Relationship between Withdrawal Severity and Inflammation Parameters during the Detoxification Treatment of Alcohol Use Disorder
Abstract
Objective: Alcohol withdrawal is a potentially life-threatening condition that could be seen after discontinuation or a decrease in alcohol consumption. Inflammatory processes take part in alcohol withdrawal duration. This study aimed to investigate the relationship between withdrawal severity and inflammation parameters.
Method: This retrospective study was performed via electronic health records in an alcohol and drug treatment center between August-2021 and August-2022. One hundred forty-one inpatients with alcohol use disorder and 134 controls were enrolled. Sociodemographic, clinical, and biochemical data of the participants were collected.
Results: The patients and the control group were similar in age, gender, and educational status. The patients’ group had higher levels of neutrophils and lower levels of lymphocytes than the control group. Neutrophil-to-lymphocyte (NLR) and monocyte-to-lymphocyte ratio (MLR) levels were higher in the patients’ group. The alcohol withdrawal severity of patients was positively correlated with NLR levels, MLR levels, the amount of daily alcohol, and years of heavy alcohol consumption.
Conclusion: NLR and MLR are inexpensive and easily accessible markers that could be used to estimate alcohol withdrawal severity.
Thanks
None.
References
- Calvete E, Orue I, Hankin BL. Early maladaptive schemas and social anxiety in adolescents: The mediating role of anxious automatic thoughts. J Anxiety Disord 2013; 27(3): 278-288.
- Danışman M, İspir GZ, Oğur B. Delirium tremens and central pontine myelinolysis in a patient with alcohol use disorder and pneumonia: a case report and a narrative review. Fortschr Neurol Psychiatr 2022; 90(5): 288-290.
- Jesse S, Bråthen G, Ferrara M, et al. Alcohol withdrawal syndrome: mechanisms, manifestations, and management. Acta Neurol Scand 2017; 135(1): 4-16.
- Fiellin DA, O'connor PG, Holmboe ES, Horwitz RI. Risk for delirium tremens in patients with alcohol withdrawal syndrome. Subst Abus 2002; 23(2): 83-94.
- Ballard HS. The hematological complications of alcoholism. Alcohol Health Res World 1997; 21(1): 42-52.
- Renaud SC, Beswick AD, Fehily AM, et al. Alcohol and platelet aggregation: the Caerphilly prospective heart disease study. Am J Clin Nutr 1992; 55(5): 1012-1017.
- Buonacera A, Stancanelli B, Colaci M, Malatino L. Neutrophil to lymphocyte ratio: an emerging marker of the relationships between the immune system and diseases. Int J Mol Sci 2022; 23(7): 3636.
- Najjar S, Pearlman DM, Alper K, et al. Neuroinflammation and psychiatric illness. J Neuroinflammation 2013; 10: 816.
- Pinto JV, Moulin TC, Amaral OB. On the transdiagnostic nature of peripheral biomarkers in major psychiatric disorders: a systematic review. Neurosci Biobehav Rev 2017; 83: 97-108.
- Orum MH, Kara MZ, Egilmez OB. Relationship between immune cells and alcohol dependents and controls: what about the lymphocyte-related ratios? J Immunoassay Immunochem 2018; 39(3): 348-350.
- Baykara S, Kaya Ş, Berk ŞŞ. Complete blood count parameters and lymphocyte-related ratios in patients with alcohol use disorder. Bağımlılık Dergisi 2019; 20(4): 206-213.
- Araos P, Figueroa S, Amador CA. The role of neutrophils in hypertension. Int J Mol Sci 2020; 21(21): 8536.
- Demir M. The relationship between neutrophil lymphocyte ratio and non-dipper hypertension. Clin Exp Hypertens 2013; 35(8): 570-573.
- Dundee J, Mcgowan W, Lilburn J, et al. Comparison of the actions of diazepam and lorazepam. Br J Anaesth 1979; 51(5): 439-446.
- Sullivan JT, Sykora K, Schneiderman J, et al. Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA‐Ar). Br J Addict 1989; 84(11): 1353-1357.
- Kalyoncu ÖA, Mirsal H, Pektaş Ö, et al. The efficacy of venlafaxine on depressive symptoms of patients diagnosed with both alcohol use disorder and major depressive disorder. Bağımlılık Dergisi 2007; 8(2): 59-65.
- Hydzik P, Szpak D, Gomółka E. Osteopontin level in the serum of patients with alcoholic liver disease, treated for alcohol withdrawal syndrome--a preliminary report. Przegl Lek 2013; 70(8): 542-545.
- Huang M-C, Chen C-C, Peng F-C, et al. The correlation between early alcohol withdrawal severity and oxidative stress in patients with alcohol dependence. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33(1): 66-69.
- Yıldırım YE, Umut G, Evren C, et al. Neutrophil-lymphocyte ratio as a predictor of delirium tremens in hospitalized patients with alcohol withdrawal. Alcohol 2023; 109: 43-48.
- Doyle A, Chaudhary S, Mackey W, et al. Treatment of alcohol withdrawal syndrome in patients with alcohol-related liver disease. Age 2021; 51(4): 53.
- Voican CS, Njiké‐Nakseu M, Boujedidi H, et al. Alcohol withdrawal alleviates adipose tissue inflammation in patients with alcoholic liver disease. Liver Int 2015; 35(4): 967-978.
- Liangpunsakul S, Toh E, Ross RA, et al. Quantity of alcohol drinking positively correlates with serum levels of endotoxin and markers of monocyte activation. Sci Rep 2017; 7: 4462.
- Kraemer KL, Mayo‐Smith MF, Calkins DR. Independent clinical correlates of severe alcohol withdrawal. Subst Abus 2003; 24(3): 197-209.
Alkol Kullanım Bozukluğunun Detoksifikasyon Tedavisi Sırasında Yoksunluk Şiddeti İle İnflamasyon Parametreleri Arasındaki İlişki ̇
Abstract
Amaç: Alkol yoksunluğu, alkol alımının kesilmesinden veya azaltılmasından sonra görülebilen, potansiyel olarak yaşamı tehdit eden bir durumdur. İnflamatuar süreçler alkol yoksunluk süresinde yer alır. Bu çalışmada alkol yoksunluk şiddeti ile inflamasyon parametreleri arasındaki ilişkinin incelenmesi amaçlanmıştır.
Yöntem: Bu retrospektif çalışma Ağustos-2021 ve Ağustos-2022 tarihleri arasında bir alkol ve uyuşturucu madde tedavi merkezinde elektronik sağlık kayıtları üzerinden gerçekleştirilmiştir. Alkol kullanım bozukluğu olan 141 hasta ve 134 kontrol grubu çalışmaya dahil edilmiştir. Katılımcıların sosyodemografik, klinik ve biyokimyasal verileri toplanmıştır.
Bulgular: Hastaların ve kontrol grubunun yaş, cinsiyet ve eğitim durumu açısından benzer oldukları görülmüştür. Hasta grubunun, kontrol grubundan daha yüksek nötrofil seviyelerine ve daha düşük lenfosit seviyelerine sahip olduğu; nötrofil-lenfosit oranı (NLO) ve monosit-lenfosit oranı (MLO) düzeylerinin de hasta grubunda daha yüksek olduğu saptanmıştır. Hastaların alkol yoksunluk şiddetinin NLO düzeyleri, MLO düzeyleri, günlük alkol miktarı ve ağır alkol tüketim süresi ile pozitif korelasyon gösterdiği görülmüştür.
Sonuç: NLO ve MLO, alkol yoksunluk şiddetini tahmin etmek için kullanılabilecek ucuz ve kolay erişilebilir belirteçlerdir
References
- Calvete E, Orue I, Hankin BL. Early maladaptive schemas and social anxiety in adolescents: The mediating role of anxious automatic thoughts. J Anxiety Disord 2013; 27(3): 278-288.
- Danışman M, İspir GZ, Oğur B. Delirium tremens and central pontine myelinolysis in a patient with alcohol use disorder and pneumonia: a case report and a narrative review. Fortschr Neurol Psychiatr 2022; 90(5): 288-290.
- Jesse S, Bråthen G, Ferrara M, et al. Alcohol withdrawal syndrome: mechanisms, manifestations, and management. Acta Neurol Scand 2017; 135(1): 4-16.
- Fiellin DA, O'connor PG, Holmboe ES, Horwitz RI. Risk for delirium tremens in patients with alcohol withdrawal syndrome. Subst Abus 2002; 23(2): 83-94.
- Ballard HS. The hematological complications of alcoholism. Alcohol Health Res World 1997; 21(1): 42-52.
- Renaud SC, Beswick AD, Fehily AM, et al. Alcohol and platelet aggregation: the Caerphilly prospective heart disease study. Am J Clin Nutr 1992; 55(5): 1012-1017.
- Buonacera A, Stancanelli B, Colaci M, Malatino L. Neutrophil to lymphocyte ratio: an emerging marker of the relationships between the immune system and diseases. Int J Mol Sci 2022; 23(7): 3636.
- Najjar S, Pearlman DM, Alper K, et al. Neuroinflammation and psychiatric illness. J Neuroinflammation 2013; 10: 816.
- Pinto JV, Moulin TC, Amaral OB. On the transdiagnostic nature of peripheral biomarkers in major psychiatric disorders: a systematic review. Neurosci Biobehav Rev 2017; 83: 97-108.
- Orum MH, Kara MZ, Egilmez OB. Relationship between immune cells and alcohol dependents and controls: what about the lymphocyte-related ratios? J Immunoassay Immunochem 2018; 39(3): 348-350.
- Baykara S, Kaya Ş, Berk ŞŞ. Complete blood count parameters and lymphocyte-related ratios in patients with alcohol use disorder. Bağımlılık Dergisi 2019; 20(4): 206-213.
- Araos P, Figueroa S, Amador CA. The role of neutrophils in hypertension. Int J Mol Sci 2020; 21(21): 8536.
- Demir M. The relationship between neutrophil lymphocyte ratio and non-dipper hypertension. Clin Exp Hypertens 2013; 35(8): 570-573.
- Dundee J, Mcgowan W, Lilburn J, et al. Comparison of the actions of diazepam and lorazepam. Br J Anaesth 1979; 51(5): 439-446.
- Sullivan JT, Sykora K, Schneiderman J, et al. Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA‐Ar). Br J Addict 1989; 84(11): 1353-1357.
- Kalyoncu ÖA, Mirsal H, Pektaş Ö, et al. The efficacy of venlafaxine on depressive symptoms of patients diagnosed with both alcohol use disorder and major depressive disorder. Bağımlılık Dergisi 2007; 8(2): 59-65.
- Hydzik P, Szpak D, Gomółka E. Osteopontin level in the serum of patients with alcoholic liver disease, treated for alcohol withdrawal syndrome--a preliminary report. Przegl Lek 2013; 70(8): 542-545.
- Huang M-C, Chen C-C, Peng F-C, et al. The correlation between early alcohol withdrawal severity and oxidative stress in patients with alcohol dependence. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33(1): 66-69.
- Yıldırım YE, Umut G, Evren C, et al. Neutrophil-lymphocyte ratio as a predictor of delirium tremens in hospitalized patients with alcohol withdrawal. Alcohol 2023; 109: 43-48.
- Doyle A, Chaudhary S, Mackey W, et al. Treatment of alcohol withdrawal syndrome in patients with alcohol-related liver disease. Age 2021; 51(4): 53.
- Voican CS, Njiké‐Nakseu M, Boujedidi H, et al. Alcohol withdrawal alleviates adipose tissue inflammation in patients with alcoholic liver disease. Liver Int 2015; 35(4): 967-978.
- Liangpunsakul S, Toh E, Ross RA, et al. Quantity of alcohol drinking positively correlates with serum levels of endotoxin and markers of monocyte activation. Sci Rep 2017; 7: 4462.
- Kraemer KL, Mayo‐Smith MF, Calkins DR. Independent clinical correlates of severe alcohol withdrawal. Subst Abus 2003; 24(3): 197-209.
Details
| Primary Language | English |
|---|---|
| Subjects | Psychiatry, Subtance Abuse |
| Journal Section | Research |
| Authors | |
| Publication Date | March 31, 2024 |
| Acceptance Date | July 17, 2023 |
| Published in Issue | Year 2024 Volume: 25 Issue: 1 |
Bağımlılık Dergisi - Journal of Dependence