Evolution of Metabolic Abnormalities in Alcoholic Patients during Withdrawal

Abstract

Chronic alcohol intoxication is accompanied by metabolic abnormalities. Evolution during the early withdrawal period has been poorly investigated. The aim of this study was to determine the evolution of metabolic parameters during alcohol withdrawal. Patients and Methods. Thirty-three patients admitted in our department for alcohol withdrawal were prospectively included. Results. Baseline hypophosphatemia was found in 24% of cases. FEPO4 was reduced from 14.2 ± 9% at baseline to 7.3 ± 4.2% at day 3 (P < 0.01). FEPO4 inversely correlated with albuminemia (rs = −0.41, P = 0.01). CPK level was 124 ± 104 IU/L in men and 145 ± 85 IU/L in women (nl < 308 and <192 IU/L, resp.), 7% and 28% of patients having a CPK level >nl, respectively. No correlation was found between the sodium and CPK levels (P = 0.75) nor between the CPK level and the amount of alcohol ingested (rs = 0.084, P = 0.097). Baseline urate level was elevated and returned to normal after three days. Baseline magnesium concentration was normal and stable over time. Conclusion. Chronic alcohol intoxication was accompanied by phosphaturia, rapidly reversible after alcohol withdrawal and inversely correlated with albuminemia, slight hyponatremia, low levels of 25 hydroxy vitamin D, elevated CPK level in about 30% of women, and hyperuricemia with rapid normalization.

Emerging Noninvasive Biomarkers, and Medical Management Strategies for Alcoholic Hepatitis: Present Understanding and Scope

“…Heavy alcohol drinking causes electrolyte and mineral disturbances, hypomagnesemia observed as one of the most common ones [97]. Acute alcohol abuse, chronic and heavy alcohol drinking could lead to hypomagnesemia [98][99][100]. Hypomagnesemia could occur in patients with hepatic steatosis originating from alcoholic and non-alcoholic liver disease [101].…”

Acute Phosphate Restriction Impairs Bone Formation and Increases Marrow Adipose Tissue in Growing Mice

“…Acute or acquired hypophosphatemia often accompanies medical illness. It has been reported in 25% of those with chronic alcoholism, 34% of patients in intensive care, and 3% of hospitalized patients . Hypophosphatemia is known to cause osteomalacia because of impaired mineralization of newly formed matrix and rickets, which is a consequence of impaired phosphate‐mediated hypertrophic chondrocyte apoptosis .…”

Unpeeling the Evidence for the Banana Bag: Evidence-Based Recommendations for the Management of Alcohol-Associated Vitamin and Electrolyte Deficiencies in the ICU

“…This equates to a daily supplementary dose of approximately 4.5 g of magnesium sulfate for a 70-kg adult, followed by 2-3 g/d thereafter. These patients may also be deficient in phosphorus, with up to 24% of patients presenting with hypophosphatemia (56). Careful monitoring of electrolyte administration is advised in these patients with concomitant renal impairment.…”