Complicaciones médicas del trastorno por uso de alcohol. Inflamación y enfermedad cardiovascular

Abstract

Alcohol consumption is highly prevalent in our environment and is associated with damage to a large number of organs, promoting the development of diseases such as alcohol-related liver disease (ARLD), cardiovascular disease, and cancer. Excessive alcohol consumption is also associated with laboratory abnormalities suggestive of liver damage. Systemic inflammation, intestinal permeability, bacterial translocation, and monocyte activation are relevant factors in the pathogenesis of ARLD. It is unknown whether these phenomena are already present in patients with less advanced forms of the disease. The aim of this doctoral thesis is to analyze the values of systemic inflammation markers, mononcyte activation and bacterial translocation in patients with alcohol use disorder (AUD), as well as their association with other clinical and analytical parameters, with concomitant use of cocaine and/or cannabis, with the presence of liver fibrosis estimated by FIB-4, with sex or the presence of cardiovascular risk factors. For this purpose, the studies carried out included patients with AUD admitted for detoxification in two Addiction Units of two different hospitals in the metropolitan area of Barcelona, Hospital Universitario Germans Trias i Pujol de Badalona and Hospital Universitario de Bellvitge de l’Hospitalet de Llobregat. Patients with AUD admitted for detoxification have higher levels of markers of systemic inflammation, monocyte activation, and bacterial translocation. Cannabis use in these patients is associated with higher levels of sCD163, a marker of monocyte activation. Laboratory parameters such as elevated glucose, aspartate aminotransferase (AST), mean corpuscular volume (MCV), C-reactive protein (CRP), and low hemoglobin levels are also associated with higher levels of systemic inflammation markers such as IL-6 and monocyte activation markers such as sCD14 and CD163. The presence of advanced liver fibrosis, measured with the FIB-4 index, is associated with elevated levels of these systemic inflammation and monocyte activation markers, as well as with higher levels of lipopolysaccharide-binding protein (LBP) and lower levels of lipopolysaccharide (LPS). The presence of type 2 diabetes mellitus or a history of cardiovascular disease in patients with AUD was associated with higher mean sCD163 levels, furthermore, patients with type 2 diabetes mellitus who were treated with insulin had higher mean levels of both IL-6 and IL-10. Women had lower mean daily consumption and a shorter mean duration of AUD when they were admitted for detoxification. Women had a lower prevalence of diabetes and previous cardiovascular disease, as well as lower mean plasma sCD163 and IL-10 levels.

Date of Award	28 Nov 2025
Original language	Spanish
Awarding Institution	Universitat Autònoma de Barcelona (UAB)
Supervisor	Daniel Fuster Marti (Director)