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Abbas D, Ciricillo JA, Elom HA, Moon AM. Extrahepatic Health Effects of Alcohol Use and Alcohol-associated Liver Disease. Clin Ther 2023; 45:1201-1211. [PMID: 37806811 DOI: 10.1016/j.clinthera.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE Alcohol use disorder (AUD) is a growing public health concern and an important contributor to global morbidity and mortality. While the hepatotoxic effects of alcohol are well known, the adverse effects of alcohol are manifested in almost every organ system. With the growing public health impact of AUD, the aim of this narrative review is to highlight the epidemiology and burden of AUD and its association with extrahepatic diseases including malignancy and disorders of the gastrointestinal (GI), cardiovascular, immunologic, neurologic, endocrine, and hematologic systems. METHODS A narrative review of the literature was performed to identify studies addressing the epidemiology, pathophysiology, clinical manifestations, and therapy of extrahepatic health manifestations of alcohol use. FINDINGS In the United States, an estimated 14.5 million people have AUD and approximately 88,000 adults die yearly due to alcohol-related causes. The consumption of alcohol and AUD is associated with injuries, violence, cancers, nonmalignant conditions of the GI system, infections, effects on the cardiovascular system, and neurodegenerative diseases. These conditions contribute to the increased mortality associated with AUD and are burdensome to patients and caregivers. IMPLICATIONS Increased awareness of the extrahepatic manifestations of AUD, screening for AUD using validated screening tools, such as the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) score, and offering evidence-based interventions to patients with AUD is imperative to reduce the public health burden of AUD. Although historically controversial, recent evidence suggests that any level of alcohol consumption can have negative health consequences. Further research is warranted to determine if any amount of alcohol is safe for consumption. Public health efforts are warranted to help curtail the growing burden of AUD.
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Affiliation(s)
- Daniyal Abbas
- Department of Internal Medicine, East Carolina University, Greenville, North Carolina
| | - Jacob A Ciricillo
- Department of Internal Medicine, University of Cincinnati Medicine Center, Cincinnati, Ohio
| | - Hilary A Elom
- Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Andrew M Moon
- Department of Gastroenterology and Hepatology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
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Capacity of a Microbial Synbiotic To Rescue the In Vitro Metabolic Activity of the Gut Microbiome following Perturbation with Alcohol or Antibiotics. Appl Environ Microbiol 2023; 89:e0188022. [PMID: 36840551 PMCID: PMC10056957 DOI: 10.1128/aem.01880-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
The human gut microbiome contributes crucial bioactive metabolites that support human health and is sensitive to perturbations from the ingestion of alcohol and antibiotics. We interrogated the response and recovery of human gut microbes after acute alcohol or broad-spectrum antibiotic administration in a gut model simulating the luminal and mucosal colonic environment with an inoculated human microbiome. Both alcohol and antibiotic treatments reduced the production of major short-chain fatty acids (SCFAs) (acetate, propionate, and butyrate), which are established modulators of human health. Treatment with a microbial synbiotic restored and enhanced gut function. Butyrate and acetate production increased by up to 29.7% and 18.6%, respectively, relative to untreated, dysbiotic samples. In parallel, treatment led to increases in the relative abundances of beneficial commensal organisms not found in the synbiotic (e.g., Faecalibacterium prausnitzii and the urolithin-producing organism Gordonibacter pamelaeae) as well as species present in the synbiotic (e.g., Bifidobacterium infantis), suggesting synergistic interactions between supplemented and native microorganisms. These results lead us to conclude that functional shifts in the microbiome, evaluated by both metabolite production and specific taxonomic compositional changes, are an appropriate metric to assess microbiome "recovery" following a dysbiosis-inducing disruption. Overall, these findings support the execution of randomized clinical studies to determine whether a microbial synbiotic can help restore microbiome function after a disruption. IMPORTANCE The human gut microbiome is sensitive to disruptions by common stressors such as alcohol consumption and antibiotic treatment. In this study, we used an in vitro system modeling the gut microbiome to investigate whether treatment with a microbial synbiotic can help restore microbiome function after stress. We find that a complex gut community treated with alcohol or antibiotics showed reduced levels of production of short-chain fatty acids, which are critical beneficial molecules produced by a healthy gut microbiota. Treatment of stressed communities with a microbial synbiotic resulted in the recovery of SCFA production as well as an increase in the abundance of beneficial commensal organisms. Our results suggest that treatment with a microbial synbiotic has the potential to restore healthy gut microbiome function after stress and merits further investigation in clinical studies.
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Mitkin NA, Unguryanu TN, Malyutina S, Kudryavtsev AV. Association between Alcohol Consumption and Body Composition in Russian Adults and Patients Treated for Alcohol-Related Disorders: The Know Your Heart Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2905. [PMID: 36833602 PMCID: PMC9957482 DOI: 10.3390/ijerph20042905] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
There is conflicting evidence about the association between alcohol consumption and body composition (BC). We aimed to investigate this association in Russian adults. The study population included 2357 residents of Arkhangelsk aged 35-69 years, and 272 in-patients treated for alcohol problems (narcological patients) who participated in the Know Your Heart (KYH) cross-sectional study in 2015-2017. The participants were divided into five subgroups based on their alcohol use characteristics: non-drinkers, non-problem drinkers, hazardous drinkers, harmful drinkers, and narcological patients. Considering men, hazardous drinkers had a larger waist circumference (WC), waist-to-hip ratio (WHR), and percentage of body fat mass (%FM) compared to non-problem drinkers. In harmful drinking men, these differences were the opposite: a lower body mass index (BMI), hip circumference (HC), and %FM. Men among narcological patients had the lowest mean BMI, WC, HC, WHR, and %FM compared to other subgroups of men. As for women, non-drinkers had a lower BMI, WC, HC, and %FM compared to non-problem drinkers. Women among narcological patients had the lowest mean BMI and HC but an increased WHR compared to other subgroups of women. In conclusion, alcohol consumption levels had an inverted J-shaped association with adiposity-related BC parameters: they were elevated in hazardous drinkers but were reduced in harmful drinkers, and were even lower in patients with alcohol-related diagnoses.
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Affiliation(s)
- Nikita A. Mitkin
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway
- International Research Competence Centre, Northern State Medical University, Troitsky Ave., 51, 163069 Arkhangelsk, Russia
| | - Tatiana N. Unguryanu
- Department of Hygiene and Medical Ecology, Northern State Medical University, Troitsky Ave., 51, 163069 Arkhangelsk, Russia
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Bogatkova st., 175/1, 630008 Novosibirsk, Russia
- Department of Therapy, Hematology and Transfusiology, Novosibirsk State Medical University, Krasny Ave., 52, 630091 Novosibirsk, Russia
| | - Alexander V. Kudryavtsev
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway
- International Research Competence Centre, Northern State Medical University, Troitsky Ave., 51, 163069 Arkhangelsk, Russia
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Kuźnicki P, Neubauer K. Emerging Comorbidities in Inflammatory Bowel Disease: Eating Disorders, Alcohol and Narcotics Misuse. J Clin Med 2021; 10:4623. [PMID: 34640641 PMCID: PMC8509435 DOI: 10.3390/jcm10194623] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/26/2021] [Accepted: 10/04/2021] [Indexed: 12/16/2022] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic and potentially devastating condition of the digestive tract which is exemplified by increasing prevalence worldwide, byzantine pathogenesis with a poorly defined role of the environmental factors, and complex clinical demonstration. As a systemic disease, IBD may progress with a wide spectrum of extraintestinal manifestations (EMs) and comorbidities affecting different organs and systems, from anaemia, undernutrition, and cancer to those which are often neglected like anxiety and depression. Evolving IBD epidemiology and changing environment are reflected by an expanding list of IBD-related comorbidities. In contrast to the well-established role of smoking the connection between alcohol and IBD is still debatable on many levels, from pathogenesis to complications. Furthermore, little is known about narcotics use in IBD patients, even if there are obvious factors that may predispose them to narcotics as well as alcohol misuse. Last but not least, the question arises what is the prevalence of eating disorders in IBD. In our paper, we aimed to discuss the current knowledge on alcohol and drugs misuse and eating disorders as emerging extraintestinal comorbidities in IBD.
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Affiliation(s)
- Paweł Kuźnicki
- Department of Gastroenterology and Hepatology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland;
| | - Katarzyna Neubauer
- Department of Gastroenterology and Hepatology, Division of Dietetics, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
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Zhao T, Gao X, Huang G. Acute diarrhea-induced shock during alcohol withdrawal: a case study. J Int Med Res 2021; 49:300060521990464. [PMID: 33626960 PMCID: PMC7917873 DOI: 10.1177/0300060521990464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We present the case of a 54-year-old man with severe acute diarrhea during alcohol withdrawal, despite special feeding, correction of vitamin deficiencies, and protection of the gastrointestinal mucosa. Diarrhea is often overlooked, so we aim to draw attention to the risk of combined malnutrition, acute diarrhea, and alcohol withdrawal because this can lead to lethal complications. We recommend that patient's bowel movements should be carefully observed during alcohol withdrawal, even during hospitalization.
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Affiliation(s)
- Tong Zhao
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - XiaoLei Gao
- Department of Cardiology, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - GuangBiao Huang
- Department of Psychiatry, Huzhou 3rd Hospital, Huzhou, Zhejiang, China
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Testino G, Leone S, Balbinot P, Fagoonee S, Pellicano R. Inflammatory bowel disease and alcohol consumption. MINERVA GASTROENTERO 2019; 65. [DOI: 10.23736/s1121-421x.19.02560-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Khasawneh M, Spence AD, Addley J, Allen PB. The role of smoking and alcohol behaviour in the management of inflammatory bowel disease. Best Pract Res Clin Gastroenterol 2017; 31:553-559. [PMID: 29195675 DOI: 10.1016/j.bpg.2017.10.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 09/11/2017] [Accepted: 10/20/2017] [Indexed: 02/09/2023]
Abstract
In the era of increasing use of immunosuppressive and biologic therapy for inflammatory bowel disease, environmental influences remain important independent risk factors to modify the course of the disease, affect the need for surgery and recurrence rates post-surgical resection. The effect of smoking on inflammatory bowel disease has been established over the decades, however the exact mechanism of how smoking affects remains as area of research. Alcohol is also among the socio-environmental factors which has been recognised to cause a flare of symptoms in inflammatory bowel disease patients. Nonetheless, the exact relation to date is not fully understood, and various paradoxical results from different studies are still a point of controversy.
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Affiliation(s)
- Mais Khasawneh
- South Eastern Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
| | - Andrew D Spence
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Jennifer Addley
- South Eastern Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
| | - Patrick B Allen
- South Eastern Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom.
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Zhang YJ, Wang F, Zhou Y, Li Y, Zhou T, Zheng J, Zhang JJ, Li S, Xu DP, Li HB. Effects of 20 Selected Fruits on Ethanol Metabolism: Potential Health Benefits and Harmful Impacts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:399. [PMID: 27043608 PMCID: PMC4847061 DOI: 10.3390/ijerph13040399] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/28/2016] [Accepted: 03/30/2016] [Indexed: 12/12/2022]
Abstract
The consumption of alcohol is often accompanied by other foods, such as fruits and vegetables. This study is aimed to investigate the effects of 20 selected fruits on ethanol metabolism to find out their potential health benefits and harmful impacts. The effects of the fruits on ethanol metabolism were characterized by the concentrations of ethanol and acetaldehyde in blood, as well as activities of alcohol dehydrogenase and acetaldehyde dehydrogenase in liver of mice. Furthermore, potential health benefits and harmful impacts of the fruits were evaluated by biochemical parameters including aspartate transaminase (AST), alanine transferase (ALT), malondialdehyde, and superoxide dismutase. Generally, effects of these fruits on ethanol metabolism were very different. Some fruits (such as Citrus limon (yellow), Averrhoa carambola, Pyrus spp., and Syzygium samarangense) could decrease the concentration of ethanol in blood. In addition, several fruits (such as Cucumis melo) showed hepatoprotective effects by significantly decreasing AST or ALT level in blood, while some fruits (such as Averrhoa carambola) showed adverse effects. The results suggested that the consumption of alcohol should not be accompanied by some fruits, and several fruits could be developed as functional foods for the prevention and treatment of hangover and alcohol use disorder.
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Affiliation(s)
- Yu-Jie Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
| | - Fang Wang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
| | - Yue Zhou
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
| | - Ya Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
| | - Tong Zhou
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
| | - Jie Zheng
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
| | - Jiao-Jiao Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
| | - Sha Li
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China.
| | - Dong-Ping Xu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
| | - Hua-Bin Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
- South China Sea Bioresource Exploitation and Utilization Collaborative Innovation Center, Sun Yat-Sen University, Guangzhou 510006, Guangdong Province, China.
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Li S, Gan LQ, Li SK, Zheng JC, Xu DP, Li HB. Effects of herbal infusions, tea and carbonated beverages on alcohol dehydrogenase and aldehyde dehydrogenase activity. Food Funct 2014; 5:42-9. [PMID: 24162728 DOI: 10.1039/c3fo60282f] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Various alcoholic beverages containing different concentrations of ethanol are widely consumed, and excessive alcohol consumption may result in serious health problems. The consumption of alcoholic beverages is often accompanied by non-alcoholic beverages, such as herbal infusions, tea and carbonated beverages to relieve drunk symptoms. The aim of this study was to supply new information on the effects of these beverages on alcohol metabolism for nutritionists and the general public, in order to reduce problems associated with excessive alcohol consumption. The effects of 57 kinds of herbal infusions, tea and carbonated beverages on alcohol dehydrogenase and aldehyde dehydrogenase activity were evaluated. Generally, the effects of these beverages on alcohol dehydrogenase and aldehyde dehydrogenase activity are very different. The results suggested that some beverages should not be drank after excessive alcohol consumption, and several beverages may be potential dietary supplements for the prevention and treatment of problems related to excessive alcohol consumption.
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Affiliation(s)
- Sha Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.
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Chiang CP, Wu CW, Lee SP, Ho JL, Lee SL, Nieh S, Yin SJ. Expression Pattern, Ethanol-Metabolizing Activities, and Cellular Localization of Alcohol and Aldehyde Dehydrogenases in Human Small Intestine. Alcohol Clin Exp Res 2012; 36:2047-58. [DOI: 10.1111/j.1530-0277.2012.01836.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 03/09/2012] [Indexed: 12/12/2022]
Affiliation(s)
- Chien-Ping Chiang
- Department of Dermatology; Tri-Service General Hospital, National Defense Medical Center; Taipei; Taiwan
| | - Chew-Wun Wu
- Department of Surgery; Taipei Veterans General Hospital; Taipei; Taiwan
| | - Shiao-Pieng Lee
- Department of Dentistry; Tri-Service General Hospital, National Defense Medical Center; Taipei; Taiwan
| | - Ji-Lin Ho
- Department of Biochemistry; National Defense Medical Center; Taipei; Taiwan
| | - Shou-Lun Lee
- Department of Biological Science and Technology; China Medical University; Taichung; Taiwan
| | - Shin Nieh
- Department of Pathology; Tri-Service General Hospital, National Defense Medical Center; Taipei; Taiwan
| | - Shih-Jiun Yin
- Department of Biochemistry; National Defense Medical Center; Taipei; Taiwan
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