Zobrazit v EDS

Phosphatidylethanol levels distinguish steatotic liver disease subgroups and are associated with risk of major liver outcomes

Uloženo v:
Podrobná bibliografie
Název: Phosphatidylethanol levels distinguish steatotic liver disease subgroups and are associated with risk of major liver outcomes
Autoři: Vaz, Juan, Nasr, Patrik, Helander, Anders, Shang, Ying, Wester, Axel, Strandberg, Rickard, Grip, Emilie Toresson, Hagstrom, Hannes
Zdroj: Journal of Hepatology. 83(5)
Témata: Phosphatidylethanol, alcohol consumption, prognosis, direct alcohol biomarker, metabolic dysfuntion-associated steatotic liver disease, alcohol-related liver disease, alcohol use disorder
Popis: Background & Aims: Phosphatidylethanol (PEth) is an ethanol metabolite used as a specific biomarker for recent alcohol consumption. We aimed to determine the proportion of patients with or at risk for metabolic dysfunction-associated steatotic liver disease (MASLD) who had PEth levels indicative of harmful alcohol consumption, and to assess associations between PEth levels and the risk of major adverse liver outcomes (MALOs). Methods: We conducted a cohort study involving persons tested for PEth in Stockholm, Sweden between 2012 and 2020 (N = 46,406), including patients with various steatotic liver disease (SLD) subtypes and individuals without SLD. Cumulative incidences of MALOs were calculated for the different groups while accounting for competing risk. Cox regression was used to evaluate the association between baseline PEth levels and the incidence of MALOs. Results: Among 6,377 patients with presumed MASLD, 1,294 (20%) had baseline PEth levels between 0.05 and 0.30 mu mol/L (35-210 ng/ml), indicating excessive alcohol intake (MetALD), while 854 patients (13%) had values >0.30 mu mol/L, indicating alcohol-related liver disease (ALD). Patients with MASLD and PEth levels between 0.05-0.30 mu mol/L had similar median FIB-4 and cirrhosis prevalence as those with MASLD and PEth levels <0.05 mol/L. However, patients with PEth levels between 0.05-0.30 mu mol/L had higher cumulative incidences of MALOs compared to those with PEth levels <0.05 mol/L. Elevated PEth levels were linked to significantly higher rates of MALOs in patients without cirrhosis, even after adjustments for age, sex, SLD subtype, and FIB-4. Patients with ALD had the highest PEth levels and worst prognosis. Conclusions: PEth is a valuable alcohol biomarker for distinguishing between SLD subtypes, especially ALD, and predicts adverse outcomes in people with and without SLD. (c) 2025 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Popis souboru: electronic
Přístupová URL adresa: https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-219203
https://doi.org/10.1016/j.jhep.2025.04.019
Databáze: SwePub
Popis
Abstrakt:Background & Aims: Phosphatidylethanol (PEth) is an ethanol metabolite used as a specific biomarker for recent alcohol consumption. We aimed to determine the proportion of patients with or at risk for metabolic dysfunction-associated steatotic liver disease (MASLD) who had PEth levels indicative of harmful alcohol consumption, and to assess associations between PEth levels and the risk of major adverse liver outcomes (MALOs). Methods: We conducted a cohort study involving persons tested for PEth in Stockholm, Sweden between 2012 and 2020 (N = 46,406), including patients with various steatotic liver disease (SLD) subtypes and individuals without SLD. Cumulative incidences of MALOs were calculated for the different groups while accounting for competing risk. Cox regression was used to evaluate the association between baseline PEth levels and the incidence of MALOs. Results: Among 6,377 patients with presumed MASLD, 1,294 (20%) had baseline PEth levels between 0.05 and 0.30 mu mol/L (35-210 ng/ml), indicating excessive alcohol intake (MetALD), while 854 patients (13%) had values >0.30 mu mol/L, indicating alcohol-related liver disease (ALD). Patients with MASLD and PEth levels between 0.05-0.30 mu mol/L had similar median FIB-4 and cirrhosis prevalence as those with MASLD and PEth levels <0.05 <mu>mol/L. However, patients with PEth levels between 0.05-0.30 mu mol/L had higher cumulative incidences of MALOs compared to those with PEth levels <0.05 <mu>mol/L. Elevated PEth levels were linked to significantly higher rates of MALOs in patients without cirrhosis, even after adjustments for age, sex, SLD subtype, and FIB-4. Patients with ALD had the highest PEth levels and worst prognosis. Conclusions: PEth is a valuable alcohol biomarker for distinguishing between SLD subtypes, especially ALD, and predicts adverse outcomes in people with and without SLD. (c) 2025 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
ISSN:01688278
16000641
DOI:10.1016/j.jhep.2025.04.019