Yehia Asmaa, Sousa Ricardo A L, Abulseoud Osama A
Department of Neuroscience, Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Phoenix, AZ, United States.
Department of Medical Physiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Front Psychiatry. 2023 Jul 21;14:1230406. doi: 10.3389/fpsyt.2023.1230406. eCollection 2023.
The sex difference in alcohol use disorder (AUD) is ingrained in distinctive neurobiological responses between men and women, which necessitates further investigation for a more tailored management.
Minding the findings of iron dysregulation in AUD and the sex difference in iron homeostasis in multiple physiological and pathological settings, we examined the sex difference in the association between serum ferritin and blood alcohol concentration (BAC) in intoxicated males ( = 125) and females ( = 59). We included patients with both serum ferritin tested of any value and a BAC above the level of detection during the same hospital admission period. We investigated sex difference in the relationship between BAC, serum ferritin and liver enzymes in intoxicated critically ill and noncritically ill patients.
We found a negative association between serum ferritin and BAC in critically ill, intoxicated females [ = 0.44, (1,14) = 11.02, = 0.005], with much attenuated serum ferritin in females compared to their male counterparts (194.5 ± 280.4 vs. 806.3 ± 3405.7 ng/L, = 0.002). We found a positive association between serum ferritin and liver enzymes [alanine transaminase (ALT) and aspartate transferase (AST)] in critically ill intoxicated females [ALT: = 0.48, (1,10) = 9.1, = 0.013; AST: = 0.68, (1,10) = 21.2, = 0.001] and in noncritically ill intoxicated males [ALT: = 0.1, (1,83) = 9.4, = 0.003; AST: = 0.1, (1,78) = 10.5, = 0.002]. The effect of BAC on serum ferritin was not mediated by ALT [indirect effect: ( = 0.13, = 0.1)]. We also found a significant effect of sex, anemia, intensive care unit (ICU) admission and mortality on serum ferritin.
Our results suggest that high BAC in intoxicated female patients is associated with attenuated serum ferritin levels, questioning the role of low serum ferritin in female vulnerability to alcohol.
酒精使用障碍（AUD）中的性别差异根植于男性和女性不同的神经生物学反应，这需要进一步研究以实现更有针对性的管理。
鉴于AUD中铁调节异常的研究结果以及多种生理和病理情况下铁稳态的性别差异，我们研究了醉酒男性（n = 125）和女性（n = 59）血清铁蛋白与血液酒精浓度（BAC）之间关联的性别差异。我们纳入了在同一住院期间血清铁蛋白检测值为任何数值且BAC高于检测水平的患者。我们调查了醉酒的重症和非重症患者中BAC、血清铁蛋白和肝酶之间关系的性别差异。
我们发现重症醉酒女性的血清铁蛋白与BAC呈负相关[r = 0.44，(1,14) = 11.02，P = 0.005]，与男性相比，女性的血清铁蛋白水平显著降低（194.5 ± 280.4 vs. 806.3 ± 3405.7 ng/L，P = 0.002）。我们发现重症醉酒女性的血清铁蛋白与肝酶[丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）]呈正相关[ALT：r = 0.48，(1,10) = 9.1，P = 0.013；AST：r = 0.68，(1,10) = 21.2，P = 0.001]，以及非重症醉酒男性[ALT：r = 0.1，(1,83) = 9.4，P = 0.003；AST：r = 0.1，(1,78) = 10.5，P = 0.002]。BAC对血清铁蛋白的影响不是由ALT介导的[间接效应：(r = 0.13，P = 0.1)]。我们还发现性别、贫血、重症监护病房（ICU）入院和死亡率对血清铁蛋白有显著影响。
我们的结果表明，醉酒女性患者的高BAC与血清铁蛋白水平降低有关，这对低血清铁蛋白在女性酒精易感性中的作用提出了质疑。
