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THE RELATIONSHIP BETWEEN ALCOHOL CONSUMPTION AND THE PRESENCE OF ADVANCED LIVER FIBROSIS IN THE GENERAL POPULATION

Horia-Octav Minea 1, Carol Stanciu 1, Sebastian Zenovia 1, Robert Nastasa 1, Ermina Stratina 1, Remus Stafie 1, Adrian Rotaru 1, Catalin Sfarti 1, Stefan Chiriac 1, Ana Maria Singeap 1, Irina Girleanu 1, Tudor Cuciureanu 1, Cristina Maria Muzica 1, Camelia Cojocariu 1, Laura Huiban 1, Anca-Victorita Trifan 1

Affiliations

1 University of Medicine and Pharmacy Gr.T.Popa/Institute of Gastroenterology and Hepathology Iasi, Iasi, Romania

Summary

AI Generated

A cross-sectional study of 689 asymptomatic alcohol consumers in Romania found advanced liver fibrosis in 19.3% of patients, with excessive alcohol consumption conferring approximately twice the risk in women versus men and in younger versus older age groups.

Advanced fibrosis (≥F3) detected by transient elastography in 19.30% of 689 asymptomatic patients who consumed moderate to high levels of alcohol for at least one year.
Excessive alcohol consumption was associated with higher odds of advanced fibrosis in women (OR=5.08) compared to men (OR=2.27), and in patients under 40 years (OR=6.29) compared to those over 55 years (OR=3.21).
Logistic regression models identified predictive associations between advanced fibrosis and excessive alcohol consumption combined with low albumin, reduced triglycerides in men, reduced cholesterol in the 40-55 age group, and reduced ferritin in those over 55 years.
The authors conclude that transient elastography screening could enable early diagnosis of advanced liver fibrosis in asymptomatic populations to prevent progression of alcohol-related liver disease.

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Abstract

Introduction

Although chronic alcohol consumption has progressively decreased in recent years, a third of people over 15 years declare at least one episode of excessive use every month, which ranks Romania on second position, with a rate of 35%, far above the average registered in the EU (20%). Therefore, Romania has one of the highest incidence rates of alcohol-related liver cirrhosis, which has become a major public health problem. This study aimed to investigate the prevalence of liver fibrosis in the asymptomatic alcohol-consuming population.

Aims & Methods

The study aimed to evaluate the relationship between advanced liver fibrosis measured by transient elastography, laboratory parameters, and the amount of alcohol consumed depending on non-modifiable risk factors such as age and gender. Between January 2022 and December 2022, we examined patients with day hospitalization in the Institute of Gastroenterology and Hepatology in Iasi, without liver history, who admitted a moderate or high consumption (women <7 versus >7 drinks/week; men <14 versus >14 drinks/week) for at least one year. The classification of the fibrosis stage by transient elastography was adjusted according to transaminase values. The results were analyzed by univariate analysis and logistic regression to establish models of prediction.

Results

The study included 689 patients with an average age of 49.32±14.31 years, a proportion of 63.7% represented by men. Advanced fibrosis (³ F3) was detected in 19.30% of the examined patients, predominantly in men (14.1%) and patients over 55 years old (12.5%). Excessive alcohol consumption is associated 2 times more with advanced fibrosis in women (OR=5.08; CI 95%: 3.45-9.50, p<0,001) and the group under 40 years old (OR=6.29; CI 95%: 1.67-9.43, p<0,001) compared to men (OR=2.27; CI 95%: 1.76-3.81, p=0,012) respectively patients over 55 years old (OR=3.21; CI 95% : 2.28-4.45 p<0,001). Using logistic regression, it was demonstrated that there was a strong correlation between advanced fibrosis, excessive alcohol consumption, low serum albumin level and the reduction of triglycerides in men (R² Nagelkerke = 0.854; p<0.001) supplemented with the reduction of cholesterol in the age group 40-55 years (R² Nagelkerke = 0.785; p<0.001), respectively of ferritin in those over 55 years old (R² Nagelkerke = 0.804; p<0.001). The association of excessive alcohol consumption, age, low levels of albumin, LDL-cholesterol and C-reactive protein generated a significant predictive model (R² Nagelkerke = 0.784; p<0.001) for female patients.

Conclusion

Screening using transient elastography represents an approach that could provide early diagnosis of advanced liver fibrosis in an asymptomatic population, with the possibility to prevent the evolution of ALD and the development of complications of cirrhosis.

Conference

UEG Week Copenhagen 2023

Topics

Hepatobiliary

Submission format

Abstract

Session

PP 07 Liver & biliary (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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When the acid is gone: Dealing with gastric atrophy

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