SYSTEMIC COMPLICATIONS OF CHRONIC ALCOHOL CONSUMPTION. CASE-CONTROL STUDY CORPSES VERSUS SURVIVING PATIENTS
DOI:
https://doi.org/10.22551/MSJ.2022.02.03Abstract
The aim of this prospective study is to investigate the forensic cases of the Institute of Legal Medicine (ILM) Iasi compared to a group of living patients, based on chronic alcohol consumption in the past. Material and methods: The study group consisted of 120 subjects, of which 60 cadavers from ILM Iasi, alleged victims of chronic ethanol consumption, and 60 patients admitted to the Cardiology Clinic I of the “Sf. Spiridon” County Clinical Emergency Hospital from Iasi, in order to perform a case-control study. Results: The studied cases are dominated by male patients over 60 years of age, from rural areas. A cut off value of ethyl glucuronide (EtG) greater than 500 ng/ml proves to be a good predictor in the determinism of liver cirrhosis and dilated cardiomyopathy. Conclusions: Elevated levels of EtG have been shown to be a good predictor of liver cirrhosis and dilated cardiomyopathy.
References
2. Thundiyil JG, Rowley F, Papa L, Olson KR, Kearney TE. Risk factors for complications of drug-induced seizures. J Med Toxicol. 2011; 7:16-23 / doi:10.1007/s13181-010-0096-4.
3. Clark JC. Sudden death in the chronic alcoholic. Forensic Sci Int. 1988; 36(1-2): 105-111 / doi:10.1016/0379-0738(88)90222-8.
4. Srividya B. Impact of Alcohol on Drug Metabolism and Alcohol-Drug Pharmacokinetic. Interactions in Alcoholics. Research and Review. J Pharmacol Toxicol Studies 2016; 4(2): 112-119.
5. Jepsen P, Vilstrup H, Mellemkjaer L, et al. Prognosis of patients with a diagnosis of fatty liver - a registry-based cohort study. Hepatogastroenterology 2003; 50(54): 2101-2104.
6. Marsman HA, Heisterkamp J, Halm JA, Tilanus HW, Metselaar HJ, Kazemier G. Management in patients with liver cirrhosis and an umbilical hernia. Surgery 2007; 142(3): 372-375 / doi:10.1016 /j.surg.2007.05.006.
7. Valleur M, Matysiak J, Antonescu A. Patologiile excesului [The pathologies of the excess]. Bucur-essti: Nemira, 2008.
8. Loly JP, Meurisse N, Gast P, Honore P, Louis E, Meurisse M. Alcool et complications pancréatiques [Alcool and pancreatic complications] Rev Med Liege 2019; 74(5-6): 342-348.
9. Voskoboinik A, Prabhu S, Ling LH, Kalman JM, Kistler PM. Alcohol and Atrial Fibrillation: A Sobering Review. J Am Coll Cardiol. 2016; 68(23): 2567-2576 / doi:10.1016/j.jacc.2016.08.074.
10. Pham T, Rubenfeld GD. Fifty Years of Research in ARDS. The Epidemiology of Acute Respiratory Distress Syndrome. A 50th Birthday Review. Am J Respir Crit Care Med 2017; 195(7): 860-870 / doi:10.1164/ rccm.201609-1773CP.
11. Carpenter RW, Treloar Padovano H, Emery NN, Miranda R Jr. Rate of alcohol consumption in the daily life of adolescents and emerging adults. Psychopharmacology (Berl) 2019; 236(11): 3111-3124 / doi:10.1007/s00213-019-05262-8.
12. White LF, Jiang W, Ma Y, So-Armah K, Samet JH, Cheng DM. Tutorial in biostatistics: the use of generalized additive models to evaluate alcohol consumption as an exposure variable. Drug Alcohol Depend 2020; 209: 107944 / doi:10.1016/j.drugalcdep.2020.107944.
13. You M, Arteel GE. Effect of ethanol on lipid metabolism. J Hepatol 2019; 70(2): 237-248 / doi:10.1016/j.jhep.2018.10.037.
14. Jeon S, Carr R. Alcohol effects on hepatic lipid metabolism. J Lipid Res. 2020; 61(4): 470-479 / doi:10.1194/jlr.R119000547.
15. Mazzolini G, Sowa JP, Atorrasagasti C, Kücükoglu Ö, Syn WK, Canbay A. Significance of simple steatosis: an update on the clinical and molecular evidence. Cells. 2020; 9(11): 2458 / doi:10.3390/ cells9112458.
16. Rachakonda V, Bataller R, Duarte-Rojo A. Recent advances in alcoholic hepatitis. F1000Res. 2020; 9:F1000 Faculty Rev-97 / doi:10.12688/f1000research.20394.1.
17. Moure-Rodriguez L, Carbia C, Lopez-Caneda E, Corral Varela M, Cadaveira F, Caamano-Isorna F. Trends in alcohol use among young people according to the pattern of consumption on starting uni-versity: a 9-year follow-up study. PLoS One 2018; 13(4): e0193741 / doi:10.1371/ journal. pone. 0193741.
18. Day E, Rudd JHF. Alcohol use disorders and the heart. Addiction. 2019; 114(9): 1670-1678 / doi:10.1111/add.14703.
19. Rosenbloom JI, Mukamal KJ, Frost LE, Mittleman MA. Alcohol consumption patterns, beverage type, and long-term mortality among women survivors of acute myocardial infarction. Am J Cardiol 2012; 109(2): 147-152 / doi:10.1016/j.amjcard.2011.08.021.
20. Seki E, Schwabe RF. Hepatic inflammation and fibrosis: functional links and key pathways. Hepatol-ogy 2015; 61(3): 1066-1079 / doi:10.1002/hep.27332.
21. Tsochatzis EA, Bosch J, Burroughs AK. Liver cirrhosis. Lancet 2014; 383(9930): 1749-1761 / doi:10.1016/S0140-6736(14)60121-5.
22. Petrescu F, Petrescu OI, Taisescu CI, et al. Histopathological aspects described in patients with chronic hepatitis C. Rom J Morphol Embryol 2015; 56(2): 439-444.
23. Li X, Nie Y, Lian H, Hu S. Histopathologic features of alcoholic cardiomyopathy compared with idiopathic dilated cardiomyopathy. Medicine (Baltimore) 2018; 97(39): e12259 / doi:10.1097/MD. 0000000000012259.
24. Rocco A, Compare D, Angrisani D, Sanduzzi Zamparelli M, Nardone G. Alcoholic disease: liver and beyond. World J Gastroenterol 2014; 20(40): 14652-14659 / doi:10.3748/wjg.v20.i40.14652.
25. European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu; European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of alcohol-related liver disease. J Hepatol 2018; 69(1): 154-181 / doi:10.1016/j.jhep.2018.03.018.
26. Xiao J, Wang F, Wong NK, et al. Epidemiological Realities of Alcoholic Liver Disease: Global Burden, Research Trends, and Therapeutic Promise. Gene Expr 2020; 20(2): 105-118 /doi:10.3727/ 105221620X15952664091823.
27. Karsan HA, Parekh S. Management of alcoholic hepatitis: Current concepts. World J Hepatol 2012; 4(12): 335-341 / doi:10.4254/wjh.v4.i12.335.
28. Fischbach FT. Drug monitoring. In: Fischbach FT, Dunning MB editors. A manual of laboratory and diagnostic tests, 7th edition, Philadelphia: Lippincott Williams & Wilkins, 2004, 415-420.
29. Liang R, Liu A, Perumpail RB, Wong RJ, Ahmed A. Advances in alcoholic liver disease: An update on alcoholic hepatitis. World J Gastroenterol 2015; 21(42): 11893-11903 / doi:10.3748/wjg.v21. i42.11893.
30. Singal AK, Kamath PS, Gores GJ, Shah VH. Alcoholic hepatitis: current challenges and future direc-tions. Clin Gastroenterol Hepatol. 2014; 12(4): 555-564 / doi:10.1016/j.cgh.2013.06.013.
31. Crabb DW, Bataller R, Chalasani NP, et al. Standard Definitions and Common Data Elements for Clinical Trials in Patients With Alcoholic Hepatitis: Recommendation From the NIAAA Alcoholic Hepatitis Consortia. Gastroenterology. 2016; 150(4): 785-790 / doi:10.1053/j.gastro.2016.02.042.
32. Mehal W, To U. New approaches for fibrosis regression in alcoholic cirrhosis. Hepatol Int. 2016; 10(5): 773-778 / doi:10.1007/s12072-016-9752-3.
33. Tilg H, Day CP. Management strategies in alcoholic liver disease. Nat Clin Pract Gastroenterol Hepatol. 2007; 4(1): 24-34 / doi:10.1038/ncpgasthep0683.
34. Szabo G. Gut-liver axis in alcoholic liver disease. Gastroenterology 2015; 148(1): 30-36 / doi:10.1053/j.gastro.2014.10.042.
35. Dunn W, Shah VH. Pathogenesis of Alcoholic Liver Disease. Clin Liver Dis 2016; 20(3): 445-456 / doi:10.1016/j.cld.2016.02.004.
36. Kong LZ, Chandimali N, Han YH, et al. Pathogenesis, Early Diagnosis, and Therapeutic Management of Alcoholic Liver Disease. Int J Mol Sci 2019; 20(11): 2712 / doi:10.3390/ijms20112712.
37. Higashi T, Friedman SL, Hoshida Y. Hepatic stellate cells as key target in liver fibrosis. Adv Drug Deliv Rev. 2017; 121: 27-42 / doi:10.1016/j.addr.2017.05.007.
38. Adebayo D, Neong SF, Wong F. Refractory Ascites in Liver Cirrhosis. Am J Gastroenterol. 2019; 114(1): 40-47 / doi:10.1038/s41395-018-0185-6.
39. Chaudhary K, Khanna R. Renal replacement therapy in end-stage renal disease patients with chronic liver disease and ascites: role of peritoneal dialysis. Perit Dial Int. 2008; 28(2): 113-117.
40. Taranu T, Florea L, Paduraru D, Georgescu SO, Francu LL, Stan CI. Morphological changes of the peritoneal membrane in patients with long-term dialysis. Rom J Morphol Embryol 2014; 55(3): 927-932.
41. Mehal WZ, Schuppan D. Antifibrotic therapies in the liver. Semin Liver Dis. 2015; 35(2): 184-198 / doi:10.1055/s-0035-1550055.
42. Elpek GO. Cellular and molecular mechanisms in the pathogenesis of liver fibrosis: An update. World J Gastroenterol. 2014; 20(23): 7260-7276 / doi:10.3748/wjg.v20.i23.7260.
43. Friedman SL. Hepatic stellate cells: protean, multifunctional, and enigmatic cells of the liver. Physiol Rev 2008; 88(1): 125-172 / doi:10.1152/physrev.00013.2007.
44. Mederacke I, Hsu CC, Troeger JS, et al. Fate tracing reveals hepatic stellate cells as dominant con-tributors to liver fibrosis independent of its etiology. Nat Commun 2013; 4: 2823 / doi:10.1038/ ncomms3823.
45. Lee YA, Wallace MC, Friedman SL. Pathobiology of liver fibrosis: a translational success story Gut 2015; 64(5): 830-841 / doi:10.1136/gutjnl-2014-306842.
46. Pellicoro A, Ramachandran P, Iredale JP, Fallowfield JA. Liver fibrosis and repair: immune regulation of wound healing in a solid organ. Nat Rev Immunol 2014; 14(3): 181-194 / doi:10.1038/nri3623.
47. Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 2011; 342: d671 / doi:10.1136/bmj.d671.
48. Glymour MM. Alcohol and cardiovascular disease. BMJ 2014; 349: g4334 / doi:10.1136/bmj.g4334.
49. Huang Y, Li Y, Zheng S, Yang X, Wang T, Zeng J. Moderate alcohol consumption and atherosclerosis : Meta-analysis of effects on lipids and inflammation. Wien Klin Wochenschr 2017; 129(21-22): 835-843 / doi:10.1007/s00508-017-1235-6.
50. Puddey IB, Mori TA, Barden AE, Beilin LJ. Alcohol and Hypertension-New Insights and Lingering Controversies. Curr Hypertens Rep 2019; 21(10): 79 / doi:10.1007/s11906-019-0984-1.
51. Piano MR, Phillips SA. Alcoholic cardiomyopathy: pathophysiologic insights. Cardiovasc Toxicol. 2014; 14(4): 291-308 / doi:10.1007/s12012-014-9252-4.
52. Guzzo-Merello G, Cobo-Marcos M, Gallego-Delgado M, Garcia-Pavia P. Alcoholic cardiomyopathy. World J Cardiol. 2014; 6(8): 771-781 / doi:10.4330/wjc.v6.i8.771.
53. Kimball SR, Lang CH. Mechanisms Underlying Muscle Protein Imbalance Induced by Alcohol. Annu Rev Nutr 2018; 38: 197-217 / doi:10.1146/annurev-nutr-071816-064642.
54. Iacovoni A, De Maria R, Gavazzi A. Alcoholic cardiomyopathy. J Cardiovasc Med (Hagerstown) 2010; 11(12): 884-892 / doi:10.2459/JCM.0b013e32833833a3.
55. Mirijello A, Tarli C, Vassallo GA, et al. Alcoholic cardiomyopathy: What is known and what is not known. Eur J Intern Med. 2017; 43: 1-5 / doi:10.1016/j.ejim.2017.06.014.
56. Kryzhanovs.kii SA, Kolik LG, Tsorin IB, et al. Alcoholic Cardiomyopathy: Translation Model. Bull Exp Biol Med 2017; 163(5): 627-631 / doi:10.1007/s10517-017-3865-0.
57. Weintraub RG, Semsarian C, Macdonald P. Dilated cardiomyopathy. Lancet 2017; 390(10092): 400-414 / doi:10.1016/S0140-6736(16)31713-5.
58. Ren J, Wold LE. Mechanisms of alcoholic heart disease. Ther Adv Cardiovasc Dis 2008; 2(6): 497-506 / doi:10.1177/1753944708095137.
59. Brandt M, Wenzel P. Alcohol puts the heart under pressure: Acetaldehyde activates a localized renin angiotensin aldosterone system within the myocardium in alcoholic cardiomyopathy. Int J Cardiol. 2018; 257: 220-221 / doi:10.1016/j.ijcard.2018.01.037.
60. Laurent D, Edwards JG. Alcoholic Cardiomyopathy: Multigenic Changes Underlie Cardiovascular Dysfunction. J Cardiol Clin Res 2014; 2(1): 1022.
61. Fernandez-Sola J. Cardiovascular risks and benefits of moderate and heavy alcohol consumption. Nat Rev Cardiol. 2015; 12(10): 576-587 / doi:10.1038/nrcardio.2015.91.
62. Fatjo F, Sancho-Bru P, Fernandez-Sola J, et al. Up-regulation of myocardial L-type Ca2+ channel in chronic alcoholic subjects without cardiomyopathy. Alcohol Clin Exp Res. 2007; 31(7): 1099-1105 / doi:10.1111/j.1530-0277.2007.00404.x.
63. Molina PE, Gardner JD, Souza-Smith FM, Whitaker AM. Alcohol abuse: critical pathophysiological processes and contribution to disease burden. Physiology (Bethesda) 2014; 29(3): 203-215 / doi:10.1152/physiol.00055.2013.
64. Steiner JL, Lang CH. Etiology of alcoholic cardiomyopathy: Mitochondria, oxidative stress and apop-tosis. Int J Biochem Cell Biol. 2017; 89: 125-135 / doi:10.1016/j.biocel.2017.06.009.
65. Simon HU, Haj-Yehia A, Levi-Schaffer F. Role of reactive oxygen species (ROS) in apoptosis induc-tion. Apoptosis. 2000; 5(5): 415-418 / doi:10.1023/a:1009616228304.
66. Wang Y, Li Z, Zhang Y, et al. Targeting Pin1 Protects Mouse Cardiomyocytes from High-Dose Alcohol-Induced Apoptosis. Oxid Med Cell Longev 2016; 2016: 4528906 / doi:10.1155/2016/ 45 28 906.
67. Wang Y, Zhao J, Yang W, et al. High-dose alcohol induces reactive oxygen species-mediated apoptosis via PKC-β/p66Shc in mouse primary cardiomyocytes. Biochem Biophys Res Commun 2015; 456(2): 656-661 / doi:10.1016/j.bbrc.2014.12.012.
68. Urbano-Marquez A, Fernandez-Sola J. Alcohol consumption and heart failure. J Card Fail 2005; 11(5): 329-332 / doi:10.1016/j.cardfail.2005.04.023.
69. El Hajj EC, El Hajj MC, Voloshenyuk TG, et al. Alcohol modulation of cardiac matrix metallopro-teinases (MMPs) and tissue inhibitors of MMPs favors collagen accumulation. Alcohol Clin Exp Res 2014; 38(2): 448-456 / doi:10.1111/acer.12239.
70. Vaideeswar P, Chaudhari C, Rane S, Gondhalekar J, Dandekar S. Cardiac pathology in chronic alco-holics: a preliminary study. J Postgrad Med 2014; 60(4): 372-376 / doi:10.4103/0022-3859.143958.
71. Guzzo-Merello G, Segovia J, Dominguez F, et al. Natural history and prognostic factors in alcoholic cardiomyopathy. JACC Heart Fail. 2015; 3(1): 78-86 / doi:10.1016/j.jchf.2014.07.014.
72. Lam BQ, Srivastava R, Morvant J, Shankar S, Srivastava RK. Association of Diabetes Mellitus and Alcohol Abuse with Cancer: Molecular Mechanisms and Clinical Significance. Cells 2021; 10(11): 3077 / doi:10.3390/cells10113077.
73. Engler PA, Ramsey SE, Smith RJ. Alcohol use of diabetes patients: the need for assessment and intervention. Acta Diabetol 2013; 50(2): 93-99 / doi:10.1007/s00592-010-0200-x.
74. Goonoo N, Bhaw-Luximon A, Ujoodha R, Jhugroo A, Hulse GK, Jhurry D. Naltrexone: a review of existing sustained drug delivery systems and emerging nano-based systems. J Control Release 2014; 183: 154-166 / doi:10.1016/j.jconrel.2014.03.046.
75. Avram I, Lupascu FG, Confederat L, Constantin S, Stan CI, Profire L. Chitosan microparticles loaded with antidiabetic drugs - Preparation and characterization. Farmacia 2017; 65: 443-448.
76. Stan CD, Dragan M, Tataringa G, Stan CI, Tuchilus CG, Mircea C. Monoclonal antibodies -past, present and future. Medical-Surgical Journal - Revista Medico-Chirurgicala. 2017; 121(2): 444-450.
77. Birsan M, Dragan M, Stan CD, et al. Patient satisfaction regarding compounded pharmaceutical products and implications on pharmaceutical practice management. Farmacia 2021; 69: 806-812.
Additional Files
Published
Issue
Section
License
COPYRIGHT
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.
COPYRIGHT TRANSFER FORM FOR
REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /
THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI
We, the undersigned authors of the manuscript entitled
_____________________________________________________________________________________
_____________________________________________________________________________________
warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.
- we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
- the manuscript does not break the intellectual property rights of any other person.
- we have read the submitted version of the manuscript and we are fully responsible for the content.
Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):
- ______________________________/_________________________
- ______________________________/_________________________
- ______________________________/_________________________
N.B. All the authors must sign this form