Markers of Liver Function & Oxidative Stress in Alcohol Consumers
with or without Overweight
Acta Universitatis Tamperensis, No. 1592
By Päivikki Alatalo
Tampere University Press
Distributed by Coronet Books
$82.50 Paper Original
Alcohol consumption and excess body weight create a major burden for modern health care. Both heavy drinking and obesity lead to derangements in liver function and increased oxidative stress; however, little is still known about the early-phase effects of ethanol intake and adiposity.
The relationships between alcohol consumption, body mass index (BMI) and various laboratory markers (e.g., alanine and aspartate aminotransferases (ALT, AST) and albumin as markers of liver status, uric acid reflecting the status of oxidative stress, and ?-glutamyl-transferase (GGT) and ferritin being associated with both liver function and oxidative stress) were studied here in a large number of volunteers originally recruited by the NORIP survey for establishing common reference intervals in Nordic countries. The population consisted of apparently healthy abstainers and moderate drinkers (1–21 measures of alcohol/week, 75% of men, 62% of women), and also included subjects who were overweight (BMI 25–30 kg/m2, 41% of men, 22% of women) or obese (BMI >30 kg/m2, 4% of both men and women). In addition, the present study included a group of heavy drinkers who were devoid of liver disease. The dose-response effects of ethanol and adiposity and their interactions on marker levels were assessed in the categories of drinking habits and BMI. The impacts were also evaluated by calculating the reference limits from different subpopulations and by comparing them with the widely used NORIP recommendations, which have been determined from the total survey population.
The levels of serum ALT and GGT were significantly different between male moderate drinkers and abstainers, whereas AST, albumin and ferritin in men and the markers in women only differed between heavy drinkers and abstainers. When the BMI was included in the analyses on liver enzymes (ALT, AST, GGT), activities increased as a function of body weight throughout the BMI scale. The activities were further higher in moderate drinkers than in abstainers of the corresponding BMI. Some observations also suggested an interaction between the effects of the subject’s drinking habits and BMI on these enzymes, but the results of the statistical tests were not significant. For uric acid, the concentrations were similarly higher across the categories of BMI, and higher in male moderate drinkers than abstainers. The calculations of reference limits revealed that especially in men, a substantial increase has been introduced into the currently recommended limits by moderate drinking and excess body weight. The calculated upper reference limits from normal weight male abstainers for ALT were 50 U/l (while the current recommendation is 70 U/l), and for GGT 44 U/l in those <40 years (80 U/l) and 69 U/l in those ?40 years (115 U/l).
It may be concluded that moderate drinking and an increased BMI have notable effects on markers of liver function and oxidative stress at the population level. These should be recognized in order to improve the clinical value of such measurements for diagnostic purposes and for preventive medicine.
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