Alcoholic Ketosis: Prevalence, Determinants, and Ketohepatitis in Japanese Alcoholic Men
Alcoholic Ketosis: Prevalence, Determinants, and Ketohepatitis in Japanese Alcoholic Men
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酒精酮症：日本酗酒男性的患病率、决定因素和酮症肝炎
DOI：
10.1093/alcalc/agu048
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
Maruyama K
中科院分区：
文献类型：
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作者：
Yokoyama A;Yokoyama T;Mizukami T;Matsui T;Shiraishi K;Kimura M;Matsushita S;Higuchi S;Maruyama K
目的酒精性酮症和酮症酸中毒是常见于急诊酒精中毒患者的代谢异常。我们试图找出与酒精性酮症相关的决定因素或因素。MethodsThe subjects of this cross-sectional survey was 1588名日本男性酗酒者结果尿试纸法检测结果显示酮症的患病率为34.0%，酗酒者中± 21.5%; +8.9%; 2+/3+ 3.6%。较高的尿酮水平与较高的血清总胆红素、天冬氨酸转氨酶（AST）、丙氨酸转氨酶和γ-谷氨酰转肽酶水平相关。比例优势模型的多变量分析显示，（95%置信区间）为0.94（0.84-1.06）每增加10岁，0.93（0.89-0.97）自最后一次饮酒后间隔每增加1天，（1.41-2.26）在慢代谢乙醇脱氢酶-1B存在下（ADH 1B *1/*1），1.61（1.10-2.36）和1.30（1.03-1.65）当选择的饮料分别是威士忌和烧酒时，（蒸馏无碳水化合物饮料与其他饮料），2.05（1.27-3.32）在低血糖<80 mg/dl时，0.91体重指数（BMI）每增加1 kg/m2（0.88-0.94），1.09（1.00-1.18）每+10支烟，2.78（2.05-3.75）当血清总胆红素≥2.0 mg/dl时，和1.97（1.47-2.66）当血清AST ≥200 IU/结论酮症是我国日本男性酒精中毒人群中非常常见的并发症，常伴有酒精性肝损伤，ADH 1B *1/* 1基因型，饮用威士忌或烧酒、低血糖、较低的BMI和吸烟是酮症发展的重要决定因素。
AimsAlcoholic ketosis and ketoacidosis are metabolic abnormalities often diagnosed in alcoholics in emergency departments. We attempted to identify determinants or factors associated with alcoholic ketosis.MethodsThe subjects of this cross-sectional survey were 1588 Japanese alcoholic men (≥40 years) who came to an addiction center within 14 days of their last drink.ResultsThe results of the dipstick urinalyses revealed a prevalence of ketosis of 34.0% (±, 21.5%; +, 8.9%; and 2+/3+; 3.6%) in the alcoholics. Higher urine ketone levels were associated with higher serum total bilirubin, aspartate transaminase (AST), alanine transaminase and gamma-glutamyl transpeptidase levels. A multivariate analysis by the proportional odds model showed that the odds ratio (95% confidence interval) for an increase in ketosis by one category was 0.94 (0.84–1.06) per 10-year increase in age, 0.93 (0.89–0.97) per 1-day increase in interval since the last drink, 1.78 (1.41–2.26) in the presence of slow-metabolizing alcohol dehydrogenase-1B (ADH1B*1/*1), 1.61 (1.10–2.36) and 1.30 (1.03–1.65) when the beverage of choice was whiskey and shochu, respectively (distilled no-carbohydrate beverages vs. the other beverages), 2.05 (1.27–3.32) in the presence of hypoglycemia <80 mg/dl, 0.91 (0.88–0.94) per 1-kg/m2increase in body mass index (BMI), 1.09 (1.00–1.18) per +10 cigarettes smoked, and 2.78 (2.05–3.75) when the serum total bilirubin level was ≥2.0 mg/dl, and 1.97 (1.47–2.66) when the serum AST level was ≥200 IU/l.ConclusionKetosis was a very common complication and frequently accompanied by alcoholic liver injury in our Japanese male alcoholic population, in whichADH1B*1/*1genotype, consumption of whiskey or shochu, hypoglycemia, lower BMI and smoking were significant determinants of the development of ketosis.