Category 9: Alcoholic Liver Disease, NAFLD and Drug-Induced Liver Disease ~HIGH PREVALENCE OF ELEVATED LIVER ENZYMES IN GREEK BLOOD DONORS: ASSOCIATIONS WITH MALE GENDER AND CENTRAL ADIPOSITY G.V Papathecdoridis 1, J. Goulis 1, D. Christodoulou 1, S. Manolakopoulos 1, M. Raptopoulou 2, E. Andrioti 3, N. Alexandropoulos4, S. Savvidou 5, A. Papachristou 6, E. Zervou 7, K. Seferiadiss, P Kousidou9, E. Vogiatzalds ~°, E. Tsianos 2 . :Hellenic
Foundation for Gastroenterology & Nutrition, Greece," 2Hellenic Association for the Study of Liver, Greece; S3rd Regional Transfusion Center, Hippokration Hospital of Athens, Athens, Greece," 4Biochemical Department, Hippokration Hospital of Athens, Greece," STransfusion Center, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece," 6Biochemical Department, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece; 7Blood Bank, University Hospital of loannina, [oannina, Greece," XLaboratory of Biochemistry, University Hospital of Ioannina, Ioannina, Greece," 9Transfusion Center, 3rd General Hospital of IKA Athens, Athens, Greece," :°Department of Microbiology. Polyclinic Hospital of Athens, Athens, Greece Non-alcoholic fatty liver disease (NAFLD) is an increasingly recognized condition, but its exact prevalence is unknown. In this prospective, multicenter study, we evaluated the serum levels of alanine aminotransferase (ALT), aspartate arninotransfevase (AST) and ¥-glutarnyltranspeptidase (GGT) in volunteer blood donors as well as their associations with epidemiological and anthropometfical characteristics. In total, 3172 blood donors consecutively admitted at 4 transfusion centers during tile morning sessions of a 3-month period were evaluated. Of those, 109 (3.4%) were excluded [HBsAgjanti-HCV/anti-H1V positive: 16, abnormal liver enzymes and alcohol abuse (~>thrice weekly and ) 4 0 g alcohol): 73, missing liver enzymes: 20]. All anthropometrical measurements were made by trained interviewers using tile same type of devices. Abnormal (>ULN) liver enzymes (ALT/AST/GGT) were found in 540/3063 (17.6%) individuals (abnormal ALT:14.3%, AST:4.6%, GGT:4.7%). In particular, U L N < e n z y m e s ~ < l . 2 × U L N were detected in 6.6%, 1.2 × ULN2 × ULN in 2.4% of cases. Individuals with abnormal compared to those with norreal enzymes were significantly more frequently males (91% vs 76%, P < 0.001) and heavier (mean weight: 90 vs 81 kg, P < 0.001; BMI: 28.5 vs 26.5kg/m 2, P < 0.001) and had higher waist (101 vs 93 cm, P <0.001), hip (108 vs 102 cm, P < 0.001) and neck circumference (40 vs 37 cm, P <0.001), higher wais~fip ratio and more frequently a family history of diabetes (22% vs 18%, P = 0.03). Tire prevalence of abnormal liver enzymes was also associated with the transNsion center, ranging between 7.3% and 22.1% (P<0.001), and alcohol consumption (P 0.009), b u t i t was not associated with age, smoking habits, presence of chronic diseases, chronic drug or NSAIDs/aspirin use. There were no significant differences between individuals with low (~<1.2 × ULN) and high (>1.2 × ULN) elevations of enzymes. In multivariate analysis, presence of elevated enzymes was independently associated with male gender (OR: 2.2, 95%CI: 1.4-3.4; P 0.001), waist circumference (OR: 1.04, 95%CI: 1.02 1.06; P 0.001) and transfusion center (P 0.002). In conclusion, > 15% of Greek blood donors exhibit elevated liver enzymes, most likely as a result of unrecognized NAFLD. The prevalence o f elevated liver enzymes may range significantly between different population groups, but it is mainly associated with male gender and waist circumference, which may be considered as a marker of central obesity.
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INFLUENCE OF ALCOHOL ABSTINENCE IN LIVER FUNCTION, IRON METABOLISM, OXIDATIVE STRESS AND INFLAMMATION MARKERS FROM CHRONIC ALCOHOL CONSUMERS
j. Peneda1,2, M. Hagenfeldt 1, A. Fonseca 1, L. RodrigxtesI , E Gomes 1, L. Batalha I , D. Neto 3, L. Costa I . : Centro Biopatologia, Instituto
Nacional de Sa~de Dr. Ricardo Jorge, Lisboa, Portugal, 2Servi9o de Gastrenterologia, Hospital Dos Capuchos, Lisboa, Portugal," 3 Centro Regional de Alcoologia do Sul, Lisboa, Portugal Increased hepatic iron (Fe) stores have been frequently observed in chronic alcoholism. In the presence of Fe overload, excess Fe may be present as low-molecular-rnass complexes that can initiate free-radical reactions, suggesting the importance of the catalytic activity of this metal in oxidative stress-related mechanisms in this condition. Also, it is known that markers of liver function and fitfla.mmation are altered during persistent alcohol intake. The objective of this study is to clarify the effect of alcohol consumption in markers of liver function, Fe metabolism, oxidative stress and fitflarnmation, measured in blood samples obtained from individuals with chronic alcoholism. In order to achieve this goal, 26 patients with chronic alcoholism (22 men and 4 women, mean age = 38 years) were monitored during 4 weeks of alcohol abstinence. Blood samples were collected just before the start of abstinence (TO) and at tile end of the abstinence period (T1) to measure markers of Fe metabolism (Fe, Tf, Ft, Tfsat), lipid peroxidation (MDA), liver function (ALT and AST), inflammation (CRP and Cp) and antioxidant status (SOD1). Tile results obtained showed the alcohol abstinence (T1 vs TO) significantly decreased serum Fe (p= 0.04), Tfsat (p =0.003), Ft (p= 0.003), Cp (p = 0.03), CRP (p =0.04), AST (p 0.001) and ALT (p < 0.000), and increased Tf (p 0.003). Also, MDA and SOD measured after the abstinence period were, respectively, decreased and increased comparatively to TO, although not significantly. However, a significant decrease in MDA was observed in individuals with serum Ft >450ng/dl comparatively to patients with serum Ft <350 ng/dl both before (p 0.0004) and after tile treatment (p 0.003). According to tire results obtained in this study, an abstinence period of only 4 weeks is sufficient to iTtfluence Fe metabolism, fitflammatlon and lipid peroxidation markers towards tile normality in chronic alcohol consumers. Also, a high positive correlation between markers of antioxidant defence and Fe status was found giving additional support for the role of oxidative stress on the physiopathology of chronic alcoholism.
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SCREENING FOR SIGNIFICANT FIBROSIS USING NON-INVASIVE BIOMARKERS (FIBROTEST) IN HYPERLIPIDEMIC PATIENTS (HP)
M. Munteanu I , EH. Giral 2, D. Messous3, A. Mercadier 4, M. Bernard 3, Ratziu 5, R. Morea I , E Imbert-Bismut3, E. Bruckert 2, T. Povnard5.
:Biopredictive Department, GHPS, Paris, France; 2Metabolism Unit, GHPS, Paris, France," 3Biochemistry Department, GHPS, Paris, France," 4 Transfusion Unit, GHPS; Paris, France," SHepato_Gastroenterology, GHPS, Paris, France Background: Insulin resistance is a cause of liver disease that can lead to cirrhosis. HP have multiple insulin resistance factors and frequent abnormal liver function tests. HP should be screened for significant liver fibrosis (bridging fibrosis: early F2, advanced F3, cirrhosis F4) but biopsy is inappropriate because of the high number of patients at risk. Aim: To use FibroTest, validated in chronic hepatitis C [1], B [2], alcoholic [3] and non-alcoholic steatosis [4], to identify HP with F2F3F4. Methods: A consecutive cohort of HE HCV-HBVneg, <50g alcohol/day, followed in a lipid center was analyzed. FibroTest was retrospectively performed on frozen fasting seva (-80 iC); a control group of blood donors was prospectively included. FibroTest was performed blinded with security algorithms to identify high-risk of false negative/positive.