Alcoholic Ketosis: Prevalence, Determinants, and Ketohepatitis in Japanese Alcoholic Men.

Abstract

AIMS:

Alcoholic ketosis and ketoacidosis are metabolic abnormalities often diagnosed in alcoholics in emergency departments. We attempted to identify determinants or factors associated with alcoholic ketosis.

METHODS:

The subjects of this cross-sectional survey were 1588 Japanese alcoholic men (≥40 years) who came to an addiction center within 14 days of their last drink.

RESULTS:

The results of the dipstick urinalyses revealed a prevalence of ketosis of 34.0% (±, 21.5%; +, 8.9%; and 2+/3+; 3.6%) in the alcoholics. Higher urine ketone levels were associated with higher serum total bilirubin, aspartate transaminase (AST), alanine transaminase and gamma-glutamyl transpeptidase levels. A multivariate analysis by the proportional odds model showed that the odds ratio (95% confidence interval) for an increase in ketosis by one category was 0.94 (0.84-1.06) per 10-year increase in age, 0.93 (0.89-0.97) per 1-day increase in interval since the last drink, 1.78 (1.41-2.26) in the presence of slow-metabolizing alcohol dehydrogenase-1B (ADH1B*1/*1), 1.61 (1.10-2.36) and 1.30 (1.03-1.65) when the beverage of choice was whiskey and shochu, respectively (distilled no-carbohydrate beverages vs. the other beverages), 2.05 (1.27-3.32) in the presence of hypoglycemia <80 mg/dl, 0.91 (0.88-0.94) per 1-kg/m(2) increase in body mass index (BMI), 1.09 (1.00-1.18) per +10 cigarettes smoked, and 2.78 (2.05-3.75) when the serum total bilirubin level was ≥2.0 mg/dl, and 1.97 (1.47-2.66) when the serum AST level was ≥200 IU/l.

CONCLUSION:

Ketosis was a very common complication and frequently accompanied by alcoholic liver injury in our Japanese male alcoholic population, in which ADH1B*1/*1 genotype, consumption of whiskey or shochu, hypoglycemia, lower BMI and smoking were significant determinants of the development of ketosis.

• Authors: Akira Yokoyama, Tetsuji Yokoyama, Takeshi Mizukami, Toshifumi Matsui, Koichi Shiraishi, Mitsuru Kimura, Sachio Matsushita, Susumu Higuchi, Katsuya Maruyama
• Journal: Alcohol and alcoholism (Oxford, Oxfordshire) (Alcohol Alcohol) Vol. 49 Issue 6 Pg. 618-25 (Nov 2014) ISSN: 1464-3502 [Electronic] England
• PMID: 25085997 (Publication Type: Journal Article)
• Copyright: © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Chemical References

• Ketone Bodies
• gamma-Glutamyltransferase
• Aspartate Aminotransferases
• Alanine Transaminase
• Bilirubin

Topics

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Alanine Transaminase (blood)
• Alcoholism (complications, epidemiology, metabolism)
• Aspartate Aminotransferases (blood)
• Bilirubin (blood)
• Cross-Sectional Studies
• Hepatitis, Alcoholic (epidemiology, metabolism)
• Humans
• Japan (epidemiology)
• Ketone Bodies (urine)
• Ketosis (epidemiology, etiology)
• Male
• Middle Aged
• Prevalence
• gamma-Glutamyltransferase (blood)