Chronic alcohol effects on anterior pituitary and ovarian hormones in healthy women

The effects of chronic alcohol intake on menstrual cycle status and hormonal function were studied in 26 healthy, adult women under controlled research ward conditions. Women were classified as heavy, social or occasional alcohol users on the basis of the actual number of drinks consumed during 3 consecutive weeks of alcohol availability. Heavy, social and occasional users drank an average of 7.81 ( +/- 0.69), 3.84 ( +/- 0.19) and 1.22 ( +/- 0.21) drinks/day, respectively. This drinking pattern was highly consistent with subjects' self-reports of alcohol use before the study. No evidence of menstrual cycle dysfunction or abnormality in reproductive hormone levels was found in the occasional drinkers or in two of the social drinkers who consumed less than an average of three drinks/day. In contrast, 50% of the social drinkers who consumed more than three drinks/day and 60% of the heavy drinkers had significant derangements of menstrual cycle and reproductive hormone function. The major abnormality found in social drinkers was anovulatory cycles, and three of the five women who were heavy drinkers had persistent hyperprolactinemia. These findings suggest that alcohol-related menstrual cycle and reproductive hormone dysfunction may be more prevalent among women who are social and heavy drinkers than has been assumed previously.     

Operant acquisition of marihuana by women

Marihuana acquisition and use patterns were studied in 21 women on a clinical research ward. Women could earn one 1-g marihuana cigarette or 50 cents in 30 min of performance on a second-order Fixed-Ratio 300 (Fixed-Interval 1 sec:S) schedule of reinforcement. A 7-day drug-free base line was followed by 21 days of marihuana availability and a postmarihuana drug-free period of 7 days. Five heavy marihuana users smoked an average of 6.1 (+/- 1.45) marihuana cigarettes per day and increased marihuana use significantly through time (P less than .001). Seven moderate marihuana users smoked an average of 2.72 (+/- 0.16) marihuana cigarettes per day and used significantly less marihuana through time (P less than .01). Nine occasional marihuana users smoked less than one cigarette per day (0.90 +/- 0.22) and maintained stable patterns of marihuana use. Women who increased marihuana use during the premenstruum reported significantly greater premenstrual dysphoria on the Premenstrual Assessment Form than women whose marihuana use decreased or remained the same (P less than .05 to .01). There were no marihuana dose-related effects on operant performance. The heavy, moderate and occasional marihuana smokers did not differ in operant purchase points earned, hours worked or money earned. Each marihuana dose-group earned an equivalent number of purchase points during the drug-free periods and the period of marihuana availability. Some subjects continued to work for money when smoking 15 to 20 marihuana cigarettes per day and periods of maximal operant work coincided with periods of maximal marihuana smoking (noon-midnight).(ABSTRACT TRUNCATED AT 250 WORDS)     

Relation between hepatic alcohol dehydrogenase activity and the ascorbic acid in leucocytes of patients with liver disease.

1. Hepatic alcohol dehydrogenase activity and leucocyte ascorbic acid content was measured in thirty-five patients with liver disease and in ten control subjects with duodenal ulcer. The patients with liver disease were divided into three groups consisting of non-drinkers, moderate drinkers and alcoholic/heavy drinkers. 2. There was no significant difference in hepatic alcohol dehydrogenase activity between the groups with liver disease, but all patients had less than half the hepatic alcohol dehydrogenase activity of the control subjects (P less than 0-001). 3. The ascorbic acid in leucocytes was significantly lower in the alcoholic/heavy drinker group than that in the control subjects (P less than 0-02) when the Student's t-test was applied, but no significant difference was found when the Mann-Whitney U-test was used. 4. A correlation coefficient of r = 0-77 (P less than 0-001) was observed among the thirty-five patients with liver disease when hepatic alcohol dehydrogenase activity was compared with leucocyte ascorbic acid content. An insignificant correlation (r = 0-332) was found in the control subjects with no liver disease. 5. This comparison was also significant among non-drinkers with liver disease (r = 0-873; P less than 0-001), moderate drinkers (r = 0-739; P less than 0-02) and alcoholic/heavy drinkers (r = 0-702; P less than 0-005). 6. The addition of ascorbic acid in vitro (0-5-10 mmol/1) had no effect on the activity of alcohol dehydrogenase. 7. The relation between hepatic alcohol dehydrogenase activity and leucocyte ascorbic acid content is probably a consequence of liver disease, as opposed to any specific effect of ascorbic acid deficiency of alcohol consumption on alcohol dehydrogenase activity.     

Older males, cognitive function, and alcohol consumption

We investigated the question, how do older men who drink alcohol differ from those who do not drink on measures of cognitive function, memory, affect, and health? Of the nonprobability sample of male participants (N = 60), 35 (58%) of the males reported some degree of alcohol consumption. Eleven men had one or more drinks per day, 14 had one or more drinks per week, and 9 were occasional drinkers. The drinkers reported significantly less depression, had higher self-reported general health and vitality, and had higher cognitive performance, cognitive flexibility, and verbal memory, and greater knowledge of memory processes.     

Citalopram decreases desirability, liking, and consumption of alcohol in alcohol-dependent drinkers.

In previous studies serotonin uptake inhibitors such as citalopram decreased alcohol consumption in alcoholics. The mechanism of the effect is not fully understood. This study tested the hypothesis that it is mediated by changes in desire to drink and alcohol effects. After a 1-week baseline period, subjects (13 men and three women; aged 26 to 69 years; healthy, nondepressed, alcohol-dependent drinkers [mean, 6.6 drinks per day]) were randomized in a double-blind fashion to receive 40 mg/day citalopram and placebo for 1 week each, separated by a 1-week washout period. Daily standard alcoholic drinks (13.6 gm ethanol), nonalcoholic drinks, and tobacco use were recorded; evening urine samples were taken; and interest, desire, craving, and liking for alcohol were rated. Medical status, depression, and anxiety were assessed weekly, but no other treatment or advice was given. Daily alcoholic drinks significantly decreased during citalopram treatment (mean +/- SEM = 4.6 +/- 0.6) compared with placebo (5.7 +/- 0.8; p = 0.01), and the average decrease was 17.5%. Percentage of days abstinent increased during citalopram administration (27.7% +/- 5.7%) compared with placebo (15.5% +/- 3.7%; p less than 0.01). Citalopram decreased interest, desire, craving, and liking for alcohol (all p less than 0.05). There was clear internal validation of these measures in that variations in each correlated with alcohol consumption (all r greater than 0.5, p less than 0.05). Nonalcoholic drinks, self-reports of cigarettes smoked (daily smokers), and body weight did not change significantly. In experimental bar sessions, after the citalopram and placebo periods, subjects were required to consume as many of 18 minidrinks as possible (equivalent to six standard drinks) at 5-minute intervals. Subjects rated their desire for alcohol, intoxication, and mood. Citalopram had no significant effects on the desirability of alcohol or subjective feelings of intoxication. The findings indicate that serotonin uptake inhibitors may act by decreasing the urge to drink and the reinforcing effects of alcohol. Also, a naturalistic outpatient trial is a sensitive, simple, and economic procedure for detecting these drug effects.     

Relationship between obesity, alcohol consumption, and physical activity of male office workers in South Korea

This study investigated the relationship between obesity, alcohol consumption, and physical activity of males in South Korea. A total of 141 middle-aged office workers were recruited from two companies in Seoul, Korea. The data were collected through a structured questionnaire and body composition analyzer (Inbody 230). Based on body mass index, 30.5% of the study participants were overweight and 48.9% were obese. Based on the percentage of body fat and the waist-to-hip ratio, 21.3% and 47.5% were obese, respectively. Most of the participants drank alcohol, with a mean of 52.26 drinks in the preceding month. Among them, 38.8% were heavy drinkers. The prevalence of low and moderate physical activity was 73% and 22%, respectively. Significant differences were found for body mass index, percentage of body fat, and waist-to-hip ratio after controlling for physical activity as a covariate. Body mass index, percentage of body fat, and waist-to-hip ratio of light and heavy drinkers were higher than that of moderate drinkers. The prevalence of overweight, obesity, and alcohol consumption was high in male office workers. Heavy alcohol consumption should be considered a relating factor of obesity in office workers.     

A cross-sectional study of alcohol consumption patterns and biologic markers of glycemic control among 459 women

OBJECTIVE: Little research has explored associations of drinking patterns with glycemic control, especially among women. Our objective was to determine the relationship of patterns of alcohol consumption-including average daily consumption, weekly frequency of consumption, drinking with meals, and beverage type-with biologic markers of insulin resistance in young women. RESEARCH DESIGN AND METHODS: This study was cross-sectional in design. The subjects consisted of a stratified random subpopulation of 459 U.S. normal-weight and overweight female nurses, 33-50 years of age, drawn from the Nurses' Health Study II and sampled for distinct drinking patterns. Women provided blood samples and detailed information on dietary and lifestyle factors between 1995 and 1999. The main outcome measures were fasting insulin, C-peptide, and HbA(1c). RESULTS: Adjusting for age, smoking, physical activity, television watching, BMI, and several dietary factors, average alcohol intake was inversely associated with HbA(1c) (units in percentage of HbA(1c)): 0 g/day (reference = 5.36%), 0.1 to <5.0 g/day (-0.04%), 5.0 to <15.0 g/day (-0.09%), 15.0 to <25.0 g/day (-0.10%), and > or =25.0 g/day (-0.17%) (P value, test for trend <0.001). We found an inverse association of alcohol intake and insulin, but only for women with a BMI > or =25 kg/m(2). Specifically, insulin levels were lowest for episodic drinkers consuming > or =2 drinks per day on 0-3 days per week. Consumption with meals and type of alcoholic beverage did not further influence these results. CONCLUSIONS: Moderate alcohol consumption of 1-2 drinks per day on a few to several days of the week may have a beneficial glycemic effect, particularly among overweight women.     

Alcohol use self report in chronic back pain--relationships to psychosocial factors, function performance, and medication use

Background Context: Alcohol consumption is a known risk factor for spinal disability, but there is no data on the relationship between reported alcohol consumption and behaviours in persons who are disabled.

Purpose: To determine the interaction between reported alcohol consumption, physical performance, and medication use in this group. To determine psychosocial correlates of reported alcohol consumption in this group.

Methods: A retrospective review 147 men and 136 women with more than 3 months disability who underwent a multidisciplinary physical, functional and psychosocial Spine Team Assessment. Questions about alcohol consumption were related to outcome measures.

Results: None of the women reported more than 5 drinks/week. Ten men reported more than 12 drinks per week. These performed significantly better on the Progressive Isoinertial Lifting Evaluation (PILE) low lift and the Functional Assessment Screening Test (FAST) 5 minute twisting test, and trended towards better performance on all other tests (the PILE high lift, all 4 other FAST components, Sorenson trunk extension test, and bicycle ergometer submaximal stress test). They had less back pain disability (Quebec p = 0.061), but no difference in depression (CESD), pain (visual analog scale) or fear (Tampa). They used fewer Non-steroidal medications, but similar narcotic medications as the others. No significant differences in the SF-36 were noted.

Conclusions: This first assessment of the relationship of alcohol consumption with back pain disability suggests that women with chronic back pain disability seldom report heavy alcohol consumption. Men with back pain disability who consume large amounts of alcohol have less physical disability despite similar pain. Despite potential interactions, heavy drinkers with pain do not use fewer narcotic analgesics than light drinkers.     

Beverage-specific effects of ethanol consumption on its biological markers

BACKGROUND: Serum gamma-glutamyltransferase (GGT) and erythrocyte mean corpuscular volume (MCV) are well-known biological markers of excessive ethanol consumption. METHODS: The beverage-specific effects of ethanol consumption on GGT level and MCV value were analyzed cross-sectionally and retrospectively among middle-aged Japanese men who underwent a retirement health checkup (n = 974). RESULTS: Both the consumption of distilled alcohol and that of fermented alcohol positively correlated with the logarithm of GGT [standard regression coefficient (beta) 0.261 and 0.174, respectively]. The prevalence rate of elevated GGT levels > or = 70 IU/L) was higher among heavy drinkers of distilled alcohol than among heavy drinkers of fermented alcohol (38.8% vs. 27.6%, p = 0.013). The MCV value correlated with distilled alcohol consumption (beta: 0.212, p < 0.0001) but not with fermented alcohol consumption (beta: 0.043, not significant). The prevalence rate of an elevated MCV (> or = 97 fL) was higher among heavy drinkers of distilled alcohol than among heavy drinkers of fermented alcohol (35.3% vs. 16.8%, p < 0.001). CONCLUSIONS: These results suggest that MCV is less sensitive for detecting heavy consumption of fermented alcohol than for detecting that of distilled alcohol in apparently healthy middle-aged men.     

Caffeinated Cocktails: Energy Drink Consumption, High-risk Drinking, and Alcohol-related Consequences among College Students

Objectives:  The consumption of alcohol mixed with energy drinks (AmED) is popular on college campuses in the United States. Limited research suggests that energy drink consumption lessens subjective intoxication in persons who also have consumed alcohol. This study examines the relationship between energy drink use, high-risk drinking behavior, and alcohol-related consequences.
Methods:  In Fall 2006, a Web-based survey was conducted in a stratified random sample of 4,271 college students from 10 universities in North Carolina.
Results:  A total of 697 students (24% of past 30-day drinkers) reported consuming AmED in the past 30 days. Students who were male, white, intramural athletes, fraternity or sorority members or pledges, and younger were significantly more likely to consume AmED. In multivariable analyses, consumption of AmED was associated with increased heavy episodic drinking (6.4 days vs. 3.4 days on average; p < 0.001) and twice as many episodes of weekly drunkenness (1.4 days/week vs. 0.73 days/week; p < 0.001). Students who reported consuming AmED had significantly higher prevalence of alcohol-related consequences, including being taken advantage of sexually, taking advantage of another sexually, riding with an intoxicated driver, being physically hurt or injured, and requiring medical treatment (p < 0.05). The effect of consuming AmED on driving while intoxicated depended on a student's reported typical alcohol consumption (interaction p = 0.027).
Conclusions:  Almost one-quarter of college student current drinkers reported mixing alcohol with energy drinks. These students are at increased risk for alcohol-related consequences, even after adjusting for the amount of alcohol consumed. Further research is necessary to understand this association and to develop targeted interventions to reduce risk.     

Alcohol and cocaine use among first-year college students

We surveyed 1528 first-year students at the University of Virginia, 1 month after their arrival on campus, who had used alcohol at some time in their lives. Our survey was designed to identify alcohol and cocaine use, and related psychosocial patterns. Men drank more and more often than women. Our data suggest that body weight should be considered in defining those who drink heavily and often. We define 'frequent heavy drinking' as five or more drinks in a row each week for men and three to four drinks or more in a row each week for women. Frequent heavy drinkers, cocaine users, and students with psychosocial problems appeared disproportionately among students planning to join fraternities and sororities. Although first-year students used cocaine infrequently, its users followed the patterns of frequent heavy drinkers. We believe efforts to correct alcohol and cocaine misuse by college students should be directed, in part, at social organizations such as Greek-letter societies. Also, we must attend to psychosocial features that predispose to alcohol and cocaine misuse.     

Alcohol consumption and the prevalence of the Metabolic Syndrome in the US.: a cross-sectional analysis of data from the Third National Health and Nutrition Examination Survey

OBJECTIVE: The aim of this study was to examine the relations of alcohol consumption to the prevalence of the metabolic syndrome and its components in the U.S. population. RESEARCH DESIGN AND METHODS: We performed a cross-sectional analysis on data from 8,125 participants from the Third National Health and Nutrition Examination Survey who were evaluated for each component of the metabolic syndrome, using the National Cholesterol Education Program criteria, fasting insulin, and alcohol consumption. Current alcohol consumption was defined as > or =1 alcoholic drink per month. RESULTS: After adjustment for age, sex, race/ethnicity, education, income, tobacco use, physical activity, and diet, subjects who consumed 1-19 and > or =20 drinks of alcohol per month had odds ratios (ORs) for the prevalence of the metabolic syndrome of 0.65 and 0.34, respectively (P <0.05 for all), compared with current nondrinkers. These findings were particularly noteworthy for beer and wine drinkers. The association of > or =20 alcoholic drinks per month with the prevalence of the metabolic syndrome was consistent across ethnicities but was most striking in white men and women (ORs 0.35 and 0.22, respectively; P <0.05). Alcohol consumption was significantly and inversely associated with the prevalence of the following three components of the metabolic syndrome: low serum HDL cholesterol, elevated serum triglycerides, high waist circumference, as well as hyperinsulinemia (P <0.05 for all). CONCLUSIONS: Mild to moderate alcohol consumption is associated with a lower prevalence of the metabolic syndrome, with a favorable influence on lipids, waist circumference, and fasting insulin. This association was strongest among whites and among beer and wine drinkers.     

The addictions forum

Background: In the United States, more than 82% of people report using alcohol in their lifetime. The purpose of this study is to (1) examine gender, ethnicity, age and socio-economic status differences in alcohol consumption and (2) examine the relationship between age and average number of drinks per day as moderated by ethnicity.

Method: The data examined are from the 2010 Arizona Health Survey (n = 7700). Regression analysis was used to determine how demographics correlate with alcohol use. In addition, ethnicity mediates age and average number of drinks per day.

Results: Reported current alcohol use was highest among non-Hispanic whites compared to Hispanics and Native Americans. More non-Hispanic whites and Hispanics reported consuming alcohol than Natives; however, Natives were twice as likely to report heavy episodic drinking defined as averaging three or more drinks per day than non-Hispanic whites and Hispanics. Age and average number of drinks were moderated by ethnicity. Hispanics average less drinks as they age, non-Hispanic whites remain consistent throughout their lifetime and Native Americans average more drinks as they age.

Conclusions: These results provide a unique look at drinking patterns by ethnicity over the life course. Rates of drinking that may have been safe when someone was younger may no longer be safe as the person ages and health changes.     

Fluoxetine differentially alters alcohol intake and other consummatory behaviors in problem drinkers

The effects of fluoxetine, a relatively selective long-acting serotonin uptake inhibitor, on the consumption of alcoholic and nonalcoholic drinks, cigarette smoking, and body weight were assessed in 29 men who were early stage problem drinkers. After a 2-week baseline, subjects were randomly assigned to receive 40 mg/day fluoxetine (n = 8), 60 mg/day fluoxetine (n = 11), or placebo (n = 10) for 4 weeks. Fluoxetine 60 mg/day decreased mean daily alcoholic drinks from (X +/- SEM) 8.3 +/- 0.7 during baseline to 6.9 +/- 0.7 and decreased total drinks per 14 days from 115.8 +/- 9.3 to 96.5 +/- 9.5 (p less than 0.01; 17.3% decrease from baseline), with no significant increase in days of abstinence. Neither 40 mg/day fluoxetine nor placebo had effects on intake of alcohol. Fluoxetine 60 mg/day decreased total and mean daily alcoholic drinks compared with 40 mg/day fluoxetine (ANCOVA, both p less than 0.02), but neither dose of fluoxetine was different from placebo. Compared with placebo, both 40 mg/day fluoxetine and 60 mg/day fluoxetine no differences were detected between treatment groups, 60 mg/day fluoxetine increased mean daily nonalcoholic beverages from baseline (5.0 +/- 0.4 to 5.6 +/- 0.3, p less than 0.01) and increased daily cigarettes smoked (from 25.1 +/- 4.6 to 26.9 +/- 4.5, p less than 0.05), whereas no significant changes from baseline were observed with 40 mg/day fluoxetine or placebo.(ABSTRACT TRUNCATED AT 250 WORDS)     

Relationship of alcohol consumption to changes in HDL-subfractions

Abstract. Epidemiological studies have consistently shown an apparent protective effect of moderate alcohol consumption on coronary artery disease (CAD). This has been considered to be due to the rise in the high-density cholesterol lipoprotein (HDL-cholesterol). Since the response of the HDL-subfractions to moderate or heavy dose of alcohol is less clear, we now compared the high-density lipoprotein cholesterol status between groups consuming different amounts of alcohol. In this population-based survey serum total high-density lipoprotein cholesterol and its HDL₂ and HDL₃ subfractions were blindly compared between 264 consecutive middle-aged men (37 teetotallers, 137 moderate drinkers, 90 heavy drinkers) participating in a voluntary health screening and 104 male alcoholics.
Alcohol consumption correlated significantly (P<0.001) with total HDL-cholesterol, HDL₂, HDL₃ when all subjects ( n = 368) were included but the correlation disappeared when alcoholics were excluded (n = 264). In comparison with teetotallers, alcoholics had significantly higher total HDL-cholesterol, HDL₂ and HDL₃ values (P < 0.001). Moderate or heavy intake of alcohol had no effect on HDL₂ but increased the HDL₃-_-fraction.
If the protective effect of moderate alcohol consumption is mediated by high-density lipoprotein, it may not be accounted for by changes in the HDL₂-_-fraction. The observed increases in the concentration of the HDL₃-_-fraction, however, suggest that this subfraction may not be inert with respect to coronary disease and could possibly have a role in the protective effect.     

Alcohol consumption, clinical findings and retrospective psycho social data in a random sample of men in suburban Stockholm

A sample of 200 men from the general population of suburban Stockholm was investigated regarding alcohol consumption, with the aim of studying psychosocial factors in relation to consumption. Three symptoms related to heavy drinking were studied: (1) Inability to cut down or stop drinking, referred to here as subjective, relative loss of control over drinking; (2) morning shakes and malaise relieved by drinking, termed morning drinks; and (3) amnesia induced by alcohol, referred to as blackouts. The subjects were divided into three groups: (I) 41 men with low alcohol consumption without any symptom of alcoholism, (II) 106 men with low, moderate or high alcohol consumption with different numbers of such symptoms and (III) 53 heavy-drinking men with two or three symptoms. There was a higher frequency of psycho-somatic problems in group III (51%) (p less than 0.01) than in group I (22%). The children of group III had greater problems at school. Group III had more often been judged guilty of crimes (26%) (p less than 0.01) than groups II (12%) and I (5%). Group III had a significantly higher frequency of nervous problems (61%) than the other groups, and 8% of group III had been in-patients at a clinic for treatment of alcoholics.     

Relation of drinking alcohol to atherosclerotic risk in type 2 diabetes

OBJECTIVE: The effects of drinking alcohol on atherosclerotic risks were investigated in 194 type 2 diabetic patients to determine whether drinking alcohol influences risk of atherosclerosis in diabetic subjects. RESEARCH DESIGN AND METHODS: The subjects were divided by the degree of their average weekly alcohol consumption into three groups: nondrinkers, light drinkers (ethanol consumption <210 g/week), and heavy drinkers (ethanol consumption > or = 210 g/week). The degree of atherosclerotic progression was evaluated using aortic pulse wave velocity (a-PWV), and possible atherosclerotic risks were evaluated using known atherosclerotic risk factors. RESULTS: a-PWV was significantly lower in light drinkers than in nondrinkers and heavy drinkers, but there was no significant difference in a-PWV between nondrinkers and heavy drinkers. Systolic blood pressure, HDL cholesterol, and triglyceride levels were significantly higher in heavy drinkers than in nondrinkers and light drinkers, whereas there was no significant difference in these levels between nondrinkers and light drinkers. The mean levels of BMI and blood HbA(1c), uric acid, and fibrinogen were not different between the three groups. There were significant positive correlations of a-PWV with age and systolic blood pressure and weak but significant negative correlations of a-PWV with alcohol consumption and HDL cholesterol level. CONCLUSIONS: Light drinking, but not heavy drinking, has preventive effects on atherosclerosis in type 2 diabetic subjects. The known beneficial effects of drinking alcohol on blood lipids and fibrinogen may not be involved in the preventive effect of light drinking on atherosclerosis in diabetic subjects.     

Moderate alcohol consumption: the gentle face of Janus

OBJECTIVES: The regular consumption of alcohol in moderate amounts (defined in North America as up to 2 drinks per day for men and 1 drink per day for females) has been recognized in the last decade as a negative risk factor for atherosclerosis and its clinical sequelae: coronary heart disease (CHD), ischemic stroke, and peripheral vascular disease. Mortality and morbidity attributable to CHD are 40-60% lower in moderate drinkers than among abstainers. Among the mechanisms accounting for these reductions, increased circulating concentrations of HDL-cholesterol and inhibition of blood coagulation appear to be paramount. Additional benefits are, in certain beverages, conferred by the presence of constituents other than alcohol (e.g., flavonoids and hydroxystilbenes), which prevent oxidative damage, free radical formation, and elements of the inflammatory response. CONCLUSIONS: A number of other diseases appear to be beneficially modulated by moderate alcohol consumption based on epidemiologic surveys and, in some instances, experimental evidence. These include duodenal ulcer, gallstones, enteric infections, rheumatoid arthritis, osteoporosis, and diabetes mellitus (type II). Compared with abstainers, moderate drinkers exhibit improved mental status characterized by decreased stress and depression, lower absenteeism from work, and decreased incidence of dementia (including Alzheimer's disease). Although limits of safe drinking have been conservatively defined, it is regrettable that political considerations are hampering the clinical application of this knowledge and its dissemination to the lay public.     

Characterization of phosphatidylethanol blood concentrations for screening alcohol consumption in early pregnancy

Objective. Phosphatidylethanol (PEth) is formed endogenously by the direct action of ethanol, and has a half-life long enough to make it a reliable biomarker of alcohol exposure in early pregnancy. In this study, we aimed to characterize PEth blood concentrations to differentiate different levels of alcohol exposure in pregnant women. Methods. The study consisted of 305 consecutive pregnant women who had been referred to our hospital for antenatal care. Of them, 117 self-reported alcohol ingestion in the first trimester of pregnancy and 188 were abstainers. Total PEth concentration in whole blood was quantified by liquid chromatography-mass spectrometry (LC-MS/MS). Alcohol ingestion was classified according to the United States National Institute on Alcohol Abuse and Alcoholism into light drinkers: ≤ 3 drinks/week, moderate drinkers: 3–7 drinks/week, and heavier drinkers: > 7 drinks/week (a standard drink = 14 g of ethanol). Results. Participants had quantifiable PEth blood levels 3–4 weeks after the last drink. There were 4.8% abstainers who had positive PEth concentrations; all of them reported a positive history of alcohol consumption before conception. PEth blood concentrations were significantly correlated to drinks per occasion (r = 0.44; P < 0.001) and days drinking per week (r = 0.34; P < 0.001). However, almost 74% of participants with ≤ 3 drinks/week of alcohol, and 46% with 3–7 drinks/week, had PEth blood concentrations below the lower limit of quantification (LLOQ). The area under the curve (AUC) generated by a receiver operation characteristic curve (ROC) analysis increased as the cutoff value of PEth blood concentration increased. However, the cutoff values were below or close to the LLOQ. Conclusions: Our study presents a formal characterization of PEth blood concentrations for screening alcohol ingestion in first-trimester pregnant women. However, caution is recommended for overrepresenting either negative or positive results.     

Long-term ethanol consumption and macrocytosis: diagnostic and pathogenic implications

Although excessive alcohol consumption is known to elevate the mean cell volume (MCV) of erythrocytes, the relationships among the intensity of ethanol exposure, the generation of abnormal red blood cell indices, and the underlying pathogenic mechanisms have remained unclear. The authors examined 105 alcoholics with a wide range of ethanol consumption (40-500 g of ethanol/day), 62 moderate drinkers (mean consumption 1-40 g/day), and 24 abstainers, who underwent detailed interviews, measurements of blood cell counts, markers of liver status, and circulating antibodies against ethanol-derived protein modifications. Follow-up information was collected from healthy volunteers with detailed records on drinking habits. Data from the NORIP project for laboratory parameters in apparently healthy moderate drinkers or abstainers (n = 845) were used for reference interval comparisons. The highest MCV (P < 0.001) and mean cell hemoglobin (MCH) (P < 0.01) occurred in the alcoholics. However, the values in the moderate drinkers also responded to ethanol intake such that the upper normal limit for MCV based on the data from moderate drinkers was 98 fl, as compared with 96 fl from abstainers. Follow-up cases with carefully registered drinking habits showed parallel changes in MCV and ethanol intake. Anti-adduct IgA and IgM against acetaldehyde-induced protein modifications were elevated in 94% and 64% of patients with high MCV, respectively, the former being significantly less frequent in the alcoholics with normal MCV (63%) (P < 0.05). The data indicate dose-related responses in red blood indices upon chronic ethanol consumption, which may also be reflected in reference intervals for hematological parameters in health care. Generation of immune responses against acetaldehyde-modified erythrocyte proteins may be associated with the appearance of such abnormalities.