Rex Karsten Fleischer, Krarup Henrik Bygum, Laurberg Peter, Andersen Stig
Department of Internal Medicine, Queen Ingrid's Hospital, Nuuk, Greenland.
Arctic Health Research Centre, Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark;
Int J Circumpolar Health. 2016 Feb 26;75:29528. doi: 10.3402/ijch.v75.29528. eCollection 2016.
Hepatitis B virus (HBV) infection is common in Arctic populations and high alcohol intake has been associated with an increased risk of a number of diseases. Yet, a description of the influence of alcohol intake in persons with HBV infection on liver biochemistry is lacking.
We aimed to describe the association between reported alcohol intake and liver biochemistry taking into account also HBV infection, ethnicity, Inuit diet, body mass index (BMI), gender and age in an Arctic population.
Population-based investigation of Inuit (n=441) and non-Inuit (94) in Greenland and Inuit living in Denmark (n=136). Participants filled in a questionnaire on alcohol intake and other life style factors. Blood samples were tested for aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), bilirubin, albumin, hepatitis B surface antigen, hepatitis B surface antibody and hepatitis B core antibody. We also performed physical examinations.
Participation rate was 95% in Greenland and 52% in Denmark. An alcohol intake above the recommended level was reported by 12.9% of non-Inuit in Greenland, 9.1% of Inuit in East Greenland, 6.1% of Inuit migrants and 3.4% of Inuit in the capital of Greenland (p=0.035). Alcohol intake was associated with AST (p<0.001) and GGT (p=0.001), and HBV infection was associated with ALP (p=0.001) but not with AST, GGT, bilirubin or albumin in the adjusted analysis. Inuit had higher AST (p<0.001), GGT (p<0.001) and ALP (p=0.001) values than non-Inuit after adjustment for alcohol, diet, BMI and HBV exposure. Ethnic origin modified the association between alcohol and AST, while HBV infection did not modify the associations between alcohol and liver biochemistry.
Non-Inuit in Greenland reported a higher alcohol intake than Inuit. Ethnic origin was more markedly associated with liver biochemistry than was alcohol intake, and Greenlandic ethnicity modified the effect of alcohol intake on AST. HBV infection was slightly associated with ALP but not with other liver biochemistry parameters.
乙型肝炎病毒（HBV）感染在北极人群中很常见，高酒精摄入量与多种疾病风险增加有关。然而，目前缺乏关于HBV感染者酒精摄入量对肝脏生化指标影响的描述。
我们旨在描述北极人群中报告的酒精摄入量与肝脏生化指标之间的关联，同时考虑HBV感染、种族、因纽特饮食、体重指数（BMI）、性别和年龄等因素。
对格陵兰岛的因纽特人（n = 441）和非因纽特人（94）以及居住在丹麦的因纽特人（n = 136）进行基于人群的调查。参与者填写了一份关于酒精摄入量和其他生活方式因素的问卷。检测血样中的天冬氨酸转氨酶（AST）、γ-谷氨酰转移酶（GGT）、碱性磷酸酶（ALP）、胆红素、白蛋白、乙肝表面抗原、乙肝表面抗体和乙肝核心抗体。我们还进行了体格检查。
格陵兰岛的参与率为95%，丹麦为52%。格陵兰岛12.9%的非因纽特人、东格陵兰岛9.1%的因纽特人、因纽特移民6.1%以及格陵兰岛首府3.4%的因纽特人报告酒精摄入量高于推荐水平（p = 0.035）。在调整分析中，酒精摄入量与AST（p < 0.001）和GGT（p = 0.001）相关，HBV感染与ALP相关（p = 0.001），但与AST、GGT、胆红素或白蛋白无关。在对酒精、饮食、BMI和HBV暴露进行调整后，因纽特人的AST（p < 0.001）、GGT（p < 0.001）和ALP（p = 0.001）值高于非因纽特人。种族起源改变了酒精与AST之间的关联，而HBV感染并未改变酒精与肝脏生化指标之间的关联。
格陵兰岛的非因纽特人报告的酒精摄入量高于因纽特人。种族起源比酒精摄入量与肝脏生化指标的关联更显著，格陵兰种族改变了酒精摄入量对AST的影响。HBV感染与ALP略有关联，但与其他肝脏生化指标无关。
