Alcohol Consumption in Patients with Psoriasis and its Relationship to Disease Severity (original) (raw)
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Psoriasis and unreported excessive alcohol intake - a simple screening approach
Journal of the European Academy of Dermatology and Venereology, 2011
Psoriasis is a chronic immune-mediated skin disease of complex aetiology. Alcohol overuse has long been suspected to contribute to psoriasis pathology, and the knowledge of individual's drinking pattern may be of substantial importance for managing the disease. Unfortunately, a number of patients fail to admit to their true alcohol consumption and there is no single sign, symptom or laboratory parameter adequate for alcohol abuse diagnosis. However, there are some laboratory findings that, when present, should raise physician's suspicion that alcohol may be a problem. The aim of this article was to present simple, widely available and relatively reliable laboratory markers that might effectively assist physicians in establishing patient's drinking status. A possible screening approach is illustrated by two distinct reports of psoriatic patients who initially concealed having the problem with alcohol.
Identification of Heavy Drinkers Using a Combination of Laboratory Tests
Journal of Clinical Epidemiology, 1997
This study derived and evaluated a model that used results of commonly performed laboratory tests to identify men who are heavy drinkers. Method: The results of 40 commonly available laboratory tests were obtained on a diverse sample of 426 heavy drinkers and 188 light drinkers. A logistic regression equation for identifying heavy drinkers was derived in a training data set of 411 subjects and tested in a validation data set of 203 subjects. Results: Ten laboratory measurements were included in the final regression equation: chloride, sodium, ratio of direct to total bilirubin level, blood urea nitrogen, high density lipoproteins, monocyte count, phosphorus, platelets, aspartate aminotransferase, and mean corpuscular hemoglobin. In the validation data this model correctly identified 98% of the 161 heavy drinkers and 95% of the 42 light drinkers. Other models reported in previous literature were applied to these subjects and did not perform as well. The model performed better for subjects of lower socioeconomic status. Conclusions: The laboratory tests in our model may help identify heavy drinkers. The performance of models to identify heavy drinkers depends on the demographic characteristics of the subjects.
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.
Dose Response of Laboratory Markers to Alcohol Consumption in a General Population
American Journal of Epidemiology, 2000
The dose response to alcohol use of carbohydrate-deficient transferrin (CDT), γ-glutamyltransferase (GGT), and their combination (γ-CDT) was studied in an age-and gender-stratified, random sample from Finland in 1997. A linear association with a threshold between alcohol consumption and the three markers was observed. Body mass index was negatively associated with CDT and positively with GGT. Age was positively associated with GGT and γ-CDT. In conclusion, CDT appears to be an early phase marker of alcohol consumption. The combined marker, γ-CDT, was less associated with factors such as body mass index but more strongly correlated with alcohol consumption than were the two markers separately. Am J Epidemiol 2000;152:747-51.
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.
Changes in markers of alcohol intake in man below 'safe' drinking levels
Alcohol and Alcoholism
In a group of 343 working men, only 34 of whom regularly drank more than 60 ml of ethanol per day, logistic regression was used to determine the combination of biomarkers which best discriminated between those who regularly drank less than 30 ml or 30 ml or more of ethanol daily. The index consisted of apolipoprotein A-II, uric acid, gamma-glutamyl transpeptidase and mean corpuscular volume. Even with the relatively low level of alcohol intake reported in these subjects (assessed using a 7-day retrospective alcohol diary), the groups with higher or lower intake of alcohol were separated with a sensitivity of 68%, a specificity of 74% and a positive predictive value of 71%. Systolic blood pressure, adjusted for age and body mass index, was also linearly related to alcohol intake, and when included in the biomarker index improved the proportion correctly classified from 71% to 75%. Using the biomarkers only, 94% of subjects regularly drinking at least 80 ml of ethanol equivalent per day and 100% of the non-drinkers were correctly classified.
Journal of Studies on Alcohol, 1983
Accuracy of Retrospective Measurement of Individual Alcohol Consumption in Men; A Reinterview after 18 Years jussi Simpura • and Kari Poikolainen • Su•t•tAR¾. At a reinterview after 18 years, 67 men overestimated their past alcohol consumption by an average of 76 %. The original consumption was the best regressor of the recalled consumption, but the magnitude and direction of error in remembering the original consumption varied considerably. A persistent problem encountered in surveys on alcohol consumption has been the lack of accuracy, reflected by the fact that survey-based estimates of aggregate alcohol consumption usually cover only 40-60 % of the actual consumption by the population (1). This is a problem of validity on the population level. An equally important problem is validity on the individual level, which must be taken into consideration when studying individual drinking histories retrospectively or, in clinical practice, when trying to determine the nature of a patient's drinking problem. The unsatisfactory validity on the population level has its roots in the ability and willingness of individuals to recall the amounts of alcohol that they have consumed. Both forgetting and concealment may influence the final result and as a rule lead to an underestimate of aggregate alcohol consumption (1, 2). In the case of individual measurements, techniques applied at different times may vary, thus introducing a technical element into the problem of validity. The validity of a measure of individual consumption can rarely be evaluated because of the lack of reference data. For population estimates, on the other hand, statistical records on sales and production provide a basis for evaluating validity. Multiple interviews must be used for individuals. This is what was done in the present study. METHOD In the years 1963-1965, 94 men participated in a study designed for'the analysis of drinking rhythms. 3 The ages of the men ranged from 23 to 56 (median, 40), and
The Biometric Measurement of Alcohol Consumption
Alcoholism: Clinical and Experimental Research, 2011
Background-Proper ascertainment of the history of alcohol consumption by an individual is an important component of medical diagnosis of disease and influences the implementation of appropriate treatment strategies that include prescription of medication, as well as intervention for the negative physical and social consequences of hazardous/harmful levels of alcohol consumption. Biological (biometric) diagnostic tests that provide information on current and past quantity and frequency of alcohol consumption by an individual, prior to onset of organ damage, continue to be sought. Methods-Platelet monoamine oxidase B (MAO-B) protein was quantitated in 2 populations of subjects who had histories of different levels of alcohol consumption. Levels were assayed by immunoblotting or by ELISA. The development and evaluation of the new ELISA-based measure of platelet MAO-B protein levels is described. Results-One subject population constituted a nontreatment-seeking, cross-sectional subject sample, and the other population was a longitudinally followed, hospitalized group of subjects. An algorithm combining measures of platelet MAO-B protein with the plasma levels of carbohydratedeficient transferrin (CDT) and with liver enzymes (aspartate aminotransferase or γglutamyltransferase [GGT]) can detect hazardous/harmful alcohol use (HHAU) with the highest sensitivity and specificity in the cross-sectional nontreatment-seeking population. In the treatmentseeking population, low MAO-B protein levels at admission are associated with heavy drinking prior to admission, and these protein levels increase over a period of abstinence from alcohol. Conclusions-The platelet MAO-B protein measurement is particularly effective for male alcohol consumers. The combined use of MAO-B protein measures together with measures of CDT and GGT does, however, improve the diagnostic utility of both markers for ascertaining HHAU in women. Furthermore, measurement of changes in platelet MAO-B protein levels during treatment for alcohol dependence may help monitor the success of the treatment program.