Liver disorders associated with alcohol consumption in patients in a health area
Keywords:
alcohol consumption, alcoholic fatty liver, liver fibrosisAbstract
Introduction: excessive alcohol consumption induces liver damage in a variable manner and if it is associated with other comorbidities the impact could be greater.
Objective: to determine liver involvement in alcohol-consuming patients treated in a health area, according to the consumption pattern and its relationship with the presence of metabolic risk factors.
Methods: observational, descriptive study carried out between March 2022 - September 2023 at the Puentes Grandes polyclinic. Sample: 32 patients. Main variables: sex, age, associated metabolic risk factors, blood chemistry, liver ultrasound, fibrosis indices (APRI and FITB 4) and alcohol consumption pattern: with and without alcohol use disorder. Descriptive measures of summary, percentage, mean and standard deviation were used. To relate the variables the Chi square test with a significance value of p<0.05.
Results: males predominated (78.1 %), with an average age of 54 years. 71.9% had alcohol use disorder. The majority of patients had some metabolic risk factor (73.9 % with alcohol use disorder and 88.8% of those without). In both consumption patterns, the absence of fibrosis according to APRI and FIB-4 predominated. Abnormal liver ultrasound was prevalent in patients with alcohol use disorder (14.6 %).
Conclusions: Patients with alcohol use disorder and greater liver involvement predominated. Associated metabolic risk factors were detected in the majority of the studied sample.
References
1. Arab JP, Addolorato G, Mathurin P, Thursz MR. Alcohol-Associated Liver Disease: Integrated Management With Alcohol Use Disorder. Clin Gastroenterol Hepatol [Internet]. 2023 [acceso: 10/04/2023];21(8):2124-2134. Disponible en https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(23)00159-3
2. Shimpi TR, Shikhare SN, Chung R, Wu P, Peh WCG. Imaging of Gastrointestinal and Abdominal Emergencies in Binge Drinking. Can Assoc Radiol J [Internet]. 2019 [acceso: 10/04/2023]; 70 (1): 52-61. Disponible en https://www.sciencedirect.com/science/article/pii/S0846537118301906?via%3Dihub
3. Sogabe M, Okahisa T, Kurihara T, Kagawa M, Ueda H, Kawaguchi T, et al. Comparison of the role of alcohol consumption and qualitative abdominal fat on NAFLD and MAFLD in males and females. Sci Rep [Internet]. 2022 [acceso: 10/04/2023] ;12(1):16048. Disponible en https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9512786/
4. Fabelo Roche JR, Iglesias More S. Prevención y atención de los trastornos adictivos. La Habana: Editorial Ciencias Médicas; 2018.
5. Gonzáles Menéndez R. Como enfrentar el peligro de las drogas: Tácticas para prevenir o superar el consumo de café, tabaco, alcohol, medicamentos psicoactivos, marihuana, cocaína, opio y otras drogas. Santiago de Cuba: Editorial Oriente; 2000.
6. Crabb DW, Im GY, Szabo G, Mellinger JL, Lucey MR. Diagnosis and Treatment of Alcohol-Associated Liver Diseases: 2019 Practice Guidance From the American Association for the Study of Liver Diseases. Hepatology [Internet]. 2020 [acceso: 04/03/2021];71 (1):[aprox. 12p.]. Disponible en: http://aulavirtual.sld.cu/pluginfile.php/99328/mod_resource/content/1/Gu%C3%ADa%20AASLD%20Enfermedad%20Hep%C3%A1tica%20Alcoh%C3%B3lica.pdf
7. Velarde-Ruiz Velasco JA, Higuera-de la Tijera MF, Castro-Narroc F, Zamarripa-Dorsey GE, Abdo-Francise JM, Aiza Haddadf I. Consenso Mexicano de hepatitis alcohólica. Rev Gastroenterol Méx [Internet]. 2020 [acceso: 10/04/2023];85(3):332-353. Disponible en: http://www.revistagastroenterologiamexico.org/es-consenso-mexicano-hepatitis-alcoholica-articulo-S0375090620300483
8. Bataller R, Cabezas J, Aller R, Ventura-Cots M, Abad J, Albillos A, et al. Enfermedad hepática por alcohol. Guías de práctica clínica Documento de consenso auspiciado por la AEEH. Guía de práctica clínica. Gastroenterol Hepatol [Internet]. 2019 [acceso: 10/04/2023];42(10):657---676. Disponible en: http://ww2.aeeh.es/wp-content/uploads/2019/12/GPC-de-enfermedad-hepatica-por-alcohol.pdf
9. Adrover R, Arzeno M, Bisigniano L, Cremonte M, Daciuk N, Descalzi V, et al. Guías de Manejo de las Enfermedades Hepáticas Asociadas al Consumo de Alcohol 2018. AAEEH. Asociación argentina para el estudio de las enfermedades del hígado [Internet]. 2019 [acceso: 10/04/2023]. Disponible en: https://www.aaeeh.org.ar/es/attachment/show/46
10. Jophlin LL, Singal AK, Bataller R, Wong RJ, Sauer BG, Terrault NA, et al. ACG Clinical Guideline: Alcohol-Associated Liver Disease. Am J Gastroenterol. 2024; 119:30-54. https://doi.org/10.14309/ajg.0000000000002572
11. National Institute en alcohol Abuse and Alcoholism. Estados Unidos: NIH; 2016 [acceso: 10/04/2023]; Piénselo antes de beber. El alcohol y su salud; [aprox. 10 pantallas]. Disponible en: https://www.niaaa.nih.gov/sites/default/files/publications/Rethinking_Drinking_Spanish.pdf
12. Anderson P, Gual A, Colon J. Alcohol y atención primaria de la salud: informaciones clínicas básicas para la identificación y el manejo de riesgos y problemas [Internet]. Washington, D.C.: OPS; 2008. Disponible en: http://www.who.int/substance_abuse/publications/alcohol_atencion_primaria.pdf
13. Lazo-del-Vallín S, García-Pérez M, Ruenes-Domech C, Galbán-García E. Valor de la ecografía abdominal en el diagnóstico de la cirrosis hepática. Medimay [Internet]. 2010 [acceso: 10/04/2023];16(2): [aprox. 11p.]. Disponible en: https://revcmhabana.sld.cu/index.php/rcmh/article/view/482
14. Organización Mundial Salud. Malnutrición [Internet]. Ginebra: OMS [Internet]; 2023 [acceso: 06/01/2023]; [aprox. 6 pantallas]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/malnutrition
15. González Menéndez R. Un criterio taxonómico para los patrones de consumo etílico. Rev Cubana Salud Pública [Internet]. 2011 Mar [acceso: 22/03/2023];37: [aprox 1 p.]. Disponible en: http://scieloprueba.sld.cu/scielo.php?script=sci_arttext&pid=S0864-34662011000100011&lng=es
16. Rodríguez Martin Y. Caracterización clínica, de laboratorio, ultrasonográfica y endoscópica del paciente alcohólico con manifestaciones hepáticas´. Tesis para optar por el título de especialista de primer grado de Gastroenterología. La Habana: Universidad de Ciencias Médicas de la Habana; 2021.
17. General Assembly of the World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Coll Dent [Internet]. 2014 Summer [acceso: 10/04//2023].;81(3):14-8. Disponible en: http://pubmed.ncbi.nlm.nih.gov/25951678/
18. Peña Boza R, Diéguez Marin D, Salazar Fajardo A, Carrazana Valdés T, Rondón Carrazco Y. Alcoholismo, repercusión social en la familia. CMF # 8. Municipio Guisa. 2018. Multimed [Internet]. 2019 [acceso: 22/03/2023];23(4):[aprox 13 p.].Disponible en: http://scieloprueba.sld.cu/scielo.php?script=sci_arttext&pid=S1028-48182019000400592&lng=es
19. del Valle Díaz S, del Valle Piñera S, Piñera Martínez M, Mena Ramos M, Alexis Betancourt F. Comorbilidades en pacientes con enfermedad hepática alcohólica. MEDISAN [Internet]. 2021 [acceso: 22/03/2023]; 25(2): [aprox 14 p.]. Disponible en: http://scieloprueba.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192021000200373&lng=es
20. Malnick SDH, Alin P, Somin M, Neuman MG. Fatty Liver Disease-Alcoholic and Non-Alcoholic: Similar but Different. Int J Mol Sci [Internet]. 2022 [acceso:06/05/2023];23(24):16226. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783455/ 21. Candas Santos S, Valdés Blanco M, Cabrera Nicó A. Caracterización de pacientes con cirrosis hepática por alcoholismo. 16 de Abr [Internet]. 2020 [acceso: 18/03/2023];59(277): e867. Disponible en: http://www.rev16deabril.sld.cu/index.php/16_04/article/view/867
22. Cuba X, da Silveira A, Mansilla S, Santos D, Silva H, Suárez E. Evaluación del rendimiento diagnóstico para fibrosis hepática de los scores APRI, FIB-4, NAFLD y BARD vs Elastografía de Transición [Internet]. Montevideo: Universidad de la República Facultad de Medicina, Ciclo de Metodología Científica II; octubre 2017 [acceso: 10/02/2023]. Disponible en: https://www.colibri.udelar.edu.uy/jspui/bitstream/20.500.12008/33155/1/MCII_2017G80.pdf
23. Zhou XD, Cai J, Targher G, Byrne CD, Shapiro MD, Sung KC, et al. Metabolic dysfunction-associated fatty liver disease and implications for cardiovascular risk and disease prevention. Cardiovasc Diabetol [Internet]. 2022 [acceso: 04/03/2023];21(1):270. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719631/
24. Castellanos-Fernández MI, Crespo-Ramírez E, del Valle-Díaz S, Barreto-Suárez E, Díaz-Elías JO, Santaló-Rodríguez L, et al. Non-alcoholic fatty liver disease in Cuba. MEDICC Rev [Internet]. 2021 [acceso: 24/03/2024]; 23(1):64–71. Disponible en: http://mediccreview.org/wp-content/uploads/2021/01/MREne2021-castellanos-Non-alcoholic-Fatty-Liver-Disease-Cuba.pdf
25. Cochrane J, Chen H, Conigrave KM, Hao W. Alcohol use in China. Alcohol Alcohol [Internet]. 2003 [acceso: 24/03/2024];38(6):537-42. Disponible en: https://academic.oup.com/alcalc/article/38/6/537/209704?login=true
26. Ferrat-Clark Y, Fernández-Esperanza H, González-Guevara M, Reyes-Morejón C, Vizcaíno-Luna Y, Bermúdez-Marrero W. Caracterización de las personas consumidoras de bebidas alcohólicas. Acta Médica del Centro [Internet]. 2019 [acceso: 24/03/2024]; 13 (4):[aprox. 8 p.]. Disponible en: https://www.medigraphic.com/pdfs/medicadelcentro/mec-2019/mec194f.pdf
27. Lobos-Coyopae P, Aravena-Garrido R, Finlez-Herrera C, Fonseca-Ulloa M, Vega-Baeza M, Garrido-Gutiérrez Y, et al. Malnutrición por exceso, alteraciones de salud mental y autoconcepto en población infanto-juvenil: revisión integrativa. Revista urug enferm [Internet]. 2022 [acceso: 24/03/2024];17(2): e503. Disponible en: http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S2301-03712022000101503&lng=es
28. Lackner C, Tiniakos D. Fibrosis and alcohol-related liver disease. J Hepatol [Internet]. 2019 [acceso: 24/03/2024];70(2):294-304. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0168827818326187?via%3Dihub
29. Roerecke M, Vafaei A, Hasan OSM, Chrystoja BR, Rehm J, Cruz M, et al. Alcohol consumption and risk of liver cirrhosis: a systematic review and meta-analysis. Am J Gastroenterol. [Internet]. 2020 [acceso: 24/03/2024];114(10):1574–1586. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6776700/
30. Mahli A, Hellerbrand C. [Alcohol y obesidad: una asociación peligrosa para la enfer-medad del hígado graso]. Dig Dis [Internet]. 2016 [acceso: 24/03/2024];34 (1): [aprox. 24 p.]. Disponible en: https://www.karger.com/Article/FullText/447279
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