title: Alcoholic Ketosis: Prevalence, Determinants, and Ketohepatitis in Japanese Alcoholic Men.
abstract: OBJECTIVE
  Alcoholic ketosis and ketoacidosis are metabolic abnormalities often diagnosed in alcoholics in emergency departments. We attempted to identify determinants or factors associated with alcoholic ketosis.
  
  
  METHODS
  The subjects of this cross-sectional survey were 1588 Japanese alcoholic men (≥40 years) who came to an addiction center within 14 days of their last drink.
  
  
  RESULTS
  The results of the dipstick urinalyses revealed a prevalence of ketosis of 34.0% (±, 21.5%; +, 8.9%; and 2+/3+; 3.6%) in the alcoholics. Higher urine ketone levels were associated with higher serum total bilirubin, aspartate transaminase (AST), alanine transaminase and gamma-glutamyl transpeptidase levels. A multivariate analysis by the proportional odds model showed that the odds ratio (95% confidence interval) for an increase in ketosis by one category was 0.94 (0.84-1.06) per 10-year increase in age, 0.93 (0.89-0.97) per 1-day increase in interval since the last drink, 1.78 (1.41-2.26) in the presence of slow-metabolizing alcohol dehydrogenase-1B (ADH1B*1/*1), 1.61 (1.10-2.36) and 1.30 (1.03-1.65) when the beverage of choice was whiskey and shochu, respectively (distilled no-carbohydrate beverages vs. the other beverages), 2.05 (1.27-3.32) in the presence of hypoglycemia <80 mg/dl, 0.91 (0.88-0.94) per 1-kg/m(2) increase in body mass index (BMI), 1.09 (1.00-1.18) per +10 cigarettes smoked, and 2.78 (2.05-3.75) when the serum total bilirubin level was ≥2.0 mg/dl, and 1.97 (1.47-2.66) when the serum AST level was ≥200 IU/l.
  
  
  CONCLUSIONS
  Ketosis was a very common complication and frequently accompanied by alcoholic liver injury in our Japanese male alcoholic population, in which ADH1B*1/*1 genotype, consumption of whiskey or shochu, hypoglycemia, lower BMI and smoking were significant determinants of the development of ketosis.
authors.affiliation: National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan a_yokoyama@kurihama1.hosp.go.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Yokoyama
authors.affiliation: Department of Health Promotion, National Institute of Public Health, Saitama 351-0104, Japan.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mizukami
authors.affiliation: National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan Department of Geriatric Medicine, Kyorin University Hospital, Tokyo 181-8611, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Matsui
authors.affiliation: Department of Gastroenterology, Tokai University School of Medicine, Kanagawa 259-1193, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Shiraishi
authors.affiliation: National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Kimura
authors.affiliation: National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan.
authors.forename: Sachio
authors.initials: S
authors.lastname: Matsushita
authors.affiliation: National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Higuchi
authors.affiliation: National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Maruyama
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D003430:Cross-Sectional Studies; D006519:Hepatitis, Alcoholic / Q000453:epidemiology* / Q000378:metabolism; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007657:Ketone Bodies / Q000652:urine; D007662:Ketosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D007657:Ketone Bodies; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin