“…Heavy alcohol use has been associated with an altered metabolome (for a review see Voutilainen and Kärkkäinen, 2019). For example, increased levels of glutamate, citrate, alanine, phenylalanine, tyrosine, glucose, docosahexaenoate, 2piperidone and phosphatidylcholine diacyls, and decreased levels of glutamine, serotonin, asparagine, hydroxysphingomyelins, gamma-aminobutyric acid (GABA) and phosphatidylcholine acyl-alkyls have been associated with heavy alcohol use (Heikkinen et al, 2019;Jaremek et al, 2013;Kärkkäinen, Farokhnia, et al, 2021;Kärkkäinen, Kokla, et al, 2021;Lehikoinen et al, 2018;Würtz et al, 2016). In a prospective study with an over 30 5 years' follow-up, changes in the circulating metabolome, e.g., decreased levels of serotonin and asparagine, preceded the diagnosis of diseases related to alcohol use (Kärkkäinen et al, 2020).…”