GASTRECTOMY, LACK OF GASTRIC FIRST PASS METABOLISM OF ETHANOL AND ALCOHOLIC LIVER-DISEASE - RESULTS OF A MULTICENTER STUDY

Citation
M. Frezza et al., GASTRECTOMY, LACK OF GASTRIC FIRST PASS METABOLISM OF ETHANOL AND ALCOHOLIC LIVER-DISEASE - RESULTS OF A MULTICENTER STUDY, The Italian Journal of Gastroenterology, 29(3), 1997, pp. 243-248
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenterology & Hepatology
ISSN journal
0392-0623
Volume
29
Issue
3
Year of publication
1997
Pages
243 - 248
Database
ISI
SICI code
0392-0623(1997)29:3<243:GLOGFP>2.0.ZU;2-P
Abstract
Background. Some conditions characterized by a loss (anatomical or fun ctional) of parietal cells of the gastric antrum, containing an alcoho l-dehydrogenase, may reduce the first pass metabolism of ethanol at th at level and simultaneously, raise its bioavailability. The observatio n that the first pass metabolism was drastically suppressed after gast rectomy, would appear to suggest that the latter condition represents a risk for the development of liver damage in patients who continue to consume alcohol even in a non relevant amount. Methods. Consecutively enrolled in the study were 304 individuals of both sexes aged between 45 and 70 years of whom 114 gastrectomized and 190 pair-matched contr ol subjects all submitted to an Upper Gastrointestinal Endoscopy for w hatever disturbance. All the patients were diagnosed as having liver d isease with routine clinical and instrumental means. Information was c ollected concerning the mean daily alcohol intake, both before and aft er the operation. Results. The overall prevalence of hepatic lesions w as shown to be higher in the gastrectomized than in the control group (42.1% vs 25.8%, p=0.005). Moreover referring only to alcohol-related hepatic lesions (steatosis, steato-fibrosis and cirrhosis), the preval ence was higher in the gastrectomized patients than in the controls (2 9.8% vs 17.9%, p=0.02). As far as concerns alcohol consumption, the ga strectomized group had consumed 71 g/day and the control group 39 g/da y alcohol per person (p<0.05) in a similar period of time (35 and 33 y ears, respectively). Also the non alcohol-rebated liver damage (especi ally the viral type) was slightly higher in the gastrectomized patient s (gastrectomized 12.3% vs control 7.9%, p=ns). Accordingly, the perce ntage of serum markers of viral infection was higher in this group (HB sAg: gastrectomized 3.9% vs control 2.2%, p=ns; anti-HCV: gastrectomiz ed 13.5% vs control 5.0%, p=0.03), Finally, to test the eventual damag ing effects of gastrectomy alone (excluding ethanol and/or viral infec tion), two groups of patients with a medium to low alcoholic negative assumption (30-60 g ethanol/day) and no signs of viral infection (HBsA g and anti-HCV negative) were extrapolated. In these two selected grou ps, the prevalence of alcoholic-related hepatic lesions were not stati stically different (28 gastrectomized 20.3% vs 44 control 18.4%). Conc lusions. In conclusion, data emerging from investigations on the popul ation under study indicate that the alcohol and viral infection appear to play a more important role in determining hepatic lesions than gas troresection.