Influence of nutritional status on alcoholic myopathy.
BACKGROUND
Muscle weakness and structural changes in striated skeletal muscle are common in persons with chronic alcoholism.


OBJECTIVE
The objective of the study was to assess the role of malnutrition in the development of chronic alcoholic myopathy.


METHODS
We prospectively evaluated 146 men who reported an intake >/=100 g ethanol/d for the previous 5 y and 73 well-nourished control subjects. Alcohol consumption, energy and protein nutritional status, and deltoid muscle strength were determined. Deltoid muscle tissue specimens were taken from alcoholics and from 14 control subjects for histochemical studies and morphometric measurements of the fibers.


RESULTS
Deltoid muscle strength was less in alcoholics than in control subjects (P < 0.001). Muscle strength correlated with lifetime consumption of ethanol (r = -0.56, P < 0.001), and a decrease in muscle strength was significantly greater in the presence of energy malnutrition. Using logistic regression analysis, we observed that alcoholics with muscle strength < 18 kg had the independent risk factors of an arm muscle area < 50 cm(2) (odds ratio: 5.4; 95% CI: 2.3, 12.3), consumption of > 1600 kg ethanol throughout their lives (odds ratio: 4.5; 95% CI: 2.0, 10.1), and protein malnutrition (odds ratio: 4.2; 95% CI: 1.4, 12.7). Protein malnutrition was also associated with muscle inefficiency (P < 0.001). Histologic myopathy was present in 58% of alcoholics, was related to lifetime ethanol consumption (P = 0.001), and was more severe in the presence of protein malnutrition (P = 0.01).


CONCLUSIONS
Malnutrition is an additional developmental factor in the functional and structural muscle damage induced by chronic ethanol consumption.
Nicolás
José M
JM
Department of Internal Medicine, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Spain. nicolas@medicina.ub.es
García
Gloria
G
Fatjó
Francesc
F
Sacanella
Emilio
E
Tobías
Ester
E
Badía
Eva
E
Estruch
Ramón
R
Fernández-Solà
Joaquim
J
D000328:Adult; D000428:Alcohol Drinking; D019973:Alcohol-Related Disorders / Q000209:etiology / Q000473:pathology*; D016022:Case-Control Studies; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D009135:Muscular Diseases / Q000139:chemically induced* / Q000473:pathology; D009748:Nutrition Disorders / Q000150:complications; D009752:Nutritional Status
D000431:Ethanol