Ching-Ying Wu a, Hsing-Lin Lin b, c, d, Chao-Wen Chen b, c, Jiun-Nong Lin e, Liang-Chi Kuo b, c, Yuan-Chia Cheng b, c, Tsung-Ying Lin b, c, Wei-Che Lee b, c, d
aDepartment of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
bDivision of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
cDepartment of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
dDivision of Infectious Diseases, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
eGraduate Institute of Healthcare Administration, Kaohsiung Medical University, Kaohsiung, Taiwan
Abstract
Objective
Hepatic enzymes can be used as a predictor of hepatic injury. The present study investigated the relationship between blood alcohol concentration (BAC) and hepatic enzymes in patients intoxicated with ethanol at an emergency department (ED).
Materials and Methods
To determine whether BAC is an independent predictor of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, we retrospectively reviewed the medical data for patients who were intoxicated and whose BAC and hepatic enzyme levels were measured. Patients who had hepatitis caused by viruses or traumatic hepatic injury, as well as patients with a normal BAC, were excluded.
Results
Of the 1432 patients, 298 were female and 1134 were male. The average age of males was 41.4 ± 11.7 years and that of females was 35.6 ± 11.8 years. Mean serum AST and ALT levels were 78 ± 88 IU/L and 51 ± 67 IU/L in males, while those in females were 63 ± 110 IU/L and 40 ± 83 IU/L, respectively. Mean BACs were 199.6 ± 99.0 mg/dL for males and 175.1 ± 101.1 mg/dL for females. Log BAC had a high positive correlation with log ALT (r = 0.208; p < 0.001) and log AST (r = 0.086; p = 0.001) when BAC was above 50 mg/dL (0.05%). Multivariate linear regression showed that BAC was an independent predictor of AST and ALT (r2 = 0.057 and 0.056, respectively).
Conclusion
The high correlation of BAC with serum AST and ALT levels in patients intoxicated with ethanol when their BAC was above 50 mg/dL can be used to predict serum AST and ALT levels. However, a high BAC only appears to be associated with a slight elevation in hepatic enzymes. Therefore, in patients with acute alcohol intoxication at the ED, an elevation in AST and ALT levels should be considered as a result of hepatic injury rather than an effect of alcohol.
Keywords
Alanine aminotransferase (ALT); Alcohol; Aspartate aminotransferase (AST); Emergency department; Hepatic injury
