Head‐to‐Head Comparison Between Phosphatidylethanol Versus Indirect Alcohol Biomarkers for Diagnosis of MetALD Versus MASLD: A Prospective Study

ABSTRACT Background The current subclassification of steatotic liver disease (SLD) relies on validated questionnaires, such as Alcohol Use Disorders Identification Test (AUDIT) and Lifetime Drinking History (LDH), which, while useful, are impractical and lack precision for their use in routine clini...

Celý popis

Uložené v:
Podrobná bibliografia
Vydané v:Alimentary pharmacology & therapeutics Ročník 61; číslo 6; s. 1043 - 1054
Hlavní autori: Tavaglione, Federica, Amangurbanova, Maral, Yang, Alexander H., Tincopa, Monica A., Ajmera, Veeral, Richards, Lisa, Butcher, Christian, Hernandez, Christie, Madamba, Egbert, Singh, Seema, Bettencourt, Ricki, Sirlin, Claude B., Loomba, Rohit
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England Wiley Subscription Services, Inc 01.03.2025
Predmet:
Adult
Aged
Alanine transaminase
Alcohol
Alcohol Drinking
Alcohol use
ALD
Aspartate aminotransferase
Biomarkers
Biomarkers - blood
Body weight
California - epidemiology
Clinical medicine
Cross-Sectional Studies
Diagnosis, Differential
Drinking behavior
Fatty Liver - blood
Fatty Liver - diagnosis
Female
Glycerophospholipids - blood
Humans
Liver diseases
Liver Diseases, Alcoholic - diagnosis
Magnetic resonance imaging
Male
Metabolism
Middle Aged
NAFLD
Obesity
Obesity - complications
Overweight
Prospective Studies
Questionnaires
Sensitivity and Specificity
SLD
California
alcohol
ALD
NAFLD
SLD
biomarkers
ISSN:0269-2813, 1365-2036, 1365-2036
On-line prístup:Získať plný text
Tagy: Pridať tag
Žiadne tagy, Buďte prvý, kto otaguje tento záznam!
Popis
Shrnutí:ABSTRACT Background The current subclassification of steatotic liver disease (SLD) relies on validated questionnaires, such as Alcohol Use Disorders Identification Test (AUDIT) and Lifetime Drinking History (LDH), which, while useful, are impractical and lack precision for their use in routine clinical practice. Phosphatidylethanol (PEth) is a quantitative, objective alcohol biomarker with high sensitivity and specificity. Aims To assess the diagnostic accuracy of PEth for differentiating metabolic dysfunction and alcohol‐associated liver disease (MetALD) from metabolic dysfunction‐associated steatotic liver disease (MASLD) in a large, population‐based, prospective, multiethnic cohort of individuals with overweight or obesity. Methods This is a cross‐sectional analysis of a prospective study including 374 adults with overweight or obesity residing in Southern California who had SLD as defined by MRI‐PDFF ≥ 5%. The clinical research visit included medical history, biochemical and PEth testing, standardised validated questionnaires (including AUDIT and LDH), physical examination, and advanced imaging using MRI‐PDFF and MRE. Results Among 374 adults with SLD, the prevalence of MASLD, MetALD, and ALD was 90.1%, 6.4%, and 3.5%, respectively. PEth had a robust diagnostic accuracy in the detection of MetALD (AUROC 0.81, 95%CI 0.73–0.89) and the Youden cut‐off was 25 ng/mL. In head‐to‐head comparative efficacy analysis, PEth was both statistically and clinically superior to all previously used indirect alcohol biomarkers for diagnosing MetALD, including aspartate aminotransferase/alanine aminotransferase ratio, mean corpuscular volume, gamma glutamyltransferase, and ALD/NAFLD index (p < 0.05). Conclusions PEth outperforms previously used non‐invasive tests in differentiating MetALD from MASLD and has the potential to change clinical practice by enhancing the subclassification of SLD. Using a well‐phenotyped prospective cohort with systematic assessment through MRI‐PDFF, MRE, and PEth testing, this study demonstrates that PEth is an accurate, quantitative, objective alcohol biomarker for detecting and differentiating MetALD from MASLD, and outperforms previously available indirect alcohol biomarkers.
Bibliografia:Funding
VA is supported by NIDDK (K23DK119460). RL receives funding support from NCATS (5UL1TR001442), NIDDK (U01DK061734, U01DK130190, R01DK106419, R01DK121378, R01DK124318, P30DK120515), NHLBI (P01HL147835), John C Martin Foundation (RP124) and NIAAA (U01AA029019).
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
ISSN:0269-2813
1365-2036
1365-2036
DOI:10.1111/apt.18506