Evaluation of laboratory tests for cirrhosis and for alcohol use, in the context of alcoholic cirrhosis

Evaluation of laboratory tests for cirrhosis and for alcohol use, in the context of alcoholic cirrhosis.

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Item Type: Article
Status: Published
Official URL: https://doi.org/10.1016/j.alcohol.2017.07.006
Journal or Publication Title: Alcohol
Volume: 66
Page Range: pp. 1-7
Date: 2018
Divisions: Alcoholic Liver Disease
Depositing User: General Admin
Identification Number: 10.1016/j.alcohol.2017.07.006
ISSN: 07418329
Date Deposited: 03 Jan 2021 23:11
Abstract:

Laboratory tests can play an important role in assessment of alcoholic patients, including for evaluation of liver damage and as markers of alcohol intake. Evidence on test performance should lead to better selection of appropriate tests and improved interpretation of results. We compared laboratory test results from 1578 patients between cases (with alcoholic cirrhosis; 753 men, 243 women) and controls (with equivalent lifetime alcohol intake but no liver disease; 439 men, 143 women). Comparisons were also made between 631 cases who had reportedly been abstinent from alcohol for over 60 days and 364 who had not. ROC curve analysis was used to estimate and compare tests' ability to distinguish patients with and without cirrhosis, and abstinent and drinking cases. The best tests for presence of cirrhosis were INR and bilirubin, with areas under the ROC curve (AUCs) of 0.91 ± 0.01 and 0.88 ± 0.01, respectively. Confining analysis to patients with no current or previous ascites gave AUCs of 0.88 ± 0.01 for INR and 0.85 ± 0.01 for bilirubin. GGT and AST showed discrimination between abstinence and recent drinking in patients with cirrhosis, including those without ascites, when appropriate (and for GGT, sex-specific) limits were used. For AST, a cut-off limit of 85 units/L gave 90% specificity and 37% sensitivity. For GGT, cut-off limits of 288 units/L in men and 138 units/L in women gave 90% specificity for both and 40% sensitivity in men, 63% sensitivity in women. INR and bilirubin show the best separation between patients with alcoholic cirrhosis (with or without ascites) and control patients with similar lifetime alcohol exposure. Although AST and GGT are substantially increased by liver disease, they can give useful information on recent alcohol intake in patients with alcoholic cirrhosis when appropriate cut-off limits are used.

Keywords: Abstinence; Alcohol; Aspartate aminotransferase; Cirrhosis; Gamma glutamyl transferase.

Copyright © 2017 Elsevier Inc. All rights reserved.

Creators:
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Whitfield, John B.
UNSPECIFIED
Masson, Steven
UNSPECIFIED
Liangpunsakul, Suthat
UNSPECIFIED
Hyman, Jessica
UNSPECIFIED
Mueller, Sebastian
UNSPECIFIED
Aithal, Guruprasad
UNSPECIFIED
Eyer, Florian
UNSPECIFIED
Gleeson, Dermot
UNSPECIFIED
Thompson, Andrew
UNSPECIFIED
Stickel, Felix
UNSPECIFIED
Soyka, Michael
UNSPECIFIED
Daly, Ann K.
UNSPECIFIED
Cordell, Heather J.
UNSPECIFIED
Liang, Tiebing
UNSPECIFIED
Foroud, Tatiana
UNSPECIFIED
Lumeng, Lawrence
UNSPECIFIED
Pirmohamed, Munir
UNSPECIFIED
Nalpas, Bertrand
UNSPECIFIED
Bence, Camille
UNSPECIFIED
Jacquet, Jean-Marc
UNSPECIFIED
Louvet, Alexandre
UNSPECIFIED
Moirand, Romain
UNSPECIFIED
Nahon, Pierre
UNSPECIFIED
Naveau, Sylvie
UNSPECIFIED
Perney, Pascal
UNSPECIFIED
Podevin, Philippe
UNSPECIFIED
Haber, Paul S.
UNSPECIFIED
Seitz, Helmut K.
UNSPECIFIED
Day, Christopher P.
UNSPECIFIED
Mathurin, Philippe
UNSPECIFIED
Morgan, Timothy M.
UNSPECIFIED
Seth, Devanshi
UNSPECIFIED
Last Modified: 03 Jan 2021 23:11
URI: https://eprints.centenary.org.au/id/eprint/480

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