Statistical interpretation of medical data of patients with alcohol abuse (original) (raw)
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Indian Journal of Mental Health, 2020
Background: The aim of the research was to study the biochemical profile of the male patients diagnosed with alcohol dependence syndrome and its correlation with the severity of dependence. Methodology: A descriptive study comprising of 60 patients admitted in the psychiatry de-addiction clinic at HSK hospital from 1st July 2017 to 31st December 2017 was done after taking institutional ethical committee clearance. A semi-structured proforma was used to determine the socio-demographic details like education, occupation, socioeconomic status etc. the severity of dependence was determined using Severity of Alcohol Dependence Questionnaire (SADQ) scale and basic biochemical tests were performed. Descriptive analysis using an appropriate statistical test was done. Results: The mean age at presentation was 37.9 years. Out of 60 patients, 21 (35%) had mild dependence, 24 (40%) had moderate dependence and 15 (25%) had severe dependence. Hepatic enzymes AST and ALT were raised in 76.67% and 66.67% patients respectively. AST to ALT ratio was above 2 in 11.67% patients. There was a significant correlation between total SADQ scores and Alanine Transaminase (ρ = 0.281, P = 0.03, n = 60). Conclusion: The biochemical tests were deranged in most of the patients with alcohol dependence. Certain markers can be developed based on their significant association with the dependence levels, thus, helping in early diagnosis and prevention of alcohol dependence syndrome.
Journal of Substance Abuse Treatment, 2017
Background: Alcohol use disorders (AUD) is a phase of alcohol misuse in which the drinker consumes excessive amount of alcohol and have a continuous urge to consume alcohol which may lead to various health complications. The current methods of alcohol use disorders diagnosis such as questionnaires and some biomarkers lack specificity and sensitivity. Metabolomics is a novel scientific field which may provide a novel method for the diagnosis of AUD by using a sensitive and specific technique such as nuclear magnetic resonance (NMR). Methods: A cross sectional study was conducted on three groups: individuals with alcohol use disorders (n = 30), social drinkers (n = 54) and alcohol-naive controls (n = 60). 1 H NMR-based metabolomics was used to obtain the metabolic profiles of plasma samples. Data were processed by multivariate principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) followed by univariate and multivariate logistic regressions to produce the best fit-model for discrimination between groups. Results: The OPLS-DA model was able to distinguish between the AUD group and the other groups with high sensitivity, specificity and accuracy of 64.29%, 98.17% and 91.24% respectively. The logistic regression model identified two biomarkers in plasma (propionic acid and acetic acid) as being significantly associated with alcohol use disorders. The reproducibility of all biomarkers was excellent (0.81-1.0). Conclusions: The applied plasma metabolomics technique was able to differentiate the metabolites between AUD and the other groups. These metabolites are potential novel biomarkers for diagnosis of alcohol use disorders.
Alcoholism-clinical and Experimental Research, 1993
We evaluated three markers of ethanol intake [whole blood associated acetaldehyde (WBAA), serum β-hexosaminidase, and γ-glutamyl transpeptidase (GGT)] in four groups of subjects: teetotalers (n= 104), random insurance applicants or “normals”(n= 1,010), subjects enrolling in an alcohol treatment program or “alcoholics”(n= 31), and subjects attending outpatient drug/alcohol treatment follow-up clinics (n= 128). Significant differences (p < 0.004 for each assay and each comparison) were found in the mean values between teetotalers and normals and normals and alcoholics. Male teetotalers and normals had significantly (p < 0.002) higher levels of WBAA than females of the same group. Male normals had significantly higher levels of GGT than females (p < 0.001). GGT increased with age in the normal population into the fifth decade and decreased thereafter. WBAA was the most sensitive assay with 97% of alcoholics having values above the 99th percentile for the teetotaler population (vs. 66% for serum β-hexosaminidase and 70% for GGT). None of the alcoholic subjects had values for all three assays below the 99th percentile for teetotalers compared with 21% of those in follow-up and 72% of normals. We conclude that WBAA appears to be the best of the three markers studied and that measurement of multiple markers for ethanol use appears clinically useful and incremental.
Alcohol and Alcoholism, 1997
The development of reliable diagnostic tools for assessing alcoholism and harmful alcohol consumption is an utmost necessity for the success of efforts to prevent and treat alcohol-induced damage to both individuals and to society. A multinational study is underway to aid in the development of biological screening tools (state markers) which can, with good sensitivity and specificity, identify problem drinkers. To attain this goal information needs to be available on an individual's drinking history and habits and related factors. A detailed instrument has been developed to obtain this information. The second goal of the study was to begin to develop diagnostic 'trait markers' which provide biological information on genetically determined predisposing and protective factors in the development of alcoholism. The developed questionnaire also provides background information on subject characteristics necessary for the development of trait markers. Centres will assay the obtained biological samples for 'traditional' and newly identified state markers of excessive alcohol consumption. These will include methanol measurements, gamma-glutamyltransferase, aspartate aminotransferase, carbohydrate-deficient transferrin, serotonin metabolite ratios, and erythrocyte aldehyde dehydrogenase. DNA obtained from the lymphocytes of subjects will be assayed for polymorphisms of alcohol-and aldehyde-metabolizing enzymes and dopaminc receptor polymorphisms which can provide insights into protective and predisposing factors in alcoholism. The platelet enzymes, monoamine oxidase and adenylyl cyclase, will be assayed to assess the relationships between these putative trait markers and the genetic and environmental factors contributing to the aetiology of alcoholism. The current report is meant to introduce the study design and present a portion of the preliminary data gathered in the process of establishing this research programme.
Alcohol and Alcoholism, 2003
Aims: Alcohol consumption in France is one of the highest in the world. Factors associated with excessive alcohol drinking are numerous. However, taken separately, none of the existing clinical or biological markers of excessive alcohol intake enables an adequate identification of heavy drinkers. The aim of this cross-sectional survey was to identify socio-demographic, clinical and biological factors associated with excessive alcohol drinking, to develop a model and to assess its reliability, thus enabling the detection of heavy drinkers. Methods: Subjects were 1619 men and 1559 women, aged 35-64 years, living in three French areas (Lille, Strasbourg and Toulouse) and randomly selected from polling lists. Socio-demographic status, lifestyle, reported alcohol intake and answers to the CAGE questionnaire (alcohol dependence) were obtained by questionnaire. A blood sample was taken for quantification of biological parameters. Men who drank 60 g of ethanol a day (g/day) or above and women who drank 30 g/day or above were classified as heavy drinkers. The reference class (RC) gathered non-drinkers and moderate drinkers together. The sample was divided into two sub-samples: the first was used to estimate the parameters of a logistic regression model (heavy drinkers vs others), and the second to assess the accuracy of this model for the identification of heavy drinkers, using receiver operating characteristic (ROC) curves. A specific analysis was performed for each gender. Results: Fourteen per cent of men and 40.8% of women were non-drinkers. Nine per cent of women and 14.4% of men were heavy drinkers. Wine was the most consumed alcoholic beverage. In the univariate analyses, differences were observed between the two groups of alcohol consumers for most of the socio-demographic, clinical and biological variables considered. In the multivariate analyses, low educational level, smoking, apoprotein B, high density lipoprotein cholesterol, mean corpuscular volume (MCV), γ-glutamyl-transferase (GGT) and the CAGE score for men, and living area, age, MCV, GGT and the CAGE score for women remained independently and significantly associated with heavy drinking. In the validation subsample, these models combining different types of markers enabled a good discrimination between heavy drinkers and the RC, with an area under the ROC curve of 82% for men and of 79% for women. Conclusions: In this study, socio-demographic, clinical and biological factors and the CAGE score were independently related to excessive alcohol drinking and their joint utilization in a screening model enabled a good recognition of heavy drinkers.
Biochemical markers for alcohol consumption
Indian Journal of Clinical Biochemistry, 2003
A variety of laboratory tests are available to assist in the diagnosis of alcohol consumption and related disorders. The levels of intake at which laboratory results become abnormal vary from person to person. Laboratory tests are particularly useful in settings where cooperativeness is suspected or when a history is not available. Several biochemical and hematological tests, such as γ-glutamyltransferase (GGT) activity, aspartate aminotransferase (AST) activity, highdensity lipoprotein cholesterol (HDL-C) content of serum, and erythrocyte mean corpuscular volume (MCV) are established markers of alcohol intake. Their validity as markers is based largely on correlations with recent intake at a single time point and on decreases in elevated values when heavy drinkers abstain from alcohol. These readily available laboratory tests provide important prognostic information and should be integral part of the assessment of persons with hazardous alcohol consumption. There are several other markers with considerable potential for more accurate reflection of recent alcohol intake. These include carbohydrate deficient transferrin, β-hexosaminidase, acetaldehyde adducts and the urinary ratio of serotonin metabolites, 5-hydroxytryptophol and 5-hydroxyindoleacetic acid. These markers provide hope for more sensitive and specific aids to diagnosis and improved monitoring for intake.
Biochemical diagnosis of alcoholism
Indian Journal of Clinical Biochemistry, 2005
Medically diagnosed alcoholics can be differentiated reliably from non-alcoholics using clinically laboratory tests. In the present study, patients with liver diseases either due to alcohol or without alcohol compared with a group of normal healthy persons. Heavy drinkers showed significantly lower body weight and percent body fat, and low BMI compared with other groups. The percentage of hemoglobin and total number of RBC were found to be significantly decreased, whereas mean corpuscular volume (MCV) significantly increased in alcoholic liver disease (ALD). Hyperbilirubinemia, hyperuricemia and hypoalbuminemia correlate with alcohol intake. Albumin / globulin ratio significantly decreased in ALD. In acute liver injury AST/ ALT ratio is ≤ 1.0, whereas in alcoholic hepatitis it is always > 1.0. Moderately elevated level of ALP and high GGT values are good discriminator of alcoholic patients. Alcohol-induced liver injury is linked to oxidative stress as observed by decreased level of reduced glutathione and ascorbic acid, and increased level of thiobarbituric acid reactive substances.
HPA-Axis Activity and Nutritional Status Correlation in Individuals with Alcohol Use Disorder
Nutrients
Impaired activity of the hypothalamic–pituitary–adrenal axis (HPA-axis) is evident in alcohol use disorder (AUD), and may be implicated in various nutritional and metabolic alterations often seen in individuals with this disorder. The present study examined a possible correlation between HPA-axis activity and nutritional status components in individuals with AUD. Fourteen AUD and fourteen non-AUD males participated; anthropometric and body composition measurements were made, and fasting blood samples were analysed for plasma adrenal corticotropic hormone (ACTH), catecholamines, cortisol and beta-endorphin. Nutrient intake was estimated via a three-day diet record. Waist circumference and waist-to-hip ratio were increased in the AUD group. Thiamine and folic intake were lower in AUD group, although only folic acid intake was insufficient in both AUD and non-AUD groups. Increased epinephrine and norepinephrine were also observed in AUD group compared to non-AUD group. No clear correla...
Physiological assessment of male alcoholism
In 100 consecutive male inpatients with alcohol dependence and an equal number of age, sex, occupation and regional background matched controls, the value ofgamma-glutamyl transpeptidase (GGT). serum glutamic oxaloacetic transaminase (SGOT). serum glutamic pyruvic transaminase (SGPT), mean corpuscular volume (MCV) and serum triglycerides were statistically significantly raised among alcoholics on admission as compared to controls. After five weeks of enforced abstinence in hospital the values of GGT. SGOT and SGPT showed significant reduction among alcohol consumption, these objective laboratory tests can be used to support the clinical diagnosis of alcohol dependence. Electrocardiographic abnormalities viz. Sinus tachycardia, intraventricular conduction defects, T wave abnormalities and QTC prolongation occurred significantly more frequently in alcohol dependence patients as compared to normal controls.
Prediction of alcohol-related harm by laboratory test results
Clinical chemistry, 1993
We examined the value of laboratory markers of excessive alcohol (ethanol) intake as predictors of mortality, morbidity, and health-care utilization in a cohort of 330 patients attending an acute ambulatory care service. Among men, all four markers examined--gamma-glutamyltransferase (GGT) and aspartate aminotransferase (AST) activities, high-density lipoprotein cholesterol (HDL-C), and mean corpuscular volume (MCV)--were predictive of medical sequelae and health-care utilization over a 3-year period. In contrast, social problems were more closely related to the amount of alcohol consumption at initial assessment than to any biological marker. Serum GGT and AST activities and MCV were predictive of medical sequelae in women. The predictive value of GGT was an independent risk factor and did not merely reflect recent alcohol intake or the presence of chronic liver disease. We conclude that these readily available laboratory tests provide important prognostic information and should be...