Impact of Physical Activity on the Characteristics and Metabolic Consequences of Alcohol Consumption: A Cross-Sectional Population-Based Study

Niemelä, Onni; Bloigu, Aini; Bloigu, Risto; Halkola, Anni S.; Niemelä, Markus; Aalto, Mauri; Laatikainen, Tiina

doi:10.3390/ijerph192215048

Cited by 6 publications

(1 citation statement)

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“…Physical activity appears to be an effective modulator of the status of liver enzyme activities. Regular physical exercise is known to lead to more favorable metabolic profiles and reduction in the levels of the biomarkers of inflammation and liver status [ 50 , 89 , 90 , 91 , 92 , 93 , 94 , 95 ]. Physical activity may also play a role in regulating the status of inflammation and oxidative stress [ 35 , 50 , 96 , 97 ].…”

Section: Discussionmentioning

confidence: 99%

Associations between Liver Enzymes, Lifestyle Risk Factors and Pre-Existing Medical Conditions in a Population-Based Cross-Sectional Sample

Niemelä

Bloigu

et al. 2023

JCM

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While alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) enzymes are commonly used indicators of liver dysfunction recent studies have suggested that these may also serve as predictive biomarkers in the assessment of extrahepatic morbidity. In order to shed further light on the interactions between serum liver enzyme abnormalities, factors of lifestyle and health status we examined ALT and GGT activities in a population-based sample of 8743 adult individuals (4048 men, 4695 women from the National FINRISK 2002 Study, mean age 48.1 ± 13.1 years) with different levels of alcohol drinking, smoking, physical activity, body weight and the presence or absence of various pre-existing medical conditions. The assessments also included laboratory tests for inflammation, lipid status and fatty liver index (FLI), a proxy for fatty liver. The prevalence of ALT and GGT abnormalities were significantly influenced by alcohol use (ALT: p < 0.0005 for men; GGT: p < 0.0005 for both genders), smoking (GGT: p < 0.0005 for men, p = 0.002 for women), adiposity (p < 0.0005 for all comparisons), physical inactivity (GGT: p < 0.0005; ALT: p < 0.0005 for men, p < 0.05 for women) and coffee consumption (p < 0.0005 for GGT in both genders; p < 0.001 for ALT in men). The total sum of lifestyle risk factor scores (LRFS) influenced the occurrence of liver enzyme abnormalities in a rather linear manner. Significantly higher LRFS were observed in the subgroups of individuals with pre-existing medical conditions when compared with those having no morbidities (p < 0.0005). In logistic regression analyses adjusted for the lifestyle factors, both ALT and GGT associated significantly with fatty liver, diabetes and hypertension. GGT levels also associated with coronary heart disease, angina pectoris, cardiac insufficiency, cerebrovascular disease, asthma and depression. Combinations of abnormal ALT and GGT activities significantly increased the odds for hypertension coinciding with abnormalities in biomarkers of inflammation, lipid status and FLI. The data indicates that ALT and GGT activities readily respond to unfavorable factors of lifestyle associating also with a wide array of pre-existing medical conditions. The data supports close links between both hepatic and extrahepatic morbidities and lifestyle risk factors and may open new insights on a more comprehensive use of liver enzymes in predictive algorithms for assessing mechanistically anchored disease conditions.

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Section: Discussionmentioning

confidence: 99%

Associations between Liver Enzymes, Lifestyle Risk Factors and Pre-Existing Medical Conditions in a Population-Based Cross-Sectional Sample

Niemelä

Bloigu

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

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Predictive risk markers in alcoholism

Niemelä

2023

Advances in Clinical Chemistry

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Letter: Low to moderate alcohol intake and progression of non‐alcoholic fatty liver disease

Liu

Wei

et al. 2023

Aliment Pharmacol Ther

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We read with interest the recently published comprehensive metaanalysis by Magherman et al. on the association between low to moderate alcohol intake and progressive nonalcoholic fatty liver disease (NAFLD). 1 Non-heavy alcohol consumption was significantly associated with the progression of liver fibrosis, cirrhosis, and hepatocellular carcinoma in NAFLD, while conversely may reduce the occurrence of steatohepatitis. In addition, low alcohol intake showed a protective effect against all-cause mortality. These are in line with more recently published studies that were not included in this meta-analysis. 2,3 These interesting findings suggest that this nuanced relationship may be influenced by methodological limitations and thus lead to heterogeneity that could influence clinical decision-making regarding alcohol abstinence in NAFLD.An important source of heterogeneity is in how alcohol intake is measured. Most studies use various self-report questionnaires or clinical interviews to obtain data on alcohol intake, which could have contributed to part of the heterogeneity and may have introduced recall bias. Therefore, the use of readily available biomarkers that accurately reflect alcohol intake may represent a new approach towards measurement. Blomdahl et al. employed blood phosphatidylethanol (PEth), a biomarker with high sensitivity and specificity that is formed only in the presence of ethanol, to capture alcohol consumption in patients with NAFLD. PEth correlated well with commonly used questionnaires or interviews, and PEth ≥48 ng/mL conferred the highest risk of significant liver fibrosis progression (adjusted odds ratio: 5.9). 2 Another recent study suggested that ethyl glucuronide in hair and urine can be applied as a biomarker for harmful alcohol intake, which demonstrated promising accuracy. 4 Another aspect contributing to heterogeneity can be attributed to incomplete or missing adjustment for potential confounding factors. Metabolic comorbidity 5 and physical activity 6 in patients with NAFLD can have both independent and combined/counteracting effects on the metabolic consequences of alcohol intake. In addition, patients with NAFLD who were alcohol consumers may have different dietary intake compared to non-drinkers, 7 although another study revealed that the association of alcohol intake with the prevalence of NAFLD was independent of dietary patterns. 8 These lines of evidence suggest that sufficient adjustment for confounding factors in included patients will be critical to minimise heterogeneity.Finally, since most of the available studies are retrospective or cross-sectional, causal relationships are hard to draw in the absence of compelling clinical trials.

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Impact of Physical Activity on the Characteristics and Metabolic Consequences of Alcohol Consumption: A Cross-Sectional Population-Based Study

Cited by 6 publications

References 79 publications

Associations between Liver Enzymes, Lifestyle Risk Factors and Pre-Existing Medical Conditions in a Population-Based Cross-Sectional Sample

Associations between Liver Enzymes, Lifestyle Risk Factors and Pre-Existing Medical Conditions in a Population-Based Cross-Sectional Sample

Predictive risk markers in alcoholism

Letter: Low to moderate alcohol intake and progression of non‐alcoholic fatty liver disease

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