LD: 8 g of EAAS twice/day (BID)) or high dose (HD: 13 g of EAAS BID). Five of the twenty-five enrolled participants dropped out of the intervention. Both groups consumed the supplement BID for 4 weeks. Pre- and post-EAAS administration, IHL was determined using magnetic resonance imaging/spectroscopy, body composition was analyzed using dual-energy X-ray absorptiometry, and blood parameters were measured by LabCorp. T-tests were used for statistical analysis and considered significant at p < 0.05. While there was no significant change in IHL in the LD group, there was a significant 23% reduction in IHL in the HD group (p = 0.02). Fat mass, lean tissue mass, bone mineral content, and blood lipids were not altered. Post-EAAS phosphatidylethanol was elevated and remained unchanged in LD at 407 ± 141 ng/mL and HD at 429 ± 196 ng/mL, indicating chronic and excess alcohol consumption. The HD of the proprietary EAAS formulation consumed BID seemed to lower IHL in individuals with mild to moderate AUD. We suggest that further studies in a larger cohort be conducted to more completely address this important area of investigation.

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Effects of moderate and excess alcohol consumption on the reverse cholesterol transport in vivo

Atherosclerosis ◽

10.1016/j.atherosclerosis.2016.07.587 ◽

2016 ◽

Vol 252 ◽

pp. e105

Author(s):

D. Greco ◽

L. Mele ◽

A. Piemontese ◽

S. Battista ◽

A. Poli ◽

...

Keyword(s):

Alcohol Consumption ◽

Reverse Cholesterol Transport ◽

Cholesterol Transport ◽

Excess Alcohol Consumption

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Moderate excess alcohol consumption and adverse cardiac remodelling in dilated cardiomyopathy

Heart ◽

10.1136/heartjnl-2021-319418 ◽

2021 ◽

pp. heartjnl-2021-319418

Author(s):

Upasana Tayal ◽

John Gregson ◽

Rachel Buchan ◽

Nicola Whiffin ◽

Brian P Halliday ◽

...

Keyword(s):

Alcohol Consumption ◽

Dilated Cardiomyopathy ◽

Composite Endpoint ◽

Cardiovascular Death ◽

Left Ventricular ◽

Cardiac Structure ◽

Biological Sex ◽

History Of ◽

Prospective Longitudinal ◽

Excess Alcohol Consumption

ObjectiveThe effect of moderate excess alcohol consumption is widely debated and has not been well defined in dilated cardiomyopathy (DCM). There is need for a greater evidence base to help advise patients. We sought to evaluate the effect of moderate excess alcohol consumption on cardiovascular structure, function and outcomes in DCM.MethodsProspective longitudinal observational cohort study. Patients with DCM (n=604) were evaluated for a history of moderate excess alcohol consumption (UK government guidelines; >14 units/week for women, >21 units/week for men) at cohort enrolment, had cardiovascular magnetic resonance and were followed up for the composite endpoint of cardiovascular death, heart failure and arrhythmic events. Patients meeting criteria for alcoholic cardiomyopathy were not recruited.ResultsDCM patients with a history of moderate excess alcohol consumption (n=98, 16%) had lower biventricular function and increased chamber dilatation of the left ventricle, right ventricle and left atrium, as well as increased left ventricular hypertrophy compared with patients without moderate alcohol consumption. They were more likely to be male (alcohol excess group: n=92, 94% vs n=306, 61%, p=<0.001). After adjustment for biological sex, moderate excess alcohol was not associated with adverse cardiac structure. There was no difference in midwall myocardial fibrosis between groups. Prior moderate excess alcohol consumption did not affect prognosis (HR 1.29, 95% CI 0.73 to 2.26, p=0.38) during median follow-up of 3.9 years.ConclusionDCM patients with moderate excess alcohol consumption have adverse cardiac structure and function at presentation, but this is largely due to biological sex. Alcohol may contribute to sex-specific phenotypic differences in DCM. These findings help to inform lifestyle discussions for patients with DCM.

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Qualitative exploration of barriers to alcohol management in patients with chronic disease in a regional setting

Australian Journal of Primary Health ◽

10.1071/py19176 ◽

2020 ◽

Vol 26 (3) ◽

pp. 265 ◽

Cited By ~ 1

Author(s):

Julie Mudd ◽

Robyn Preston ◽

Sarah Larkins

Keyword(s):

Chronic Disease ◽

Alcohol Consumption ◽

General Practitioners ◽

Multidisciplinary Care ◽

Cultural Norms ◽

Health Practitioners ◽

General Practices ◽

Qualitative Exploration ◽

Regional Australia ◽

Excess Alcohol Consumption

Chronic diseases are a major contributor to the burden of disease in Australia. Alcohol consumption is similar in people with chronic disease and the general public, and may contribute to management challenges. In regional Australia, there are limited options for the management of excess alcohol consumption, so most of this burden falls to general practitioners. This study explored how staff in general practices are managing alcohol in patients with chronic disease with a view to determining what additional services may be appropriate. Brief interviews were conducted with doctors, nurses and allied health practitioners across three general practices in a regional centre. Interviews were analysed using abductive thematic techniques to elicit broad themes. In all, 18 interviews were conducted. All interviewees found the management of patients with chronic disease who were drinking in excess of guidelines to be challenging. The complexity of patients, in terms of health needs and social circumstances, affected management and self-care. Australian drinking cultural norms also affected patients’ and practitioners’ behaviour. Multidisciplinary care was highlighted by all health professionals; however, there were challenges maintaining staff motivation, a lack of training in alcohol management and a lack of referral or assistance services. Experienced practitioners identified that the patient was the key stakeholder who needed to take ownership of their health. The combined burden of excess alcohol consumption and chronic disease is a common management challenge faced by staff in general practice. Although there was evidence of awareness of the issue and a concerted effort to address the problem, most staff felt they had inadequate training, skills and resources. More undergraduate or postgraduate training in alcohol management and more resources are required to support general practitioners in this area.

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Universal screening of acute medical admissions for excess alcohol consumption: What’s the misuse?

Journal of Hepatology ◽

10.1016/j.jhep.2017.06.006 ◽

2017 ◽

Vol 67 (3) ◽

pp. 448-450

Author(s):

Stephen R. Atkinson ◽

Nikhil Vergis ◽

Alexandre Louvet ◽

Mark R. Thursz

Keyword(s):

Alcohol Consumption ◽

Universal Screening ◽

Excess Alcohol Consumption

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Optimized Spectrophotometric Determination of Aldehyde Dehydrogenase Activity in Erythrocytes

Clinical Chemistry ◽

10.1093/clinchem/38.4.584 ◽

1992 ◽

Vol 38 (4) ◽

pp. 584-588 ◽

Cited By ~ 7

Author(s):

R D Johnson ◽

J Bahnisch ◽

B Stewart ◽

D J Shearman ◽

J B Edwards

Keyword(s):

Alcohol Consumption ◽

Dehydrogenase Activity ◽

Aldehyde Dehydrogenase ◽

Biological Marker ◽

Aldh Activity ◽

Lactate Dehydrogenase Activity ◽

Analytical Imprecision ◽

Excess Alcohol Consumption ◽

Aldehyde Dehydrogenase Activity

Abstract We describe a reliable and sensitive semiautomated spectrophotometric assay of aldehyde dehydrogenase (ALDH; EC 1.2.1.3) activity in erythrocytes. The hemolysate can be stabilized with sucrose, and the technique involves only microliters of hemolysate on a centrifugal analyzer. The use of microcolumns to remove interfering hemoglobin is avoided, and reproducibility of the assay has been improved by manipulating the inherent lactate dehydrogenase activity of erythrocytes by adding lactate and oxalate to the reaction mixture. These modifications have decreased the analytical imprecision of the assay, allowing a better appraisal of aldehyde dehydrogenase activity in erythrocytes as a biological marker of excess alcohol consumption. Erythrocytic ALDH activity was significantly less in 40 alcoholics than in 145 teetotallers (median activity 128 vs 219 mU/g of hemoglobin, respectively; P = 0.0001), indicating the potential of this assay as a useful marker of excess alcohol consumption.

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