Alcohol consumption by cirrhotic subjects: Patterns of use and effects on liver function

Michael R. Lucey, Jason T. Connor, Thomas D Boyer, J. Michael Henderson, Layton F. Rikkers

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

OBJECTIVE:We investigated patterns of use of alcohol and its clinical effects among cirrhotic subjects who participated in a randomized clinical trial comparing the efficacy of transjugular intravenous portosystemic shunt and distal splenorenal shunt.METHODS: There were 132 cirrhotic subjects, 78 with alcoholic liver disease (ALD), who were followed for a median of 49 months (range 2-93 months). Alcohol use was assessed by patient questionnaire, with corroboration by family members.RESULTS: Twenty-eight subjects (21%) were drinking at study entry and 60 subjects (45%) drank during follow-up. Heavy drinking (>4 drinks/day) was recorded in 25 ALD subjects, but in no non-ALD subjects (P < 0.0001). Drinking by ALD subjects was associated with a 153% increase in gamma-glutamyl transpeptidase (GGT) (P < 0.0001). The frequencies of death (46% vs 30%), ascites (33% vs 20%), encephalopathy (56% vs 42%), and variceal bleeding (11% vs 3%) were greater in the ALD group. In a Cox proportional hazards model only 'ever heavy drinking' was associated with death (P = 0.0099), while recent heavy drinking increased the hazard of variceal hemorrhage dramatically (odds ratio 10.85).CONCLUSIONS: Whereas most cirrhotic subjects, alcoholic or not, did not drink during 5 yr of observation, heavy alcohol use occurred exclusively in ALD patients. Alcohol use by ALD subjects was associated with elevations in GGT and was linked to death and with rebleeding from shunt dysfunction.

Original languageEnglish (US)
Pages (from-to)1698-1706
Number of pages9
JournalAmerican Journal of Gastroenterology
Volume103
Issue number7
DOIs
StatePublished - Jul 2008

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Alcoholic Liver Diseases
Alcohol Drinking
Drinking
Liver
Alcohols
gamma-Glutamyltransferase
Surgical Splenorenal Shunt
Hemorrhage
Surgical Portasystemic Shunt
Brain Diseases
Proportional Hazards Models
Ascites
Liver Diseases
Randomized Controlled Trials
Odds Ratio
Observation

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

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Alcohol consumption by cirrhotic subjects : Patterns of use and effects on liver function. / Lucey, Michael R.; Connor, Jason T.; Boyer, Thomas D; Henderson, J. Michael; Rikkers, Layton F.

In: American Journal of Gastroenterology, Vol. 103, No. 7, 07.2008, p. 1698-1706.

Research output: Contribution to journalArticle

Lucey, Michael R. ; Connor, Jason T. ; Boyer, Thomas D ; Henderson, J. Michael ; Rikkers, Layton F. / Alcohol consumption by cirrhotic subjects : Patterns of use and effects on liver function. In: American Journal of Gastroenterology. 2008 ; Vol. 103, No. 7. pp. 1698-1706.
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abstract = "OBJECTIVE:We investigated patterns of use of alcohol and its clinical effects among cirrhotic subjects who participated in a randomized clinical trial comparing the efficacy of transjugular intravenous portosystemic shunt and distal splenorenal shunt.METHODS: There were 132 cirrhotic subjects, 78 with alcoholic liver disease (ALD), who were followed for a median of 49 months (range 2-93 months). Alcohol use was assessed by patient questionnaire, with corroboration by family members.RESULTS: Twenty-eight subjects (21{\%}) were drinking at study entry and 60 subjects (45{\%}) drank during follow-up. Heavy drinking (>4 drinks/day) was recorded in 25 ALD subjects, but in no non-ALD subjects (P < 0.0001). Drinking by ALD subjects was associated with a 153{\%} increase in gamma-glutamyl transpeptidase (GGT) (P < 0.0001). The frequencies of death (46{\%} vs 30{\%}), ascites (33{\%} vs 20{\%}), encephalopathy (56{\%} vs 42{\%}), and variceal bleeding (11{\%} vs 3{\%}) were greater in the ALD group. In a Cox proportional hazards model only 'ever heavy drinking' was associated with death (P = 0.0099), while recent heavy drinking increased the hazard of variceal hemorrhage dramatically (odds ratio 10.85).CONCLUSIONS: Whereas most cirrhotic subjects, alcoholic or not, did not drink during 5 yr of observation, heavy alcohol use occurred exclusively in ALD patients. Alcohol use by ALD subjects was associated with elevations in GGT and was linked to death and with rebleeding from shunt dysfunction.",
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N2 - OBJECTIVE:We investigated patterns of use of alcohol and its clinical effects among cirrhotic subjects who participated in a randomized clinical trial comparing the efficacy of transjugular intravenous portosystemic shunt and distal splenorenal shunt.METHODS: There were 132 cirrhotic subjects, 78 with alcoholic liver disease (ALD), who were followed for a median of 49 months (range 2-93 months). Alcohol use was assessed by patient questionnaire, with corroboration by family members.RESULTS: Twenty-eight subjects (21%) were drinking at study entry and 60 subjects (45%) drank during follow-up. Heavy drinking (>4 drinks/day) was recorded in 25 ALD subjects, but in no non-ALD subjects (P < 0.0001). Drinking by ALD subjects was associated with a 153% increase in gamma-glutamyl transpeptidase (GGT) (P < 0.0001). The frequencies of death (46% vs 30%), ascites (33% vs 20%), encephalopathy (56% vs 42%), and variceal bleeding (11% vs 3%) were greater in the ALD group. In a Cox proportional hazards model only 'ever heavy drinking' was associated with death (P = 0.0099), while recent heavy drinking increased the hazard of variceal hemorrhage dramatically (odds ratio 10.85).CONCLUSIONS: Whereas most cirrhotic subjects, alcoholic or not, did not drink during 5 yr of observation, heavy alcohol use occurred exclusively in ALD patients. Alcohol use by ALD subjects was associated with elevations in GGT and was linked to death and with rebleeding from shunt dysfunction.

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