Alcohol Consumption in Obese Patients Before and After Gastric Bypass as Assessed with the Alcohol Marker Phosphatidylethanol (PEth)

Abstract

Introduction Roux-en-Y gastric bypass (RYGB) causes more rapid and enhanced absorption of alcohol. RYGB patients have also been reported to use more inpatient care for alcohol-related disease than do patients after other bariatric procedures. The present study was designed to evaluate alcohol consumption level before and after gastric bypass using a sensitive and specific alcohol biomarker. Materials and Methods Two separate consecutive groups of patients and a group of healthy blood donors, as reference group, were included in the study. Alcohol intake was assessed using the alcohol marker phosphatidylethanol (PEth) at preoperative baseline and at 1 and 2 years postoperatively. In the first patient group (n = 133), neither surgeon nor patient was informed about the results of PEth testing. In the second group (n = 214), PEth results above 0.30 μmol/L were considered to indicate excessive alcohol consumption and led to preoperative alcohol counseling. The groups were followed for 2 and 1 year, respectively. Results PEth results were significantly lower in both patient groups at baseline as well as postoperatively compared with the reference group. In both patient groups, there was a significant increase in PEth values at postoperative follow-up compared to baseline. Conclusions Several physiological changes postoperatively have to be considered when interpreting PEth results in obese patients with dramatic weight reductions. According to results for PEth, obese patients treated with bariatric surgery would seem to have lower alcohol consumption compared with the reference group. Although slightly increasing their PEth values postoperatively, the RYGB patients did not reach the PEth values of the reference group.

Pharmacokinetics of Phosphatidylethanol 16:0/20:4 in Human Blood After Alcohol Intake

“…PEth has become well accepted as a direct biomarker of alcohol consumption (Aradottir et al, 2006; Beck et al, 2018; Simon, 2018; Varga et al, 1998; Walther et al, 2018) for the following reasons: First, PEth is highly specific because, as mentioned above, it is only generated in the presence of ethanol, and therefore is a direct biomarker of alcohol intake. Second, PEth is highly sensitive because it is detectable after consuming alcohol equivalent to just one or two standard drinks (Javors et al, 2016).…”

Prevalence of and Risk Factors Associated with Alcohol Overconsumption at 2 Years After Bariatric Surgery

“…Walter et al reported a prevalence of alcohol consumption (PEth > 0.05 μmol) of 26% 2 years after surgery among RYGB patients, which is in agreement with the alcohol consumption in our study (26.1%). In their study, a group of healthy blood donors was used as the reference, with PEth results > 0.05 μmol found in 44% of the controls, indicating that there could be higher alcohol consumption in the general population than among bariatric surgery patients [ 14 ].…”

“…The study found that the PEth levels of the bariatric surgery groups were lower than those of the reference group at baseline and postoperatively; notably, in both bariatric surgery groups, the PEth levels increased significantly postoperatively compared to baseline but did not reach the PEth levels of the control group. However, this study included only PEth ≥ 0.05 μmol/L without classifying it further as 0.05–0.30 μmol/L or > 0.30 μmol/L; in addition, the prevalence of alcohol overconsumption and risk factors were not examined [ 14 ]. The aim of this study was to evaluate the prevalence of alcohol overconsumption at 1 and 2 years after bariatric surgery and to identify possible risk factors associated with alcohol overconsumption.…”

Alcohol associated liver disease and bariatric surgery: Current perspectives and future directions

“…Using validated questionnaires may be more helpful than serum markers of alcohol consumption ( e.g. , phosphatidylethanol), which may vary unpredictably in patients with a history of bariatric surgery[ 64 ].…”