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Biomedical subjects

M Salaspuro

Publications and source records attributed to M Salaspuro.

At least 109 records · Page 6Linked to original sources

Methanol as a marker of alcohol abuse.

Serum methanol levels were studied in 16 skid-row alcoholics, 16 alcoholics entering a detoxification unit, 193 drunken drivers, and 50 social drinkers, all of whom had a blood-ethanol concentration exceeding 5 mmol/liter at the time of sampling. Highest mean serum methanol level was found in alcoholics entering detoxification (636 +/- 68 mumol/liter, p less than 0.001 as compared to social drinkers), followed by skid-row alcoholics (567 +/- 105 mumol/liter, p less than 0.001), drunken drivers (231 +/- 11 mumol/liter, p less than 0.001) and social drinkers (127 +/- 10 mumol/liter). During 2 days heavy drinking mean serum methanol concentration in 10 nonalcoholic volunteers increased from 177 +/- 15 mumol/liter 1 h after the beginning of drinking to 322 +/- 29 mumol/liter 42 h after the beginning of drinking (p less than 0.001). In 70 of the drunken drivers urinary methanol concentration was determined as well and a fairly good correlation (r = +0.56, p less than 0.001) between serum and urinary methanol levels were found. Our results suggest that methanol determined either from serum or urine can be used as a biological marker of alcohol abuse.

Adult↗

Laboratory markers as compared to drinking measures before and after inpatient treatment for alcoholism.

A study group, consisting of 60 male and 13 female alcohol-dependent patients, participated in an inpatient treatment for alcoholism. They were interviewed about their alcohol use before the treatment period and bimonthly for 8 months after it. It was found that the correlations between laboratory markers and average daily alcohol intake are very low (range, -0.01-0.23) in alcoholics with high alcoholic intake level (before the treatment period). It was also found that the correlations between the laboratory tests and the drinking measures after the initial assessment undergo large changes. The correlation between GGT and average daily alcohol intake before the treatment period was 0.07 (p = NS) and 2 months after the treatment period 0.55 (p less than 0.001). The long period of abstinence, the change to a lower level of alcohol consumption, and improved accuracy of reporting alcohol intake were probably causative in this change. GGT proved to have the highest correlations with the drinking measures during the follow-up and MCV before the treatment period. The frequency measure, number of drinking days, gave consistently higher correlations with the laboratory markers than the measure of drinking amount, average daily alcohol intake. Laboratory markers, GGT and MCV, are well suited for outcome evaluation of drinking behavior of alcoholics after inpatient treatment for alcoholism or other comparative periods of abstinence.

Adult↗

Effect of alcohol on blood dolichol concentration.

Serum dolichol levels were studied in 95 active alcoholics and 16 abstinent alcoholics (at the time of blood sampling) and compared to those of 41 social drinkers. Active alcoholics had a significantly higher mean serum dolichol concentration (182.7 +/- 5.1 ng/ml, p less than 0.001 than either abstinent alcoholics (138.7 +/- 5.4 ng/ml) or social drinkers (142.1 +/- 4.1 ng/ml). During weekend (48 hr) heavy drinking (5.5 g of alcohol per kg b.w.) no significant changes were seen in mean serum dolichol concentrations in 10 healthy, nonalcoholic volunteers. Neither did moderate drinking for 10 days (60 g of alcohol daily)--preceded and followed by a period of abstinence--produce any significant changes in serum dolichol levels in 10 nonalcoholic subjects. During detoxification treatment of 12 alcoholics, mean serum dolichol concentration stayed constant for the first 7 days; on entering treatment it was 227.7 +/- 15.0 ng/ml, on the 3rd day 238.5 +/- 15.9 ng/ml, and on the 7th day of treatment 222.6 +/- 18.6 ng/ml. Our results show that as well as increasing urinary dolichol excretion, chronic alcohol abuse also produces increased serum dolichol concentrations. However, contrary to urinary dolichols, serum dolichol levels do not react significantly to heavy drinking lasting for 48 hr in nonalcoholic volunteers. Furthermore in alcoholics increased serum dolichol concentrations do not decrease as rapidly during abstinence as urinary dolichol concentrations do.

Adult↗

Significant increases in urinary dolichol levels in bacterial infections, malignancies and pregnancy but not in other clinical conditions.

The effect of different clinical conditions on urinary dolichols was studied in 219 hospital patients and in 24 pregnant women. Significantly increased urinary dolichol levels were found in patients with severe bacterial infections (mean +/- SEM, 37.5 +/- 8.0 micrograms/mmol creatinine, P less than 0.001), in patients with haematological or metastatic (23.3. +/- 5.1, P less than 0.05) as well as localised (15.4 +/- 1.8, P less than 0.01) malignancies and in pregnant women (22.2 +/- 1.8, P less than 0.001) as compared to healthy controls (6.6 +/- 0.4). These results show that urinary excretion of dolichols may be increased, not only in alcoholics and patients with some rare neurodegenerative storage diseases, but also in patients suffering from various other diseases.

Adult↗

Increased rate of ethanol elimination and elevated blood acetate in asthmatics on corticosteroid, beta-2-sympathicomimetic and theophylline treatment.

The rate of ethanol elimination and blood acetate concentrations after a peroral dose of alcohol were measured in eight asthmatic patients receiving high-dose corticosteroid, sustained release theophylline and beta-2-sympathicomimetic treatment and in eight nonalcoholic, healthy controls. Mean ethanol elimination rate (ER) and mean blood acetate concentration (AC) were significantly (P less than 0.01) higher in asthmatics (ER = 134.8 +/- 12.9 mg/kg/hr, AC = 1.13 +/- 0.25 mM) than in controls (ER = 100.2 +/- 12.3 mg/kg/hr, AC = 0.64 +/- 0.10 mM). In the asthmatics there was a significant negative correlation between the age and the rate of ethanol elimination (r = -0.890, P less than 0.01); in the control group, however, this correlation was of lower degree (r = -0.423) and did not achieve statistical significance. Enhanced ethanol metabolism in asthmatics is possibly due to the effect of drugs. Our results suggest that ethanol elimination rate is increased in asthmatics receiving medication and that the effect is most significant in younger age groups.

Acetates↗

Fractures on chest radiographs in detection of alcoholism.

The prevalence of fractures seen on chest radiographs among alcoholics varies in various series from 36.0% to 8.7% while that for controls remains below 5%. The aim of our study was to find out whether the selection of the alcoholic subjects could account for this four-fold variation. We therefore chose two groups of alcoholics, group 1 consisting of 76 mainly unmarried or divorced lower class alcoholics who had attended the emergency department while intoxicated, and group 2 consisting of 108 mainly married middle class alcoholics with alcoholic liver cirrhosis. The control group consisted of 98 randomly chosen hospital patients. There was no significant difference between group 1 and group 2 in the prevalence of fractures detectable with chest radiography (25% and 21.3% respectively). 8.2% of the controls also had fractures. The fracture prevalence did not correlate with socioeconomic group. Married alcoholics had significantly less thoracic fractures than unmarried, divorced or widowed alcoholics as a group. The sensitivity and specificity of the fractures visible on chest radiograph as a marker for alcoholism is not sufficient to warrant its use in clinical or research work.

Adult↗

Intervention of heavy drinking--a prospective and controlled study of 438 consecutive injured male patients.

We studied 120 injured male patients of working age who were heavy drinkers or alcoholics, obtaining seven points or more in the Michigan Alcoholism Screening Test (MAST). They were randomly allocated either to an intervention group (IG) or to a control group (CG). In addition to the MAST interview, the consumption of alcohol during the previous week prior to hospital admission was calculated and laboratory measures (serum GGT, ASAT and ALAT) were obtained. Counselling of the patients in the IG was carried out by a trained assistant nurse and a physician. Forty-nine patients in IG and 40 patients in CG were re-examined after 6 months. In the IG 45% and in the CG 20% of the patients were improved (Chi square test, P less than 0.05). Improvement criteria were a decrease in alcohol consumption by at least one-third and decrease of S-GGT by at least 20% during the follow-up period. In respect to the laboratory measures the groups were identical at the beginning of the study and after 6 months' follow-up. Our results are encouraging and suggest that the assessment of heavy drinking should be a routine in the treatment of alcohol-related injuries and that education and counselling must be intensive to be effective.

Accidents, Traffic↗

Increased serum acetate as a marker of problem drinking among drunken drivers.

727 consecutive drunken drivers were studied for laboratory markers of excessive alcohol consumption. Serum gamma-glutamyltransferase and alanine aminotransferase showed no differences and aspartate aminotransferase and blood alcohol concentration only small differences between groups of first and repeating drunk driving offenders. The best laboratory test to differentiate the repeating offenders with probably more serious alcohol problems from the first offenders was in our material serum acetate, the mean serum acetate level of the repeating offenders being highly significantly (P less than 0.001) higher than that of the first offenders or nonalcoholic controls. Serum acetate also differentiated first offenders from nonalcoholic controls (P less than 0.001). Our results suggest that serum acetate could be used for the screening of problem drinking among drunken drivers.

Acetates↗

Blood and liver selenium concentrations in patients with liver diseases.

To study the relation between blood and liver selenium levels in hepatic disorders we measured the selenium concentrations of whole blood, serum and liver tissue obtained at laparoscopy in 17 patients with different kinds of liver diseases. As compared to healthy controls the mean concentration of selenium was decreased by 24% (p less than 0.001) in the whole blood of the patients (n = 15). Similarly, the mean concentration of selenium in serum was 35% lower in the patients than in the controls (p less than 0.001). As compared to the control samples obtained at autopsy the selenium content of liver was decreased by 13% (p less than 0.05) in the patients. Significant positive correlations were found between the selenium content of the liver and the whole blood (r = 0.62, p less than 0.05) as well as also between liver and serum (r = 0.52, p less than 0.05) selenium concentrations. In conclusion, the present study suggests that in patients with liver disorders the selenium concentrations are decreased not only in the blood but also in the liver tissue. Whether this means a decreased activity of hepatic glutathione peroxidase and, further, an increased possibility of oxidative cell injury, remains open.

Adult↗

Employed problem drinkers: a nutritional risk group?

Nutritional assessment was made in 26 employed Finnish men drinking excessively and in 49 control men. Because of their greater alcohol consumption, daily intake of energy of case men significantly exceeded that of control men; other dietary differences were negligible. Compared with control men, case men had thicker fatfolds but reduced mean body mass and arm muscle circumference. Mean circulating levels of vitamin C and alpha-tocopherol were normal and equal in case and control men, but serum retinol was raised and beta-carotene was reduced in case men. Serum concentration and 24-h urinary excretion of selenium were significantly lower in case than in control men. Serum levels of magnesium and zinc were similar in both groups, but urinary excretions were higher in case men. Heavy drinking does not result in florid nutritional deficiencies in socially intact men, but its role in subtle nutritional alterations deserves further studies.

Adult↗

Urinary dolichol--a new marker of alcoholism.

Urinary dolichol levels of 31 skid-row alcoholics and 49 alcoholics entering a detoxification unit were compared to those of 51 nonalcoholic controls (social drinkers). The mean urinary dolichol content as related to urinary creatinine was significantly (p less than 0.001) higher in the two groups of alcoholics than in the controls. In this material the sensitivity of increased urinary dolichol in the detection of alcoholism was 68% as compared to 44% sensitivity of serum gamma-glutamyltransferase. The percentage of false-positives in the control group was 3.9%. Urinary dolichol is suggested as a potential tool for the detection and follow-up of alcohol abuse.

Adult↗

Use of enzymes for the diagnosis of alcohol-related organ damage.

Elevated levels of serum enzymes are frequently associated not only with alcohol-related organ damage but also with excessive alcohol consumption and alcoholism without significant tissue injury. However, both in the early detection of alcoholism as well as also in the diagnosis of alcohol-related diseases the sensitivities and specificities of these enzyme markers vary considerably. They may be influenced by nonalcohol-related diseases, enzyme-inducing drugs, nutritional factors, metabolic disorders, age, smoking, etc. Consequently, we have neither a single laboratory test--enzyme marker--nor a test combination that is reliable enough for the exact diagnosis between alcohol- and nonalcohol-related organ damage. In most cases it is possible to determine the tissue from which the elevated enzyme is derived, but only occasionally enzyme changes reflect the quantity of the tissue injury. Gamma-glutamyltransferase (GGT) is the most widely used laboratory marker of alcoholism and heavy drinking, detecting 34-85% of problem drinkers and alcoholics. However, the unspecificity of increased serum GGT limits its use for general screening purposes. Its value in the follow-up of various treatment programs, however, is well established. An elevated level of serum aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) in an alcoholic or a heavy consumer indicates alcohol-induced organ damage. The use of test combinations significantly improves the information received with single serum enzyme determinations. An ASAT/ALAT ratio greater than 1.5 can be considered as highly suggestive for the alcoholic etiology of the liver injury. Still better discrimination between alcoholic and nonalcoholic origin of the liver disease may be achieved by the determination of the ratio of GGT to alkaline phosphatase. If this ratio exceeds 1.4 the specificity of the finding in favor for alcoholic liver injury is 78%. The determination of the mitochondrial isoenzyme of ASAT also improves the diagnostic value of ASAT determination. The ratio of mitochondrial isoenzyme to total over 4 is highly suggestive for alcohol-related liver injury. In general, however, the determination of serum activities of other enzymes such as ornithine carbamyl transferase, lactate dehydrogenase, isocitrate dehydrogenase, sorbitol dehydrogenase, alcohol dehydrogenase, guanase, aldolase, alkaline phosphatase or glutathione S-transferase do not significantly improve the diagnostic information obtained with more conventional laboratory markers of liver injury.(ABSTRACT TRUNCATED AT 400 WORDS)

Alanine Transaminase↗

Lymphocyte activation in vivo in the intestinal mucosa of patients with Crohn's disease.

We analyzed lymphocyte activation state in vivo in lamina propria by applying a panel of monoclonal antibodies for cellular activation markers and by identifying different subsets of 3H-thymidine incorporating lymphoblasts by combining autoradiography with immunoperoxidase staining. In focal lymphoblastoid infiltrates 75 +/- 8% of all inflammatory cells displayed Ia, but lymphoid cells expressing 4F2 (40 +/- 6%) and T9 (14 +/- 3%) activation markers were less frequent. The expression of receptors for interleukin-2 (Tac) was particularly low (4 +/- 1%). There were very few 3H-thymidine incorporating cells (labeling index approx. 1%) and most of them belonged to the T cell series. T4+ blasts outnumbered T8+ blasts, and in this numerically minor subpopulation the activated T4/T8 ratio was 2.9 +/- 0.7. Our results suggest that, although a big part of the local inflammatory lymphocytes in Crohn's disease may be activated according to the expression of Ia and 4F2 activation markers, only a fraction of them possess interleukin-2 receptor and have been pushed to the S-phase of the cell cycle.

Adult↗

Serum creatinine values and changes in alcohol consumption among alcohol dependent patients.

Serum creatinine has been shown to be significantly negatively correlated to alcohol related death. According to our study short term abstinence in employed male alcoholics is not reflected in serum creatinine values, whereas in employed female alcoholics abstinence raises serum creatinine values. Low serum creatinine values (below 80 mumol/l) were found to characterize employed male alcoholics with increased incidence of alcohol related diseases.

Adult↗

Phenotypic in situ characterization of lymphocytes in mild alcoholic liver disease.

The subsets and expression of activation markers of inflammatory mononuclear cells in mild alcoholic liver disease were studied using monoclonal antibodies and an avidin-biotin-peroxidase complex (ABC) method. There were few B cells and monocytes in situ. Most of the mononuclear cells were of T cell origin, T4 and T8 positive cells being evenly distributed in a ratio of 2 to 1. This contrasts with the present and earlier findings on autoimmune liver diseases. The frequency of Ia (HLA-DR) positive cells varied between 15 and 30% of all mononuclear cells, which indicates activation of the local T cells. This implies that T cells in alcoholic fatty liver are not innocent bystanders but actively participate in the local inflammatory process. Staining for Tac, 4F2 and T9 was completely negative, however. These findings suggest that the local T cell activation may be incomplete and that it is not as extensive as in autoimmune liver diseases.

Humans↗