Liver disease is the greatest cause of death related to alcohol and a major public health problem. While excessive alcohol intake results in hepatosteatosis in most individuals, this can progress in some to more severe forms of
liver disease including
fibrosis and
cirrhosis. An ongoing challenge in the management of
alcoholic liver disease is the identification of liver injury early in the disease process such that intervention strategies can prevent serious long term outcomes. Given that excessive alcohol consumption results in dysregulation of lipid metabolism we applied
lipid profiling technology to characterise and compare serum
lipid profiles from excessive chronic drinkers with no
liver disease to those with advanced
alcoholic cirrhosis. In a cohort of 59 excessive drinkers (31 with
liver cirrhosis and 28 with no evidence of
liver disease) we used electrospray ionisation tandem mass spectrometry to measure over 300 individual
lipid species in serum, including species of the major
phospholipid,
sphingolipid, glycerolipid and
sterol classes. Six of the 25
lipid classes and subclasses were significantly associated with
alcoholic liver cirrhosis; these included
dihexosylceramide, trihexosylceramide, alkylphosphatidylcholine, lysoalkylphosphatidylcholine,
phosphatidylinositol and free
cholesterol. Multivariate classification models created with only clinical characteristics gave an optimal model with an AUC of 0.847 and an accuracy of 79.7%. The addition of
lipid measurements to the clinical characteristics resulted in models of improved performance with an AUC of 0.892 and accuracy of 81.8%. The gain in AUC and accuracy of the combined models highlight the potential of serum
lipids as markers of liver injury in
alcoholic liver disease.