Syndrome of Malnutrition-Inflammation Complex in Chronic Alcoholics
Malnutrition-Inflammation Complex in Chronic Alcoholics
DOI:
https://doi.org/10.70284/njirm.v1i3.1874Keywords:
Ferritin, acute phase reactant, chronic alcohol abuse, Malnutrition – Inflammation – Complex Syndrome†(MICS)Abstract
Several studies have reported elevated serum ferritin levels in patients of chronic alcohol abuse. We hypothesized that serum
ferritin may be acting as a marker of acute phase reactant, reflecting the inflammatory status of patients of chronic alcohol abuse, rather
than as a marker of iron overload . Hence we correlated serum ferritin levels with interleukin 6 (IL-6), interleukin 1 (IL-1) and tumor
necrosis factor alpha (TNF -α ) which are markers of inflammation. Serum ferritin and IL-6 levels were significantly elevated at the time of
admission. The elevation of IL-6 correlated well with the increase in ferritin levels (r=0.78, p<0.01). Serum iron levels were not
significantly different before and after abstinence from alcohol. We also speculated that the inflammatory status was associated with the
malnutrition that is observed in alcohol abuse. Therefore we studied serum total protein, albumin, prealbumin and transferrin levels as
markers of nutrition in patients of chronic alcohol abuse. Serum levels of all these nutritional parameters increased significantly after 8
weeks of abstinence from alcohol and were accompanied by reduced levels of ferritin and IL-6. Hence it is possible that a malnutrition
inflammation complex like syndrome exists in patients of alcohol abuse.
References
259-269
2. Yang SQ, Lin HZ, Yin M, Albrecht JH, Diehl
AM. (1998) Effects of chronic ethanol
consumption on cytokine regulation of liver
regeneration Am JPhysiol.275 (4Pt 1):G696-
704.
3. Whitfield, J. B. et al.(2001). Effects of
alcohol consumption on indices of iron
stores and of iron stores on alcohol intake
markers. Alcohol Clin Exp. Res. 25, 1037-
1045
4. Loannou, G.N. et al.(2004) The effect of
alcohol consumption on the prevalence of
iron overload, iron deficiency and iron
deficiency anemia. Gastroenterology 126,
1293-1301.
5. Kalantar-Zadeh K, Don BR, Rodriguez RA,
Humpherys MH (2001). Serum ferritin is a
marker of morbidity and mortality in
hemodialysis patients. Am J Kidney Dis. 37,
564-572.
6. Rogers JT. (1996) Ferritin translation by
interleukin 1 and interleukin 6- the role of
sequences upstream of the start codons of
the heavy and light subunit genes. Blood 87,
2525-2537.
7. Rogers JT, Bridges KR, Durmowicz GP, Glass
J, Auron PE, Munro HN. (1990).Translational
control during the acute phase response.
Ferritin response to interleukin 1. J Biol
Chem 265:14572-14578.
8. Gonzalez-Quintela A. et al (2000) Influence
of acute alcohol intake and alcohol
withdrawal on circulating levels of IL-6, IL-8,
IL-10 and IL-12. Cytokine 12 , 1437 - 1440.
9. Lin ,H.Z.et al ( 1998) Chronic ethanol
consumption induces the production of
tumor necrosis factor-alpha and related
cytokines in liver and adipose
tissue.AlcoholClinExpRes.22(5Suppl),231S-
237S.
10. Khoruts, A. et al (1991) Circulating tumor
necrosis factor, interleukin-1 and
interleukin-6 concentrations in chronic
alcoholic patients. Hepatology. 13 , 267-76.
11. Kalantar – Zadeh, K, Rodriguez RA,
Humpherys MH (2004) Association between
serum ferritin and measures of
inflammation, nutrition and iron in
hemodialysis patients. Nephrol Dial
Transplant 19, 141-149.
12. Siren Sezer, F. et al (2002) Triad of
Malnutrition, Inflammation, and
atherosclerosis in hemodialysis patients.
Nephron 91 , 456-462. 14
13. Alte, D. et al (2003) Distribution and dose
response of laboratory markers to alcohol
consumption in a general population;
Results of the study of healthy in Pomerania
(SHIP). Journal of studies on Alcohol 64, 75-
82.
14. Chen, J. (2003) Combining carbohydrate –
deficient transferrin and gamma glutamyl
transferase to increase the diagnostic
accuracy for problem drinking. Alcohol and
alcoholism 38 , 574-582.
15. Singh, J. et al (1986) Gamma-Glutamyl
transpeptidase: a novel biochemical marker
in inflammation. Biochem Pharmacol 35 ,
3753-60.
16. Daniluk J, Szuster-Ciesielska A, Drabko J,
Kandefer-SzerszenM. (2001) Serum
cytokine levels in alcohol-related liver
cirrhosis. Alcohol. 23, 29-34
17. George A Kaysen,Joel A Dubin,Hans Georg
Muller , (2004) Inflammation and reduced
albumin synthesis associated with stable
decline in serum albumin in hemodialysis
patients. Kidney international 65, 1408–
1415
