The Pattern of Alcohol Consumption and the Severity of Alcohol-related Liver Disease in Patients Visiting the Liver Clinic

Introduction The purpose of this study was to discern the pattern of alcohol consumption and the severity of alcohol-related liver disease (ARLD) in patients visiting the tertiary care hospital. Methods A cross-sectional study was conducted at Dr. Ziauddin Hospital Clifton campus, Karachi. Patients visiting the liver clinic with disturbed liver enzymes and a history of alcohol intake after excluding other causes were included. A detailed history, routine investigations, insulin level, abdominal ultrasound, and transient elastography were performed. Results A total of 155 patients were included in the study, 98% of whom were men. The median age was 45.93 years (range: 18-78 years). Just over three-fourths of the visiting patients were Muslim (n=119; 76.8%). The median duration of alcohol intake was 5.7 years. All patients admitted to consuming alcohol on an empty stomach before dinner. The most common associated addiction was smoking (n=95; 61.2%). Around two-thirds of patients confessed to binge drinking (n=66; 42.9%). According to the Diagnostic and Statistical Manual of Mental Disorders criteria, 92 patients (59.35%) were alcohol dependent. Hepatic steatosis was positively correlated with the weight of patients (p=0.035). Other factors positively correlated with hepatic steatosis included insulin resistance (p=0.031), elevated uric acid levels (p=0.003), and units of alcohol intake (p=0.054). Significant fibrosis (F3-F4) was present in 73 (47.09%) patients. It was correlated with low platelet count, total bilirubin, aspartate aminotransferase, gamma-glutamyl transpeptidase, alkaline phosphatase, international normalized ratio, albumin, uric acid, controlled attenuation parameter, and units of alcohol intake with significant p-values. Further multivariant analysis showed liver fibrosis was correlated with cholesterol level with a significant p-value (p=0.045). Conclusion ARLD is mainly a male-dominant disease in our population. Most patients consumed a large volume of highly concentrated alcohol and were alcohol dependent. Insulin resistance was observed in a significant number of patients.