Increased Risk of Cerebral Hemorrhage in Chinese Male Heavy Drinkers with Mild Liver Disorder

Abstract

Background: Epidemiological evidence suggests that heavy alcohol consumption increases the risk for either stroke or liver disease. The goal of this study was to determine whether heavy drinkers with mild liver disorder (MLD) are at risk of hemorrhagic stroke. Methods:All of the 524 patients recruited were males with a first-ever acute stroke and were consecutively admitted to the Tri-Service General Hospital between January 2000 and December 2001. The risk factors, liver function, stroke subtypes, and hemostatic factors were assessed among 68 patients defined as heavy drinker stroke (HDS) and 456 patients as nonheavy drinker stroke (NHDS). Results: HDS patients had a significantly higher incidence of hemorrhagic stroke than NHDS patients. HDS patients were also associated with significantly higher occurrence of cigarette smoking, hyperuricemia, liver dysfunction, and significantly lower platelet counts. HDS patients with MLD were more likely to have hemorrhagic stroke (76.5%) than HDS patients without MLD (33.3%) and NHDS patients with (40.3%) or without (26.7%) MLD. HDS patients with MLD also exhibited a significantly higher glutamic oxaloacetic transaminase/glutamic pyruvic transaminase ratio (2.0 ± 1.2) and lower platelet number (185,000 ± 85,000 per µl) when compared with HDS patients without MLD (1.4 ± 0.5; 206,000 ± 59,000 per µl) and NHDS patients with (1.1 ± 1.0; 256,000 ± 97,000 per µl) or without (1.4 ± 0.7; 216,000 ± 68,000 per µl) MLD. Conclusions: HDS patients with MLD are at higher risk for hemorrhagic stroke in part due to the changes in hemostatic factors, although other factors may also contribute to hemorrhagic stroke.

Homozygous ALDH2*2 Is an Independent Risk Factor for Ischemic Stroke in Taiwanese Men

“…1,26 Subjects with the ALDH2*2 allele have low enzyme activity that impairs acetaldehyde metabolism. 16 The resulting acute acetaldehyde accumulation induces strongly negative psychophysiological reactions, as well as cardiovascular responses, during low to moderate alcohol intake.…”

“…1 Because it has multifactorial causes, 2 identification of its underlying pathogenesis and risk factors is essential. 3,4 As a part of the phase I oxidizing enzyme aldehyde dehydrogenase (ALDH) superfamily, ALDH2 is responsible for both ethanol metabolism and biogenic and xenogenic aldehyde detoxification.…”

Association between Alanine Aminotransferase and Intracerebral Hemorrhage in East Asian Populations

“…Therefore, hypertension and its risk factors are important in the development of ICH [11]. Additionally, previous case studies reported that ICH was associated with liver dysfunction [17,18] and elevated serum aminotransferase [4,5,6]. Elevated serum ALT is a sensitive, but nonspecific marker of hepatocellular injury and nonalcoholic fatty liver disease [19].…”

“…In a case-control study in Japan, a high ALT level was associated with increased risk of lobar ICH [5]. Another study in Taiwan observed an association between mild liver disease and ICH [6]. Thus, the East Asian Network for Stroke Prevention Study (EANS) was established to investigate the association between liver disease and stroke.…”

Efectos de la edad sobre la morbimortalidad de la hemorragia intracerebral

“…El consumo de alcohol, sobre todo la ingesta de importantes cantidades de manera regular (más de 300 gramos de alcohol por semana), parece lesionar en forma temprana (incluido en sujetos 16 jóvenes) los pequeños vasos . El riesgo probablemente se halle incrementado por los desórdenes de la hemostasia que presentan los consumidores crónicos de alcohol con afección de la funcionalidad 17 hepática .…”