Chintakindi Shravani, Boateng Bendelyn Asante, Vodkin Irine, Herrick Nicole, Moceri Maria, Raleigh Deborah, Wang Edward, El-Said Howaida, Reeves Ryan, Sepulveda Jose Silva, Alshawabkeh Laith
Herbert Wertheim School of Public Health, United States.
Health Sciences International, United States.
Int J Cardiol Congenit Heart Dis. 2022 Jan 26;7:100339. doi: 10.1016/j.ijcchd.2022.100339. eCollection 2022 Mar.
Alcohol consumption is associated with an increased risk of liver disease. There are limited studies on the epidemiology of alcohol use and its effects on Fontan-associated liver disease (FALD) in adulthood.
In this single-center prospective cohort study, patients were enrolled from the Fontan clinic between November 2019 and November 2020, excluding those with chronic hepatitis C or B. Alcohol consumption was quantified by Alcohol Use Disorders Identification Test (AUDIT) questionnaire and a supplementary questionnaire. Participants were stratified into alcohol consumers and non-consumers. Alcohol consumption was correlated to the magnitude of fibrosis on liver biopsy and the varices, ascites, splenomegaly, and thrombocytopenia (VAST) score.
Forty-three patients (age 30 ± 6.5 years) were enrolled, and most were in NYHA FC 1 or 2. Twenty-six (60.5%) participants consumed alcohol regularly in the past year (twenty with low-risk consumption and six with hazardous consumption). Alcohol consumers were more likely to have better NYHA FC. Of those, half reported alcohol consumption for longer than one year before enrollment. Eleven (25.6%) participants reported underage drinking. After multivariable adjustment, male sex was associated with increased severity of liver fibrosis (OR 3.7 [1.0 to 13.6]). Alcohol consumption was not associated with liver fibrosis (OR 1.2 [0.3 to 4.9]) or VAST scores (OR 1.2 [0.01 to 2.2]).
Alcohol consumption is prevalent among adults with the Fontan circulation but does not correlate with FALD. However, further studies are required to validate the results in cohorts with heavier alcohol consumption. Underage drinking was prevalent and warrants screening in pediatrics.
饮酒与肝病风险增加有关。关于成人饮酒流行病学及其对Fontan相关肝病（FALD）影响的研究有限。
在这项单中心前瞻性队列研究中，于2019年11月至2020年11月从Fontan诊所招募患者，排除慢性丙型或乙型肝炎患者。通过酒精使用障碍识别测试（AUDIT）问卷和一份补充问卷对饮酒情况进行量化。参与者被分为饮酒者和非饮酒者。饮酒情况与肝活检纤维化程度以及静脉曲张、腹水、脾肿大和血小板减少（VAST）评分相关。
共招募了43名患者（年龄30 ± 6.5岁），大多数为纽约心脏协会（NYHA）心功能分级1级或2级。26名（60.5%）参与者在过去一年中经常饮酒（20名低风险饮酒者和6名危险饮酒者）。饮酒者的NYHA心功能分级更可能较好。其中，一半人报告在入组前饮酒超过一年。11名（25.6%）参与者报告有未成年饮酒情况。多变量调整后，男性与肝纤维化严重程度增加相关（比值比[OR] 3.7 [1.0至13.6]）。饮酒与肝纤维化（OR 1.2 [0.3至4.9]）或VAST评分（OR 1.2 [0.01至2.2]）无关。
Fontan循环的成年人中饮酒很普遍，但与FALD无关。然而，需要进一步研究以在饮酒量更大的队列中验证结果。未成年饮酒很普遍，在儿科有必要进行筛查。
