Substance use disorder is associated with alcohol-associated liver disease in patients with alcohol use disorder.
Substance use disorder is associated with alcohol-associated liver disease in patients with alcohol use disorder.
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DOI：
10.1016/j.gastha.2022.02.004
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Luther, Jay
中科院分区：
文献类型：
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作者：
Vannier, Augustin G L;Fomin, Vladislav;Chung, Raymond T;Patel, Suraj J;Schaefer, Esperance;Goodman, Russell P;Luther, Jay
物质使用障碍(SUD)通常与酒精使用障碍(AUD)有关，某些物质已被独立证明会导致肝脏损伤。在这项工作中，我们试图确定在AUD患者中共存的SUD是否与酒精相关性肝病(ALD)相关。我们使用麻省总医院生物信息库进行横断面分析，根据ICD-10编码识别患者。我们进行了多变量分析，考虑了广泛的人口统计学和临床变量，以评估SUD和ALD之间的关联。随后，我们使用相同的方法来评估SUD和肝脏失代偿之间的关联。我们确定了2848名被诊断为AUD的患者，其中9.0%患有ALD。25.2%有SUD病史。在多因素分析中，合并肌萎缩侧索硬化症的患者比未合并肌萎缩侧索硬化症的患者更易被诊断为肌萎缩侧索硬化症(OR=1.95，P=0.001)。此外，并发肌萎缩侧索硬化症的数量与肌萎缩侧索硬化症的诊断呈正相关(OR：1.33P<；0.001)。与其他肥胖症的存在无关，非酒精性尿崩症患者的阿片类药物使用障碍与肌萎缩侧索硬化症相关(OR=1.902，P=0.02)。在随后的分析中，我们发现镇静剂使用障碍与肝脏失代偿相关(OR：2.068，P=0.03)。在AUD患者中，SUD，特别是阿片类药物使用障碍，与ALD的诊断独立相关。
Substance use disorder (SUD) commonly associates with alcohol use disorder (AUD), and certain substances have independently been shown to drive liver injury. In this work, we sought to determine if co-existing SUD in patients with AUD associated with the presence of alcohol-associated liver disease (ALD). We performed a cross-sectional analysis using the Mass General Brigham Biobank to identify patients based on ICD-10 codes. We performed multivariate analyses accounting for a wide range of demographic and clinical variables to evaluate the association between SUD and ALD. We subsequently used the same method to evaluate the association between SUD and hepatic decompensation. We identified 2848 patients with a diagnosis of AUD, 9.0% of which had ALD. 25.2% had a history of SUD. In multivariate analyses, patients with SUD were more frequently diagnosed with ALD compared to those without SUD (OR = 1.95, P = 0.001). Furthermore, the number of concurrent SUDs was positively associated with the diagnosis of ALD (OR: 1.33, P < 0.001). Independent of the presence of other SUDs, opioid use disorder in patients with AUD was associated with ALD (OR = 1.902, P = 0.02). In subsequent analyses, we found that sedative use disorder was associated with hepatic decompensation (OR: 2.068, P = 0.03). In patients with AUD, SUD, and in particular opioid use disorder, was independently associated with the diagnosis of ALD.