Non-Invasive Diagnosis and Biomarkers in Alcohol-Related Liver Disease = Non-Invasive Diagnosis and Biomarkers in Alcohol-Related Liver Disease
저자
발행기관
학술지명
권호사항
발행연도
2020
작성언어
-자료형태
학술저널
수록면
84-85(2쪽)
제공처
Alcohol-related liver disease (ALD) represents a spectrum of clinical illness and pathological change in individuals with acute and chronic alcohol consumption. Patients may have minimal abnormalities from steatosis or may develop more severe signs and symptoms of liver disease associated with inflammation seen in alcoholic hepatitis or cirrhosis. The risk of ALD is closely related with the per capita alcohol consumption; however, careful study of the relationship between development/natural history of ALD and the quantity of alcohol consumed is almost impossible, because data collection always involves numerous broad assumptions and rough estimates. Drinking becomes excessive when it causes or elevates the risk for alcohol-related problems or complicates the management of other health problems. According to the National Institute on Alcohol Abuse and Alcoholism (NIH/NIAAA), excessive drinking is defined as men who drink more than 4 standard drinks in a day (or more than 14 per week) and women who drink more than 3 drinks in a day (or more than 7 per week). Early studies in France suggested that a long-term consumption of 80 grams per day or more was associated with increased risk of cirrhosis but subsequent estimates of the threshold for harm have been below this level, especially for women. Screening for excessive alcohol use is important in the diagnosis of ALD. Besides questionnaires, several laboratory tests have been used to screen for excessive alcohol use (EAU) in clinical practice. Determination of the breath and blood alcohol concentration (BAC) or by the highly specific direct markers ethyl glucuronide (EtG) and ethyl sulphate (EtS) in blood and/or urine has been used, but they are only specific to very recent alcohol ingestion; its use may not be useful in clinical situation. Other lab tests to screening for chronic alcohol use are gamma glutaryl transferase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and mean corpuscular volume (MCV). Despite their common use, these tests revealed low sensitivities and specificities. Transferrin molecules in the blood usually contain several carbohydrate components, which is reduced, resulting in an increase in %CDT, among excessive alcohol users. Phosphatidylethanol (PEth) represents a group of phospholipids present in cell membranes, which are formed directly after alcohol intake via the enzyme phospholipase D from phosphatidylcholine in the presence of alcohol.
ALD is rarely detected at the early stage. In a study of 3,500 patients worldwide with chronic liver disease, only 3.8% of patients with ALD were seen at early stages defined as those without any signs of chronic liver disease or complications from portal HTN. Whereas the majority of patients were seen at advanced stages were those with ALD compared with viral hepatitis such as HCV and HBV. These results indicate that ALD is normally detected at later stages when patients require hospitalization owing to liver-related complications. Early detection or screening for ALD is therefore important. The diagnostic tool depends on the disease stage in the spectrum of ALD. For hepatic steatosis, liver ultrasound is accepted as an initial screen for fatty liver because it is non-invasive, inexpensive and widely available. Controlled attenuation parameter is a simple and promising new bedside technique for diagnosing steatosis in patients with ALD, but it requires further validation. For evaluation of fibrosis, several blood tests are available; however, the sensitivity and specificity are varied (depending on the cut off values). The use of transient elastography to determine the degree of fibrosis is promising. There are 2 important components for the diagnosis of alcoholic hepatitis, history of alcohol consumption and clinical presentation/laboratory tests. Excessive alcohol use should have occurred for >6 months, with < 60 days of abstinence before the onset of jaundice. Jaundice should be accompanied by malaise, tender hepatomegaly, or with hepatic decompensation. Serum bilirubin cutoff is >3 mg/dL with the AST (>50 IU/mL), and AST to alanine aminotransferase (ALT) ratio of >1.5. Liver biopsy is not always required unless the clinical diagnosis is unclear. To date, no specific non-invasive diagnosis and biomarkers in ALD are reliable and validated. Systematic studies in a large and well characterized patients with ALD are needed to address these shortcomings.
서지정보 내보내기(Export)
닫기소장기관 정보
닫기권호소장정보
닫기오류접수
닫기오류 접수 확인
닫기음성서비스 신청
닫기음성서비스 신청 확인
닫기이용약관
닫기학술연구정보서비스 이용약관 (2017년 1월 1일 ~ 현재 적용)
학술연구정보서비스(이하 RISS)는 정보주체의 자유와 권리 보호를 위해 「개인정보 보호법」 및 관계 법령이 정한 바를 준수하여, 적법하게 개인정보를 처리하고 안전하게 관리하고 있습니다. 이에 「개인정보 보호법」 제30조에 따라 정보주체에게 개인정보 처리에 관한 절차 및 기준을 안내하고, 이와 관련한 고충을 신속하고 원활하게 처리할 수 있도록 하기 위하여 다음과 같이 개인정보 처리방침을 수립·공개합니다.
주요 개인정보 처리 표시(라벨링)
목 차
3년
또는 회원탈퇴시까지5년
(「전자상거래 등에서의 소비자보호에 관한3년
(「전자상거래 등에서의 소비자보호에 관한2년
이상(개인정보보호위원회 : 개인정보의 안전성 확보조치 기준)개인정보파일의 명칭 | 운영근거 / 처리목적 | 개인정보파일에 기록되는 개인정보의 항목 | 보유기간 | |
---|---|---|---|---|
학술연구정보서비스 이용자 가입정보 파일 | 한국교육학술정보원법 | 필수 | ID, 비밀번호, 성명, 생년월일, 신분(직업구분), 이메일, 소속분야, 웹진메일 수신동의 여부 | 3년 또는 탈퇴시 |
선택 | 소속기관명, 소속도서관명, 학과/부서명, 학번/직원번호, 휴대전화, 주소 |
구분 | 담당자 | 연락처 |
---|---|---|
KERIS 개인정보 보호책임자 | 정보보호본부 김태우 | - 이메일 : lsy@keris.or.kr - 전화번호 : 053-714-0439 - 팩스번호 : 053-714-0195 |
KERIS 개인정보 보호담당자 | 개인정보보호부 이상엽 | |
RISS 개인정보 보호책임자 | 대학학술본부 장금연 | - 이메일 : giltizen@keris.or.kr - 전화번호 : 053-714-0149 - 팩스번호 : 053-714-0194 |
RISS 개인정보 보호담당자 | 학술진흥부 길원진 |
자동로그아웃 안내
닫기인증오류 안내
닫기귀하께서는 휴면계정 전환 후 1년동안 회원정보 수집 및 이용에 대한
재동의를 하지 않으신 관계로 개인정보가 삭제되었습니다.
(참조 : RISS 이용약관 및 개인정보처리방침)
신규회원으로 가입하여 이용 부탁 드리며, 추가 문의는 고객센터로 연락 바랍니다.
- 기존 아이디 재사용 불가
휴면계정 안내
RISS는 [표준개인정보 보호지침]에 따라 2년을 주기로 개인정보 수집·이용에 관하여 (재)동의를 받고 있으며, (재)동의를 하지 않을 경우, 휴면계정으로 전환됩니다.
(※ 휴면계정은 원문이용 및 복사/대출 서비스를 이용할 수 없습니다.)
휴면계정으로 전환된 후 1년간 회원정보 수집·이용에 대한 재동의를 하지 않을 경우, RISS에서 자동탈퇴 및 개인정보가 삭제처리 됩니다.
고객센터 1599-3122
ARS번호+1번(회원가입 및 정보수정)