Cultura Maya

Strana 874 VOJNOSANITETSKI PREGLED Vojnosanit Pregl 2012; 69(10): 874–879.
Correspondence to: Jelenka Nikoli, Faculty of Medicine, University of Niš, Bulevar dr Zorana Djindjia 81, 18 000 Niš, Serbia. Phone.:
+381 64 26 705 56. E-mail: jelenka.nikolic@gmail.com
C U R R E N T T O P I C S UDC: 616.89-008.441.3-06::616.36-02-07
DOI: 10.2298/VSP110405015N
Contemporary aspects of the diagnosticsof alcoholic liver disease
Savremeni aspekti dijagnostikovanja alkoholnog ošteenja jetre
Jelenka Nikoli*, Vanja Nikovi*, Danilo Aimovi†
*Faculty of Medicine, University of Niš, Niš, Serbia; †Department of Biochemical and
Medicinal Sciences, University of Novi Pazar, Novi Pazar, Serbia
Key words:
liver diseases, alcoholic; diagnosis; biological markers;
ethanol; alcohol drinking; alcoholism.Kljune rei:
jetra, bolesti izazvane alkoholom; dijagnoza; biološki
markeri; alkohol, etil; alkohol, pijenje; alkoholizam.
Introduction
Consumption of ethyl alcohol dates back for over fifty
thousand years. Alcohol has become an important sociomedical
problem lately due to its massive consumption in the
world.
In the order of causes of death alcoholism is in the third
place, right aftercardiovascular and oncological diseases.
According to the epidemiological data, the number of alcoholics
is about 5% of people in general population, or 10% of
adult males 1. The highest number of alcoholics is in the
most productive life period of thirty to fifty years.
Besides the social importance is even greater medical
significance of this phenomenon, because it shows a high
rate ofmorbidity. Alcohol through its toxic product, acetaldehyde,
induces liver damage that can occur in the form of
alcoholic fatty infiltration and alcoholic hepatitis, the
changes which are reversible upon termination of alcohol
intake, and alcoholic cirrhosis, which presents irreversible
liver damage 2. Cirrhosis of the liver progresses to complications
related to central nervous system (thedevelopment of
hepatic encephalopathy), kidney (the development of hepatorenal
syndrome), deposition of iron in the liver (hemochromatosis
development), deposition of copper in the organs
(the development of Wilson,s disease), disorder at the level
of hormones, and disturbances at the level of the lung (development
of hepatopulmonary syndrome and portopulmonary
hypertension). The effects ofalcohol on the degree of
liver injury depend on the dose, sex and age, as well on the
concentration of alcohol and the length of its usage 3–6.
It is believed that for the toxic effect of alcohol is not
important the origin of the drinks, but the concentration of
alcohol in it. Permissible weekly dose of alcohol for women
is 14 units, while for men is 21 units. The permissible level
ofalcohol is lower for women because they have lower activity
of gastric alcohol dehydrogenase enzyme. It is believed
that higher intake of alcohol than allowed, in a time period
longer than 5 years, definitely causes damage to various organs.
Lower doses of alcohol have a stimulatory effect on the
central nervous system, while higher concentrations cause a
dose-dependent depression of the centralnervous system.
Chronic alcohol intake induces tolerance to toxic effects of
alcohol and thus leads to adaptation of the central nervous
system to ethanol, and consequently to the development of
hepatic tolerance 7.
Diagnostic markers of alcoholic liver injury
Markers of alcoholic liver injury are diagnosed on the
basis of a confirmed information about the consumption of
alcohol, as well ason liver function tests and liver biopsy.
The hypothesis is that alcohol causes liver damage in patients
with chronic and excessive alcohol quantity entries,
more than 60 g per day for men, and 40 g per day for women.
The diagnosis can be confirmed by analysis of general
markers: prothrombin time, serum bilirubin, alanine aminotransferase
(ALT), aspartate aminotransferase (AST), alkaline...