ArticleJHEP reports : innovation in hepatology2025
Quantification of alcohol intake in patients with steatotic liver disease and excessive alcohol intake.
Article in JHEP reports : innovation in hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed.
- Steatotic liver disease trajectory: A holistic EASL guidance on the multidisciplinary approach to screening and patient management.JHEP reports : innovation in hepatology · 2026Review
- Steatotic liver disease in Latin America: current views and perspectives.Nature reviews. Gastroenterology & hepatology · 2026Review
- Global epidemiology of metabolic and alcohol-associated liver disease: risk factors, natural history and clinical implications.Nature reviews. Gastroenterology & hepatology · 2026Review
- The dynamic spectrum of steatotic liver disease: the global perspective.Nature reviews. Gastroenterology & hepatology · 2026Review
- Clinical trial endpoints for metabolic dysfunction and alcohol associated steatotic liver disease.Hepatology international · 2026Review
- The global epidemiology of alcohol-associated liver disease.Hepatology communications · 2026Review
- Prediction of trajectories and outcomes in early-stage metabolic dysfunction-associated steatotic liver disease: a narrative review.EClinicalMedicine · 2026Review
- Integrating Phosphatidylethanol to Enhance Alcohol Quantification in Steatotic Liver Disease and Clinical Trials.Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Diagnostic and Prognostic Potential of CXCL9 and CXCL10 Chemokines in Alcohol-Associated Liver Disease.International journal of molecular sciences · 2025Observational
- Clinical trial design, biomarkers and end points in metabolic and alcohol-related liver disease.Nature reviews. Gastroenterology & hepatology · 2025Review
- Non-invasive tests for MetALD and alcohol-related liver disease.JHEP reports : innovation in hepatology · 2025Review
- Safety and Tolerability of Injectable Extended-Release Naltrexone for the Management of Alcohol Use Disorder in Advanced Alcohol-Associated Liver Disease.Alimentary pharmacology & therapeutics · 2025Article
- Article
Corrections and comments
- Erratum issued
Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background & Aims: Quantifying alcohol intake is crucial for subclassifying participants with steatotic liver disease (SLD) and interpreting clinical trials of alcohol-related liver disease (ALD) and metabolic and alcohol-related liver disease (MetALD). However, the accuracy of self-reported alcohol intake is considered imprecise. We compared the diagnostic and prognostic utility of self-reported alcohol intake with blood-based biomarkers of alcohol intake: phosphatidylethanol (PEth) and carbohydrate-deficient transferrin (CDT). Methods: We studied 192 participants from two randomized controlled trials on MetALD and ALD, all with current or former excessive alcohol intake (≥24/36 [♀/♂] grams daily for at least 1 year) and biopsy-proven liver disease. We assessed self-reported alcohol intake, PEth, and CDT at four time points. We collected follow-up data on hepatic decompensation and death manually through electronic medical records. Results: Most participants were male (n = 161, 84%) with a mean age of 59 (SD 9) years and 73 participants reported 1-week abstinence before inclusion; the remaining reported a median alcohol intake of 43 g/day. Median PEth was 0.5 μmol/L (IQR: 0.0-1.3) and %CDT = 1.9 (IQR: 1.6-2.3). Of 32 patients reporting at least 6 months of abstinence; 27 (84%) was confirmed by PEth <0.05 μmol/L. Self-reported alcohol intake correlated well with PEth (r = 0.617) and moderately with CDT (r = 0.316). Self-reported alcohol intake, PEth, and CDT all predicted hepatic decompensation and death. However, PEth showed the highest prediction, surpassing self-reported alcohol intake (Harrel's C, PEth = 0.80 Conclusions: Self-reported abstinence can be considered reliable in clinical trials. However, PEth is superior in predicting hepatic decompensation and death in patients with MetALD and ALD. Impact and implications: An accurate quantification of alcohol intake is crucial in the clinical phenotyping of patients with steatotic liver disease and when designing clinical trials. This study found self-reported abstinence to be reliable but phosphatidylethanol was a more accurate prognostic biomarker of hepatic decompensation and death in a clinical trial setting. Findings may inform the design of future trials in patients with steatotic liver disease.
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