A recent study suggests that a blood test could be a more effective method of identifying liver disease compared to traditional inquiries about a person’s alcohol consumption.
The common practice among clinicians when screening for potential alcohol-related liver damage involves simply questioning patients about their drinking habits. Despite its frequency of use, this approach might not be the most reliable. Researchers are now pointing towards a blood test as a superior alternative for detecting whether alcohol consumption is affecting the liver, potentially allowing for timely medical intervention to prevent severe damage.
At the University of California, San Francisco, experts have identified a biomarker known as phosphatidylethanol (PEth), which could offer a more accurate assessment of a person’s alcohol intake and its impact. This biomarker helps in understanding the risk of liver fibrosis, a condition characterized by the accumulation of scar tissue in the liver, which can progress to cirrhosis, liver failure, and even liver cancer if left untreated.
“The direct measurement of alcohol’s impact through PEth is a clearer and more direct method than the subjective accounts from patients about their drinking,” explains Judy Hahn, PhD, a professor in the Division of HIV, Infectious Diseases and Global Medicine at UCSF. She likens this approach to how clinicians handle other health indicators: “We don’t simply ask someone how much fatty food they eat – we measure their cholesterol. Similarly, we don’t ask people to estimate their weight – we measure it.”
The study, published in the American Journal of Gastroenterology, compared PEth levels with another liver disease risk indicator, the Fibrosis 4 (FIB-4) score. FIB-4 is calculated using a person’s age and results from several other blood tests. The findings indicate that while PEth levels closely correlate with FIB-4, the association between FIB-4 and self-reported alcohol consumption was considerably weaker. This discrepancy could be attributed to participants underreporting or forgetting the quantity of alcohol they consume.
This extensive study, which included over 4,000 participants from the United States, Russia, Uganda, and South Africa, is the largest to date to examine the relationship between PEth levels and liver fibrosis risk. It is also the first to assess the effectiveness of PEth compared to self-reported alcohol use in predicting fibrosis risk.
The progression of liver fibrosis can be slowed or even reversed with lifestyle changes, mainly through reducing alcohol consumption and improving diet. Early detection is vital to managing the condition effectively before it develops into more advanced stages of liver disease.
The researchers propose that PEth screening could become part of routine blood tests that check for cholesterol and blood sugar levels. “To effectively prevent and manage liver fibrosis, it’s crucial to accurately understand how much alcohol a person consumes,” states Pamela Murnane, PhD, MPH, an assistant professor of epidemiology and biostatistics and the lead author of the study. “Self-reports are proving insufficient for this purpose.” This advancement in medical screening could revolutionize how clinicians approach the diagnosis and treatment of liver disease related to alcohol consumption.
More information: Murnane, Pamela M. et al, Using Phosphatidylethanol as an Adjunct to Self-Reported Alcohol Use Improves Identification of Liver Fibrosis Risk, The American Journal of Gastroenterology. DOI: 10.14309/ajg.0000000000003178
Journal information: The American Journal of Gastroenterology Provided by University of California – San Francisco
