J Gen Intern Med. 2026 Jan 30. doi: 10.1007/s11606-025-10106-7. Online ahead of print.
ABSTRACT
BACKGROUND: Alcohol use disorder (AUD) is associated with many health consequences, including cardiomyopathy with impaired systolic function, liver disease, and metabolic disturbances.
OBJECTIVE: We aimed to study the main echocardiographic abnormalities in otherwise asymptomatic individuals with AUD admitted for inpatient treatment, and to assess their associations with advanced liver fibrosis and insulin resistance, including their interaction.
DESIGN: A cross-sectional study.
PARTICIPANTS: Individuals with AUD admitted for inpatient treatment between 2019 and 2024 in a university hospital in Spain.
MAIN MEASURES: We ascertained demographic information, alcohol use characteristics, anthropometric measurements, blood test parameters, and echocardiography findings upon admission. We estimated liver fibrosis with the FIB-4 index and insulin resistance with the triglyceride (TG)/HDL ratio. We performed multivariate logistic regression analyses to assess the main associations between cardiac abnormalities, advanced liver fibrosis, and insulin resistance.
RESULTS: We included 145 individuals (28% women), with a median age of 53 years [Interquartile range (IQR) 48-58 years], daily alcohol consumption of 10.3 standard drink units (SDU) [IQR 6.8-16.30 SDU], and body mass index of 25.8 kg/m2 [IQR 22.9-30.0 kg/m2]. Among them, 33% had hypertension and 14% had diabetes. The most common echocardiographic abnormality was diastolic dysfunction, which was present in 96 patients (66%), while systolic impairment was detected only in 7 cases (5%). Advanced liver fibrosis (FIB-4 > 3.25) was more prevalent in those with diastolic dysfunction (p-value = 0.010). In the multivariate logistic regression analysis, advanced liver fibrosis and TG/HDL ratio ≥ 3 were independently associated with diastolic dysfunction, with an OR of 3.53 (95% confidence interval (CI)1.20-10.41) and 4.55 (95% CI 1.57-13.22), respectively. However, no interaction between them was found (p-value for interaction = 0.92).
CONCLUSIONS: Diastolic dysfunction is a common finding in apparently asymptomatic individuals with AUD admitted for inpatient treatment, and it is independently associated with advanced liver fibrosis and insulin resistance.
PMID:41615523 | DOI:10.1007/s11606-025-10106-7