title: Relationship between liver function and brain shrinkage in patients with alcohol dependence.
abstract: BACKGROUND
  Oxidative stress has been proposed as one of the mechanisms of alcohol-induced brain shrinkage and alcohol-induced hepatotoxicity. The aim of this study was to assess the correlations between liver function and brain volume (BV) measurements in patients with alcohol dependence.
  
  
  METHODS
  We recruited 124 patients with alcohol dependence and 111 healthy control subjects from National Institute of Health, National Institute on Alcohol Abuse and Alcoholism inpatient alcohol treatment program. Gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), as well as hematocrit (Hct) and albumin were assayed shortly after admission. Magnetic resonance imaging examination was conducted in both groups (after 3-week abstinence in the patient group). We used stepwise linear regression analyses to determine the variables most strongly correlated with brain shrinkage.
  
  
  RESULTS
  Patients with alcohol dependence had lower BV, and greater brain shrinkage as measured by gray matter ratio (GMR), white matter ratio (WMR), brain ratio (BR), and higher cerebrospinal fluid ratio ratio (CSFR) compared with their healthy counterparts. Age and sex were significantly correlated with some BV measurements in both patient and control groups. Body mass index (BMI) was significantly correlated with CSFR, BR, GMR, and WMR; Hct with CSFR and BR; serum GGT level with BV, CSFR, BR, GMR, and WMF in the patient group. No biological variables were correlated with BV indices in the control group. In gender-stratified analysis, age was significantly correlated with brain shrinkage in male patients but not in female patients. Serum GGT level in male and female patients, Hct in male patients, and AST levels in female patients were significantly correlated with brain shrinkage.
  
  
  CONCLUSIONS
  Our results showed that the higher levels of liver function indices, especially GGT, correlated with BV shrinkage as measured using CSFR, BR, GMR, and WMR in patients with alcohol dependence but not in controls. Serum GGT level outweighed aging effect on brain shrinkage in female patients.
authors: Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA.
authors: Chun-Hsin
authors: CH
authors: Chen
authors: Jonathan
authors: J
authors: Walker
authors: Reza
authors: R
authors: Momenan
authors: Robert
authors: R
authors: Rawlings
authors: Markus
authors: M
authors: Heilig
authors: Daniel W
authors: DW
authors: Hommer
mesh_terms: D017668:Age of Onset; D000368:Aged; D000375:Aging / Q000502:physiology; D000437:Alcoholism / Q000134:cerebrospinal fluid / Q000473:pathology* / Q000503:physiopathology*; D015992:Body Mass Index; D001921:Brain / Q000473:pathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008099:Liver / Q000503:physiopathology*; D008111:Liver Function Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors