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Abstinence from alcohol and alcohol rehabilitation therapy in alcoholic liver disease: a population-based study.

戒酒和酒精康复治疗酒精性肝病: 一项基于人群的研究。

  • 影响因子:2.03
  • DOI:10.1080/00365521.2020.1743751
  • 作者列表:"Björnsson ES","Hauksson K","Sigurdardottir R","Arnardottir M","Agustsson AS","Lund SH","Kalaitzakis E
  • 发表时间:2020-04-01
Abstract

:Objective: Abstinence from alcohol is recommended in patients diagnosed with alcoholic hepatitis (AH) and alcoholic cirrhosis (AC). We aimed to determine the impact of alcohol abstinence on prognosis of patients with AC and AH.Methods: All incident AC and AH patients in Iceland 2001-2016 were identified. Cirrhosis was confirmed clinically, biochemically, with imaging and histologically. Abstinence, alcohol rehabilitation and survival were analyzed.Results: Overall, 169 patients with AC and/or AH were identified. Eleven died during index hospitalization, leaving 158 patients for final analysis, median (IQR) age 56 years (48-65), 72% males. Over all 61 patients (39%) had AC, 40 (25%) AH and 57 (36%) features of both. Thirty-nine percent of patients remained abstinent during follow-up and 63% underwent alcohol rehabilitation. Moderate to severe ascites at diagnosis (odds ratio (OR): 3.05, 95% confidence interval (CI): 1.37-7.02) and lack of alcoholic rehabilitation (OR: 5.28, 95% CI: 2.24- 14.11) were independent predictors of abstinence. Abstinence at one year of follow-up was not related to increased survival. Patients surviving one year, abstinence during follow-up was related to increased survival for both groups.Conclusion: Abstinence from alcohol following AC/AH diagnosis was achieved in 39% of patients. Abstinence was not related to increased survival for alcoholic liver disease patients at one-year, which might partly indicate that this might be a marker that some patients were 'too sick to drink'. AC and AH patients who survived one year and remained abstinent had a favorable long-term prognosis.

摘要

目的: 建议诊断为酒精性肝炎 (AH) 和酒精性肝硬化 (AC) 的患者戒酒。我们旨在确定戒酒对 AC 和 AH 患者预后的影响。方法: 确定冰岛 2001-2016 中所有发生 AC 和 AH 的患者。肝硬化经临床、生化、影像学和组织学证实。对戒酒、酒精康复和生存率进行了分析。结果: 总共确定了 169 例 AC 和/或 AH 患者。指数住院期间死亡 11 例,最终分析 158 例患者,中位 (IQR) 年龄 56 岁 (48-65),男性 72% 例。所有 61 例患者 (39%) 具有 AC,40 例 (25%) AH 和 57 例 (36%) 两者的特征。39% 的患者在随访期间保持戒断,63% 的患者接受了酒精康复。诊断时的中重度腹水 (比值比 (OR): 3.05,95% 置信区间 (CI): 1.37-7.02) 和缺乏酒精康复 (OR: 5.28,95% CI: 2.24- 14.11) 是戒断的独立预测因素。随访 1 年时的禁欲与生存率增加无关。患者存活 1 年,随访期间戒酒与两组生存率增加有关。结论: 39% 的患者在 AC/AH 诊断后戒酒。戒酒与酒精性肝病患者 1 年生存率增加无关,这可能部分表明这可能是一些患者 “病得不能喝酒” 的标志。存活 1 年并保持戒断的 AC 和 AH 患者的长期预后良好。

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翻译标题与摘要 下载文献
影响因子:3.87
发表时间:2020-02-01
DOI:10.1111/liv.14321
作者列表:["Chen VL","Chen Y","Du X","Handelman SK","Speliotes EK"]

METHODS:BACKGROUND AND AIMS:Cirrhosis is characterized by extensive fibrosis of the liver and is a major cause of liver-related mortality. Cirrhosis is partially heritable but genetic contributions to cirrhosis have not been systemically explored. Here, we carry out association analyses with cirrhosis in two large biobanks and determine the effects of cirrhosis associated variants on multiple human disease/traits. METHODS:We carried out a genome-wide association analysis of cirrhosis as a diagnosis in UK BioBank (UKBB; 1088 cases vs. 407 873 controls) and then tested top-associating loci for replication with cirrhosis in a hospital-based cohort from the Michigan Genomics Initiative (MGI; 875 cases of cirrhosis vs. 30 346 controls). For replicating variants or variants previously associated with cirrhosis that also affected cirrhosis in UKBB or MGI, we determined single nucleotide polymorphism effects on all other diagnoses in UKBB (PheWAS), common metabolic traits/diseases and serum/plasma metabolites. RESULTS:Unbiased genome-wide association study identified variants in/near PNPLA3 and HFE, and candidate variant analysis identified variants in/near TM6SF2, MBOAT7, SERPINA1, HSD17B13, STAT4 and IFNL4 that reproducibly affected cirrhosis. Most affected liver enzyme concentrations and/or aspartate transaminase-to-platelet ratio index. PheWAS, metabolic trait and serum/plasma metabolite association analyses revealed effects of these variants on lipid, inflammatory and other processes including new effects on many human diseases and traits. CONCLUSIONS:We identified eight loci that reproducibly associate with population-based cirrhosis and define their diverse effects on human diseases and traits.

翻译标题与摘要 下载文献
影响因子:2.57
发表时间:2020-02-01
DOI:10.1111/eci.13198
作者列表:["Li H","Wieser A","Zhang J","Liss I","Markwardt D","Hornung R","Neumann-Cip AC","Mayerle J","Gerbes A","Steib CJ"]

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