在 binge 饮酒的男男性行为者中，高磷酰乙醇（PEth）水平的相关因素及其与自我报告的大量饮酒的一致性。
Correlates of high phosphatidylethanol (PEth) levels and their concordance with self-reported heavy alcohol consumption among men who have sex with men who binge drink alcohol.
机构信息
Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, California, USA.
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA.
出版信息
Alcohol Clin Exp Res. 2022 Aug;46(8):1565-1579. doi: 10.1111/acer.14891. Epub 2022 Jul 8.
BACKGROUND
Heavy alcohol use, including binge drinking, is associated with high morbidity and mortality among men who have sex with men (MSM). Self-reported alcohol measures may lead to inaccurate estimates due to recall and social desirability biases. Objective alcohol biomarkers like phosphatidylethanol (PEth) can be used to corroborate self-report and could help to inform treatment approaches and research strategies for alcohol using MSM.
METHODS
From 2015 to 2020, alcohol using MSM ≥18 years were enrolled in a randomized controlled trial evaluating the efficacy of naltrexone in reducing binge drinking. Using this trial's baseline data, we applied multivariable logistic regression to identify the correlates of high PEth levels (i.e., ≥87 ng/ml) and concordance between PEth levels and self-reported heavy drinking.
RESULTS
Of 118 MSM, 64% had PEth levels ≥87 ng/ml and 72% had PEth levels that were concordant with self-reported heavy alcohol use. Factors significantly associated in separate models with elevated PEth levels were income ≥$60,000 (adjusted odds ratio [aOR] = 4.09; 95% CI = 1.13 to 14.82), being employed (aOR = 4.04; 95% CI = 1.45 to 11.32), episodic cannabis use (aOR = 4.63; 95% CI = 1.27 to 16.92), and any alcohol/substance use prior to or during anal intercourse (aOR = 2.52; 95% CI = 1.08 to 5.90). Living with HIV was associated with significantly lower odds of elevated PEth levels (aOR = 0.23; 95% CI = 0.09 to 0.61). Factors associated with significantly higher concordance between PEth levels and self-reported heavy alcohol use included at least weekly use of poppers (aOR = 6.41; 95% CI = 1.27 to 32.28) and polysubstance use (aOR = 2.53; 95% CI = 1.02 to 6.27). Living with HIV was associated with lower odds of concordance (aOR = 0.36; 95% CI = 0.14 to 0.97).
CONCLUSIONS
PEth may enhance the detection of heavy drinking among MSM, including the identification of subpopulations that may benefit from targeted alcohol reduction interventions. However, PEth values for MSM living with HIV showed modest concordance with self-reported alcohol use and may need to be supplemented with additional biomarkers or evaluated against a different cutoff.
背景
大量饮酒，包括 binge drinking，与男男性行为者（MSM）的高发病率和死亡率有关。自我报告的酒精测量可能由于回忆和社会期望偏差而导致不准确的估计。客观的酒精生物标志物，如磷脂酰乙醇（PEth），可用于证实自我报告，并有助于为使用酒精的 MSM 提供治疗方法和研究策略。
方法
从 2015 年到 2020 年，≥18 岁的使用酒精的 MSM 被纳入一项评估纳曲酮减少 binge drinking 疗效的随机对照试验。利用该试验的基线数据，我们应用多变量逻辑回归来确定高水平 PEth 水平（即≥87ng/ml）的相关性以及 PEth 水平与自我报告的大量饮酒之间的一致性。
结果
在 118 名 MSM 中，64%的人 PEth 水平≥87ng/ml，72%的人 PEth 水平与自我报告的大量饮酒一致。在单独的模型中，与升高的 PEth 水平显著相关的因素包括收入≥$60,000（调整后的优势比[aOR] = 4.09；95%置信区间[CI] = 1.13 至 14.82））、就业（aOR = 4.04；95%CI = 1.45 至 11.32）、间歇性使用大麻（aOR = 4.63；95%CI = 1.27 至 16.92）和任何在肛交前后的酒精/物质使用（aOR = 2.52；95%CI = 1.08 至 5.90）。感染 HIV 与显著降低的高水平 PEth 水平相关（aOR = 0.23；95%CI = 0.09 至 0.61）。与 PEth 水平和自我报告的大量饮酒之间更高一致性相关的因素包括至少每周使用 poppers（aOR = 6.41；95%CI = 1.27 至 32.28）和多物质使用（aOR = 2.53；95%CI = 1.02 至 6.27）。感染 HIV 与一致性降低的几率相关（aOR = 0.36；95%CI = 0.14 至 0.97）。
结论
PEth 可能增强对 MSM 大量饮酒的检测，包括确定可能受益于有针对性的酒精减少干预的亚群。然而，感染 HIV 的 MSM 的 PEth 值与自我报告的饮酒量一致性较差，可能需要补充其他生物标志物或针对不同的截定点进行评估。
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