eprintid: 10204498 rev_number: 6 eprint_status: archive userid: 699 dir: disk0/10/20/44/98 datestamp: 2025-02-11 13:00:57 lastmod: 2025-02-11 13:00:57 status_changed: 2025-02-11 13:00:57 type: article metadata_visibility: show sword_depositor: 699 creators_name: Hansen, Emil Deleuran creators_name: Torp, Nikolaj creators_name: Johansen, Stine creators_name: Hansen, Johanne Kragh creators_name: Bergmann, Marianne Lerbaek creators_name: Hansen, Camilla Dalby creators_name: Detlefsen, Sonke creators_name: Andersen, Peter creators_name: Villesen, Ida creators_name: Bech, Katrine creators_name: Thorhauge, Katrine creators_name: Jensen, Gitte Hedegaard creators_name: Lindvig, Katrine Prier creators_name: Hansen, Torben creators_name: Tsochatzis, Emmanuel A creators_name: Trebicka, Jonel creators_name: Thiele, Maja creators_name: Krag, Aleksander creators_name: Israelsen, Mads title: Quantification of alcohol intake in patients with steatotic liver disease and excessive alcohol intake ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: G91 note: © 2024 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL) under a Creative Commons license (http://creativecommons.org/licenses/by-nc-nd/4.0/). abstract: Background & Aims: Quantifying alcohol intake is crucial for subclassifying participants with steatotic liver disease (SLD) and interpreting clinical trials of alcohol-related liver disease (ALD) and metabolic and alcohol-related liver disease (MetALD). However, the accuracy of self-reported alcohol intake is considered imprecise. We compared the diagnostic and prognostic utility of self-reported alcohol intake with blood-based biomarkers of alcohol intake: phosphatidylethanol (PEth) and carbohydrate-deficient transferrin (CDT). Methods: We studied 192 participants from two randomized controlled trials on MetALD and ALD, all with current or former excessive alcohol intake (≥24/36 [♀/♂] grams daily for at least 1 year) and biopsy-proven liver disease. We assessed self-reported alcohol intake, PEth, and CDT at four time points. We collected follow-up data on hepatic decompensation and death manually through electronic medical records. Results: Most participants were male (n = 161, 84%) with a mean age of 59 (SD 9) years and 73 participants reported 1-week abstinence before inclusion; the remaining reported a median alcohol intake of 43 g/day. Median PEth was 0.5 μmol/L (IQR: 0.0–1.3) and %CDT = 1.9 (IQR: 1.6–2.3). Of 32 patients reporting at least 6 months of abstinence; 27 (84%) was confirmed by PEth <0.05 μmol/L. Self-reported alcohol intake correlated well with PEth (r = 0.617) and moderately with CDT (r = 0.316). Self-reported alcohol intake, PEth, and CDT all predicted hepatic decompensation and death. However, PEth showed the highest prediction, surpassing self-reported alcohol intake (Harrel's C, PEth = 0.80 vs. self-reported = 0.68, p = 0.026). Conclusions: Self-reported abstinence can be considered reliable in clinical trials. However, PEth is superior in predicting hepatic decompensation and death in patients with MetALD and ALD. Impact and implications: An accurate quantification of alcohol intake is crucial in the clinical phenotyping of patients with steatotic liver disease and when designing clinical trials. This study found self-reported abstinence to be reliable but phosphatidylethanol was a more accurate prognostic biomarker of hepatic decompensation and death in a clinical trial setting. Findings may inform the design of future trials in patients with steatotic liver disease. date: 2025-01 date_type: published publisher: ELSEVIER official_url: https://doi.org/10.1016/j.jhepr.2024.101200 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2342166 doi: 10.1016/j.jhepr.2024.101200 medium: Electronic-eCollection pii: S2589-5559(24)00204-0 lyricists_name: Tsochatzis, Emmanouil lyricists_id: ETSOC40 actors_name: Tsochatzis, Emmanouil actors_id: ETSOC40 actors_role: owner funding_acknowledgements: 668031 [European Union's Program for Science and Innovation 'GALAXY']; [Novo Nordisk Foundation]; [Siemens Healthcare]; NNF15OC0016692 [Challenge grant 'Micro-bLiver'] full_text_status: public publication: JHEP Reports volume: 7 number: 1 article_number: 101200 pages: 9 event_location: Netherlands citation: Hansen, Emil Deleuran; Torp, Nikolaj; Johansen, Stine; Hansen, Johanne Kragh; Bergmann, Marianne Lerbaek; Hansen, Camilla Dalby; Detlefsen, Sonke; ... Israelsen, Mads; + view all <#> Hansen, Emil Deleuran; Torp, Nikolaj; Johansen, Stine; Hansen, Johanne Kragh; Bergmann, Marianne Lerbaek; Hansen, Camilla Dalby; Detlefsen, Sonke; Andersen, Peter; Villesen, Ida; Bech, Katrine; Thorhauge, Katrine; Jensen, Gitte Hedegaard; Lindvig, Katrine Prier; Hansen, Torben; Tsochatzis, Emmanuel A; Trebicka, Jonel; Thiele, Maja; Krag, Aleksander; Israelsen, Mads; - view fewer <#> (2025) Quantification of alcohol intake in patients with steatotic liver disease and excessive alcohol intake. JHEP Reports , 7 (1) , Article 101200. 10.1016/j.jhepr.2024.101200 <https://doi.org/10.1016/j.jhepr.2024.101200>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10204498/1/Quantification%20of%20alcohol%20intake%20in%20patients%20with%20steatotic%20liver%20disease%20and%20excessive%20alcohol%20intake.pdf