Does advice based on biomarkers of liver injury or non-invasive tests of liver fibrosis impact high-risk drinking behaviour: A systematic review with meta-analysis

Subhani, Mohsan; Knight, Holly; Ryder, Stephen; Morling, Joanne R.

Abstract

Background: Alcohol dependence affects over 240 million people worldwide and attributed to 3 million deaths annually. Early identification and intervention are key to prevent harm. We aim to systematically review literature on the effectiveness of adding advice based on biomarkers of liver injury or non-invasive tests of liver fibrosis (intervention-based advice ) to prevent alcohol misuse.

Methods: Electronic search was conducted on Ovid Medline, PubMed, EMBASE, Psychinfo and CINAHL for articles published up to end of February 2020. Additionally, we searched study citations, Scopus, Ethos and Clinical trials. The primary outcome measure was changed in self-reported alcohol consumption analysed by random-effects meta-analysis. Secondary outcomes included change to liver blood markers and alcohol-related health outcomes.

Results: 14 RCT and 2 observational studies comprising n=3763 participants were included. Meta-analyses showed a greater reduction in alcohol consumption and liver biomarkers for the intervention compared to control group: mean difference for weekly alcohol intake was -74.4 gram/week (95%CI -126.1, -22.6, p=0.005); and mean difference for GGT -19.7 IU/L (95% CI -33.1, -6.4, p=0.004). There was a higher incidence of alcohol attributed mortality, number of days spent in the hospital, physician visits and sickness absence in the non-intervention group. The quality of the included studies was moderate for RCT’s and high for observational studies.

Conclusions: The review confirmed a significant association between the addition of intervention-based advice in routine care to the reduction of harmful alcohol consumption, GGT and alcohol-related mortality. The findings support the inclusion of this type of advice in routine alcohol care.

Citation

Subhani, M., Knight, H., Ryder, S., & Morling, J. R. (2021). Does advice based on biomarkers of liver injury or non-invasive tests of liver fibrosis impact high-risk drinking behaviour: A systematic review with meta-analysis. Alcohol and Alcoholism, 56(2), 185–200. https://doi.org/10.1093/alcalc/agaa143

• Journal Article Type: Article
• Acceptance Date: Dec 15, 2020
• Online Publication Date: Jan 22, 2021
• Publication Date: 2021-03
• Deposit Date: Dec 15, 2020
• Publicly Available Date: Jan 23, 2022
• Journal: Alcohol and Alcoholism
• Print ISSN: 0735-0414
• Electronic ISSN: 1464-3502
• Publisher: Oxford University Press (OUP)
• Peer Reviewed: Peer Reviewed
• Volume: 56
• Issue: 2
• Pages: 185–200
• DOI: https://doi.org/10.1093/alcalc/agaa143
• Keywords: alcohol abuse, ethanol, liver injuries, hepatic fibrosis, alcohol drinking, biological markers, drinking behavior, gamma-glutamyl transferase, liver, mortality, illness, early diagnosis, self-report
• Public URL: https://nottingham-repository.worktribe.com/output/5151706
• Publisher URL: https://academic.oup.com/alcalc/article-abstract/56/2/185/6105939?redirectedFrom=fulltext
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Alcohol and Alcoholism following peer review. The version of record Mohsan Subhani, Holly Knight, Stephen Ryder, Joanne R Morling, Does Advice Based on Biomarkers of Liver Injury or Non-Invasive Tests of Liver Fibrosis Impact High-Risk Drinking Behaviour: A Systematic Review With Meta-analysis, Alcohol and Alcoholism, 2021;, agaa143, https://doi.org/10.1093/alcalc/agaa143 is available online at: https://academic.oup.com/alcalc/advance-article/doi/10.1093/alcalc/agaa143/6105939