Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta‐analysis
Year: 2021
Type: article
Study design: Systematic Review
Abstract: BACKGROUND: Objective measurement of alcohol consumption is important for clinical care and research. Adjusting for self-reported alcohol use, we conducted an individual participant data (IPD) meta-analysis to examine factors associated with the sensitivity of phosphatidylethanol (PEth), an alcohol metabolite, among persons self-reporting unhealthy alcohol consumption. METHODS: We identified 21 eligible studies and obtained 4073 observations from 3085 participants with Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) positive scores (≥3 for women and ≥4 for men) and PEth measurements. We conducted 1-step IPD meta-analysis using mixed effects models with random intercepts for study site. We examined the associations between demographic (sex, race/ethnicity, and age) and biologic (body mass index-BMI, hemoglobin, HIV status, liver fibrosis, and venous versus finger-prick blood collection) variables with PEth sensitivity (PEth≥8 ng/ml), adjusting for the level of self-reported alcohol use using the AUDIT-C score. RESULTS: One third (31%) of participants were women, 32% were African, 28% African American, 28% White, and 12% other race/ethnicity. PEth sensitivity (i.e., ≥8 ng/ml) was 81.8%. After adjusting for AUDIT-C, we found no associations of sex, age, race/ethnicity, or method of blood collection with PEth sensitivity. In models that additionally included biologic variables, those with higher hemoglobin and indeterminate and advanced liver fibrosis had significantly higher odds of PEth sensitivity; those with higher BMI and those living with HIV had significantly lower odds of PEth sensitivity. African Americans and Africans had higher odds of PEth sensitivity than whites in models that included biologic variables. CONCLUSIONS: Among people reporting unhealthy alcohol use, several biological factors (hemoglobin, BMI, liver fibrosis, and HIV status) were associated with PEth sensitivity. Race/ethnicity was associated with PEth sensitivity in some models but age, sex, and method of blood collection were not. Clinicians should be aware of these factors, and researchers should consider adjusting analyses for these characteristics where possible.
DOI: 10.1111/acer.14611
Authors: Judith A. Hahn, Pamela M. Murnane, Eric Vittinghoff, Winnie R. Muyindike, Nneka I. Emenyonu, Robin Fatch, Gabriel Chamie, Jessica E. Haberer, Joel M. Francis, Saidi Kapiga, Karen Jacobson, Bronwyn Myers, Marie Claude Couture, Ralph J. DiClemente, Jennifer L. Brown, Kaku So‐Armah, Mark Sulkowski, Gregory M. Marcus, Sarah Woolf‐King, Robert L. Cook, Veronica L. Richards, Patricia Molina, Tekeda Ferguson, David Welsh, Mariann R. Piano, Shane A. Phillips, Scott Stewart, Majid Afshar, Kimberly Page, Kathleen McGinnis, David A. Fiellin, Amy C. Justice, Kendall Bryant, Richard Saitz
Institutions: University of California, San Francisco, Mbarara University of Science and Technology, Massachusetts General Hospital, University of the Witwatersrand, London School of Hygiene & Tropical Medicine, National Institute for Medical Research, Boston University, South African Medical Research Council, University of Cape Town, University of San Francisco, New York University, University of Cincinnati, Johns Hopkins University, Johns Hopkins Medicine, Syracuse University, University of Florida Health, University of Florida, Louisiana State University Health Sciences Center New Orleans, Vanderbilt University, University of Illinois Chicago, University at Buffalo, State University of New York, University of Wisconsin–Madison, University of New Mexico, United States Department of Veterans Affairs, VA Connecticut Healthcare System, Yale University, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, Boston Medical Center
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Bill and Melinda Gates Foundation, National Institutes of Health, University of California, San Francisco, National Institute on Alcohol Abuse and Alcoholism, National Institute of Mental Health, National Institute on Drug Abuse, National Institute of General Medical Sciences, National Institute of Allergy and Infectious Diseases, National Center for Advancing Translational Sciences
Awards: G1014156338, G1044130170, URBAN ARCH (3/5) Uganda Cohort TB preventive therapy for HIV-infected alcohol users in Uganda: an evaluation of safety tolerability and adherence, G1298516616, G1559851360, G1740684091, G1937633654, G197529489, G231928015, G2364989932, G246404274, G2902682273, G3181090803, G3385694058, G3658788169, G3934014208, G4389003395, G4786526028, G4807213467, G4863538964, G513759803, G5232765764, Training in Research Program on Alcohol Use by Persons with our at Risk for HIV, G5926564212, G613578794, G679121021, G6956489653, Phosphatidylethanol as an Alcohol Biomarker in Patients with Liver Disease, G7965387109, G8142833747, URBAN ARCH (5/5) Boston Cohort - Alcohol and HIV-associated comorbidity and complications: Frailty, Functional impairment, Falls, and Fractures (the 4F study), G9000016604, G9000023595, G9000078127, G9000086312, G9000095569, G9000100957, G9000108269, G9000127083, G9000138405, G9000153727, G9000172886, G9000192262, G9000216491, G9000300513, G9000305402, G97119092
OpenAlex ID: W3140095048