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Effects of Sex, Drinking History, and Omega‐3 and Omega‐6 Fatty Acids Dysregulation on the Onset of Liver Injury in Very Heavy Drinking Alcohol‐Dependent Patients
Author(s) -
Vatsalya Vatsalya,
Song Ming,
Schwandt Melanie L.,
Cave Matthew C.,
Barve Shirish S.,
George David T.,
Ramchandani Vijay A.,
McClain Craig J.
Publication year - 2016
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.13197
Subject(s) - liver injury , medicine , heavy drinking , alanine aminotransferase , fatty liver , gastroenterology , alcohol , alcohol consumption , physiology , young adult , endocrinology , poison control , injury prevention , biology , environmental health , biochemistry , disease
Background Heavy alcohol consumption frequently causes liver inflammation/injury, and certain fatty acids ( FAs ) may be involved in this liver pathology. In this study, we evaluated the association of heavy drinking and the changes in the FA levels involved in the ω‐6 (pro‐inflammatory) and ω‐3 (anti‐inflammatory) state in alcohol‐dependent ( AD ) patients who had no clinical manifestations of liver injury. We aimed to identify sex‐based differences in patients with mild or no biochemical evidence of liver injury induced by heavy drinking. Methods A total of 114 heavy drinking AD female and male patients aged 21 to 65 years without clinical manifestations of liver injury, who were admitted to an alcohol dependence treatment program, were grouped by the alanine aminotransferase ( ALT ) levels: ≤40 IU /l, as no liver injury ( GR .1), and >40 IU /l, as mild liver injury ( GR .2). Patients were actively drinking until the day of admission. Comprehensive metabolic panel, comprehensive FA panel, and drinking history data were evaluated. Results Elevated ALT and aspartate aminotransferase (AST) showed close association with markers of heavy alcohol intake. In the patients with mild biochemical liver injury ( GR .2), females showed significantly higher AST level than males. Significant association of AST and total drinks in past 90 days ( TD 90) in females, and AST and heavy drinking days in past 90 days ( HDD 90) in males was observed. The ω‐6:ω‐3 ratio showed a significant pro‐inflammatory response only in females with mild liver injury ( GR .2) when adjusted by drinking history marker, TD 90. Docosahexaenoic acid ( DHA ) and eicosapentaenoic acid ( EPA ) were increased in males with liver injury, while females did not show any comparable rise in EPA ; and DHA levels were lower. Conclusions Measures of heavy drinking, TD 90 and HDD 90, predicted changes in liver injury. Changes in the ω‐3 and ω‐6 FA levels and the ω‐6:ω‐3 ratio showed a pro‐inflammatory shift in patients with biochemical liver injury with a significant effect in females. Changes in FAs involved in the inflammatory state may represent one mechanism for liver inflammation/injury in response to heavy alcohol drinking.