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Biomedical subjects

K Seppä

Publications and source records attributed to K Seppä.

At least 55 records · Page 3Linked to original sources
PubMed1994

Women, alcohol, and red cells.

Alcohol abuse is known to increase erythrocyte mean cell volume mainly as a consequence of direct toxic effect on the developing red cell. The influence of alcohol on other red cell parameters is unclear. The objective of this cross-sectional survey was to examine the consequences of different alcohol amounts on red cell parameters among women. We compared red cell parameters between female alcoholics, heavy drinkers, and controls. Controls (n = 138) and heavy drinkers (n = 65) consisted of consecutive 40- and 45-year-old women participating in the health screening, and alcoholics (n = 73) of consecutive women coming to a detoxification clinic. Alcoholics had significantly smaller erythrocyte counts (p < 0.01), and higher erythrocyte mean cell volume values (p < 0.001), reticulocyte counts (p < 0.01), and red cell distribution width values (p < 0.001) than controls. No difference between these groups was found, however, in hemoglobin distribution width value. The only red cell difference between controls and heavy drinkers was erythrocyte mean cell volume, which was significantly higher among heavy drinkers (p < 0.001). In alcoholics, red cell distribution width values were even more often increased (in 44%) than erythrocyte mean cell volume values (in 34%). This increase in red cell distribution width was not solely explained by iron deficiency or liver disease. Chronic alcohol abuse not only affects erythrocyte mean cell volume values, but also leads to anisocytosis seen in blood count as an increased red cell distribution width value.

Adult↗
PubMed1994

Hidden alcohol abuse among women.

Seven years ago the authors examined 64 consecutive female out-patients with macrocytosis (erythrocyte mean cell volume > or = 100 fl). The cause remained undetermined in 23 (35.9%). Their patient histories were evaluated in 1992, and the new highly specific alcohol marker, serum carbohydrate-deficient transferrin, from the frozen sera taken during the initial study was examined. It was elevated in 6 of the 23 women. Furthermore, four of these six had visited the health centre after 1985 and they all had clinical records indicative of alcohol problems. Because early intervention has proved to be effective, information about the risks of alcohol abuse (intervention) should be given to women with suspect alcohol-induced symptoms or signs.

Adult↗
PubMed1993

Semi-automatic method for determination of different isoforms of carbohydrate-deficient transferrin.

Carbohydrate deficient transferrin (CDT) has been reported to be one of the best biochemical markers of alcohol abuse. However, a need still exists for a simple and practical method for widespread laboratory use. A semi-automatic (SA) isoelectric focusing (IEF) assay for CDT (SA-IEF-CDT) by a Phast System is introduced here. Different isoforms of transferrin were separated by IEF on polyacrylamide gels (pI 4.0-6.5) and located by immunofixation with an anti-transferrin serum. The precipitation bands were stained with Coomassie Brilliant Blue and quantitated densitometrically. The present method gave a picture of the relative amounts of 10 different transferrin isoforms. The percentage of CDT with pI > or = 5.7 (representing di-, mono- and asialotransferrin) was calculated. For comparisons transferrin bands with pI > or = 5.6 (tri-, di-, mono-, and asialotransferrin), pI > or = 5.8 (mono- and asialotransferrin) and pI > or = 5.9 (asialotransferrin) as well as GGT, ASAT and ALAT were calculated. The method showed good linearity and it identified different isoforms in concentrations of < 10 mg/l of transferrin. The correlation of the present method with a commercially available method employing anion exchange followed by double antibody RIA (AE-RIA-CDT) was good (n = 38, r = 0.924). In 19/20 (95%) of healthy controls, the CDT value was below 4.4% (mean + 2 S.D.) of total transferrin, while higher values were observed in all 20 (100%) alcoholics. In conclusion, the developed semi-automatic method is a practical and reliable alternative for determination of different transferrin isoforms.

Adult↗
PubMed1993

Heavy drinking in hospital patients.

The study examines the prevalence of high consumption of alcohol among the patients of a large university hospital, and the ability of physicians to detect heavy drinking. According to self-report, the results of CAGE questionnaire or the physicians' opinion, 25% of the male and 11% of the female patients were heavy drinkers. The physicians identified 43% and 26% of the men and women who screened positively either according to CAGE or self-report. On the other hand, 17% of the men and 14% of the women who were identified by the physicians as heavy drinkers had a negative screening result. Heavy drinking was most often connected with psychiatric disorders, but it was present in all specialties. A wide range of diagnoses were found among abusers. It is concluded that all patients in all clinics should be asked about their drinking habits instead of relying solely on the physician's instinct or on the patient's self-report or CAGE. More individual interviews should be done to make possible early intervention in heavy drinking.

Adolescent↗
PubMed1993

Relationship of alcohol consumption to changes in HDL-subfractions.

Epidemiological studies have consistently shown an apparent protective effect of moderate alcohol consumption on coronary artery disease (CAD). This has been considered to be due to the rise in the high-density cholesterol lipoprotein (HDL-cholesterol). Since the response of the HDL-subfractions to moderate or heavy dose of alcohol is less clear, we now compared the high-density lipoprotein cholesterol status between groups consuming different amounts of alcohol. In this population-based survey serum total high-density lipoprotein cholesterol and its HDL2 and HDL3 subfractions were blindly compared between 264 consecutive middle-aged men (37 teetotallers, 137 moderate drinkers, 90 heavy drinkers) participating in a voluntary health screening and 104 male alcoholics. Alcohol consumption correlated significantly (P < 0.001) with total HDL-cholesterol, HDL2, HDL3 when all subjects (n = 368) were included but the correlation disappeared when alcoholics were excluded (n = 264). In comparison with teetotallers, alcoholics had significantly higher total HDL-cholesterol, HDL2 and HDL3 values (P < 0.001). Moderate or heavy intake of alcohol had no effect on HDL2 but increased the HDL3-fraction. If the protective effect of moderate alcohol consumption is mediated by high-density lipoprotein, it may not be accounted for by changes in the HDL2-fraction. The observed increases in the concentration of the HDL3-fraction, however, suggest that this subfraction may not be inert with respect to coronary disease and could possibly have a role in the protective effect.

Adult↗
PubMed1993

CDT by anion-exchange chromatography followed by RIA as a marker of heavy drinking among men.

Carbohydrate-deficient transferrin, CDT, had previously been reported to be an excellent marker for alcoholism. The present population-based study examined the diagnostic value of CDT among consecutive middle-aged males including 122 social drinkers (mean alcohol consumption 88 +/- 79 g per week) and 77 non-alcoholic heavy drinkers (301 +/- 195 g/wk). Ninety-six men with a well-documented history of chronic alcoholism (> or = 1000 g/wk) were used as a reference group. The CDT (containing mainly isotransferrin with pI = 5.8 and 5.9) was separated by anion exchange chromatography and assayed by RIA. The CDT values of social drinkers (mean +/- SD = 14 +/- 5 U/I) were significantly lower than those of heavy drinkers (19 +/- 13 U/I, p < 0.01) and alcoholics (34 +/- 18 U/I, p < 0.001). In the whole material CDT correlated positively with alcohol consumption (r = 0.53, p < 0.001). At a specificity of 91.8%, CDT found 28.6% of the heavy drinkers and 79.2% of the alcoholics; the best traditional marker, GGT, with a specificity of 86.9%, found 35.1% and 64.6%, respectively. In conclusion, CDT is a specific marker, which is superior to traditional markers for identifying alcoholics. Unfortunately, it does not seem to provide additional power for identifying the important group, non-alcoholic heavy drinkers.

Adult↗
PubMed1992

Moderate and heavy alcohol consumption have no favorable effect on lipid values.

Moderate alcohol consumption has been reported to provide protection against coronary heart disease. We studied serum lipid values in 380 men, including 184 controls (37 teetotalers and 147 moderate drinkers), 90 heavy drinkers, and 106 alcoholics. Total cholesterol values were significantly lower among alcoholics than controls (mean +/- SEM, 5.43 +/- 0.15 mmol/L [210 +/- 5.8 mg/dL] vs 6.01 +/- 0.08 mmol/L [232 +/- 3.1 mg/dL]), but their high-density lipoprotein (HDL) cholesterol values were higher (1.66 +/- 0.07 mmol/L [64 +/- 2.7 mg/dL] vs 1.14 +/- 0.02 mmol/L [44 +/- 0.8 mg/dL]). Accordingly, there was a highly significant difference in the HDL/total cholesterol ratio (0.32 +/- 0.13 vs 0.19 +/- 0.01). Heavy drinkers had significantly higher total cholesterol values than controls (6.30 +/- 0.13 mmol/L [244 +/- 5.0 mg/dL] vs 6.01 +/- 0.08 mmol/L [232 +/- 3.1 mg/dL]); the same was true of HDL cholesterol values (1.25 +/- 0.07 mmol/L [48 +/- 2.7 mg/dL] vs 1.14 +/- 0.02 mmol/L [44 +/- 0.8 mg/dL]). No significant difference was found in the HDL/total cholesterol ratio between controls and heavy drinkers or between teetotalers and moderate drinkers. Therefore, moderate alcohol intake apparently does not change HDL/total cholesterol ratio; if moderate drinking is protective against coronary heart disease, the mechanism is probably not via lipids.

Adult↗
PubMed1992

Drinking habits and detection of heavy drinking among middle-aged women.

Little is known about alcohol consumption and the efficiency of alcohol questionnaires among women. In the present study 40-year-old (n = 90) and 45-year-old (n = 75) women participating in a health screening gave a self-report about their alcohol consumption and filled out the Malmö modified Michigan Alcoholism Screening Test (Mm-MAST) and the CAGE questionnaires. Teetotallers comprised 11% of the 40-year-old group and 8% of the 45-year-old women. CAGE, but not Mm-MAST worked with the traditional cut-off point of two recommended for men. When the criterion for heavy drinking was a self-reported consumption > or = 140 g of absolute alcohol per week or a positive (> or = 2) finding in the CAGE or > or = 4 'yes' answers in the Mm-MAST, 20% of the 40-year-old and 17% of the 45-year-old group (together 19%) proved positive. Neither of the two questionnaires nor self-report alone worked perfectly for identifying the heavy drinker group (n = 31) screened. Using the three above criteria; of the heavy drinkers 52% were detected by self-report, 55% by CAGE, and 45% by Mm-MAST. CAGE in combination with self-report detected 90% and this combination, being short and simple, can be recommended for clinical practice.

Alcohol Drinking↗
PubMed1992

Abnormalities of hematologic parameters in heavy drinkers and alcoholics.

Hematologic parameters measured by a Technicon H-1 analyzer and reticulocyte values were studied in three middle-aged male groups; 184 social drinkers, 88 heavy drinkers, and 106 alcoholics. Erythrocyte mean cell volume (MCV) correlated positively (p less than 0.001) with red cell distribution width (r = 0.388) and negatively with red blood cells (r = -0.594, p less than 0.001), hemoglobin distribution width (r = -0.330, p less than 0.001), cell by cell counted hemoglobin concentration (CHCM) (r = -0.434, p less than 0.001), and the ratio between standard deviation of CHCM and CHCM (r = -0.375, p less than 0.001). In spite of these correlations high red cell distribution width values were also found in alcoholic patients with normocytosis (MCV less than or equal to 96 fl). Alcohol induced abnormalities primarily in erythrocytes. The only significant abnormality in the heavy drinker group was a high value of erythrocyte MCV, which was found in 22.7%. In the alcoholic group the MCV value was high in 39.6%, and low erythrocyte values were detected in 16%. A high erythrocyte mean cell distribution width value indicating anisocytosis was found in 40.6% of the alcoholic group. In this material the specificities of these values were also good. The scatter cytogram for red blood cells did not give any valuable visual information in the abuser groups. Thus, certain abnormalities in the Technicon H-1 system parameters, even other than MCV, can be explained by alcohol abuse.

Adult↗
PubMed1992

Intervention in alcohol abuse among macrocytic patients in general practice.

The study examined the effectiveness of routine intervention in alcohol abuse by a general practitioner, with help of a laboratory test. Patients diagnosed as abusers because of high erythrocyte mean cell volume value (MCV) and having no other cause for it were randomly allocated to two groups: 1) an intervention group, comprising 92 patients (69 men and 23 women), who were invited for follow-up at three-monthly intervals for a year; 2) a control (mini-intervention) group, 86 patients (71 men and 15 women), who were followed-up only after 12 months. Follow-up attendance was poor, particularly in the intervention group. In general, MCV-values were unchanged in the groups at the end of the study, though there was a clear trend for the female controls to have lower values (101.9 fl at the start, 98.5 fl at the end, p = 0.06). Altogether 11% (4/38) of the women and 7% (10/140) of the men had clearly reduced their alcohol consumption after one year, and this was also seen in their MCV-values. Mini-intervention, especially in women with an abnormal laboratory value, seems to be, with the help of MCV, at least as effective a way of counselling nonalcoholic abusers as a more systematic intervention.

Alcoholism↗
PubMed1992

Alcohol-induced macrocytosis and blood pressure.

The effect of alcohol on blood pressure was studied prospectively in consecutive general practice patients with macrocytosis (MCV greater than or equal to 100 fl). The patients were separated into misuser and non-misuser groups on the basis of the Malmö modified Michigan Alcoholism Screening Test. There was no significant difference in the prevalence of antihypertensive medication between the misuser and non-misuser groups. When patients using antihypertensive medication were excluded and the groups were age-adjusted, male misusers (n = 95) compared to control patients (n = 22) had significantly higher diastolic (88 mmHg and 81 mmHg, respectively, P = 0.001) and systolic (146 mmHg and 137 mmHg, respectively, P less than 0.001) blood pressure values. Female misusers (n = 24), as compared to female non-misusers (n = 59) had significantly higher diastolic (83 mmHg and 82 mmHg, respectively, P = 0.04) but not systolic blood pressure values. Thus, alcohol seems to have a pressor effect predominantly among men. As 72% of men with macrocytosis were alcohol misusers and 41% of them either had elevated systolic or diastolic blood pressure, all patients with macrocytosis should be asked about their alcohol consumption and at least the males should have blood pressure measured.

Alcoholism↗
PubMed1991

Association of a haemoglobin-acetaldehyde adduct with questionnaire results on heavy drinkers.

A new biological alcohol marker, the ratio between the acetaldehyde-induced haemoglobin fraction HbA1ach and the glycated haemoglobin fraction HbA1c (HbA1ach/HbA1c), was studied in association with data obtained in a questionnaire, the Malmö modified Michigan alcoholism screening test (Mm-MAST), completed by 270 consecutive middle-aged men participating in a voluntary health screening. None of them had earlier alcoholic health or alcohol-dependent social problems. The nine-question Mm-MAST correlated positively with the ratio of HbA1ach/HbA1c (r = 0.272, P less than 0.001). In the three drinker groups defined according to the questionnaire, HbA1ach/HbA1c values were significantly higher among heavy drinkers (mean = 40, S.E.M. = 1) than among teetotallers (mean = 32, S.E.M. = 2, P less than 0.01) or social drinkers (mean = 35, S.E.M. = 1, P less than 0.01). In the groups formed according to the respondents' own alcohol anamnesis there was no significant difference between the marker values, but the Mm-MAST score was significantly higher in both social (P less than 0.001) and heavy drinkers' (P less than 0.001) groups as compared with teetotallers. This shows that the questionnaire detected heavy drinkers better than the self-given anamnesis. The correlation of HbA1ach/HbA1c and the questionnaire means that the biological marker studied represents a new possibility to identify heavy drinkers before alcoholic health problems or social consequences have appeared.

Acetaldehyde↗
PubMed1991

Macrocytosis as a consequence of alcohol abuse among patients in general practice.

Macrocytosis, a common finding in patients without anemia or other hematologic abnormalities, is often ignored. The purpose of this prospective study was to investigate 300 consecutive, adult health-center patients with a mean cell volume (MCV) value greater than or equal to 100 fl. The incidence of macrocytosis was 2.4%. Of the 177 male and 123 female patients, only 14 (4.7%) were anemic; 80.2% of the men (89.3% of those under 60 years) and 34.1% of the women were alcohol abusers, representing the largest diagnostic group. The highest MCV value found in alcoholics without folate or vitamin B12 deficiency was 120 fl. The most useful laboratory test for identifying alcohol abuse among macrocytic patients was the measurement of serum gamma-glutamyltransferase. Of the several morphologic abnormalities in the marrow the only specific finding were vacuoles in the granulocyte or erythrocyte precursors. No underlying cause was found for macrocytosis in 6.8% of the men and 35.8% of the women. Even when it is not associated with anemia, macrocytosis should not be ignored. It may be the only indicator of a disease which often, particularly in young and middle-aged men, is alcohol abuse.

Adult↗