Predictability of Complete Blood Count Parameters for Heavy Drinking according to the Facial Flushing
- Hyun Chul Joung, Hyun Ju Yang, Jong Sung Kim, Sung Soo Kim, Seok Joon Yoon, Jung Wei Chang
- Received December 20, 2015 Accepted June 02, 2016
- ABSTRACT
-
- Background
- Alcohol is personal and social problem around the world. Though binge drinking is associated with the elevation of arbohydrate deficient trasnferrin and r-glutamyl transpeptidase, studies of the relationship between heavy drinking and other biological markers are rare. The purpose of this study is to investigate the association between heavy drinking and CBC figures through flushing and non flushing using both NIAAA and Korean guidelines.
- Methods
- The subjects were 581 Korean adult males: who had undergone a comprehensive medical evaluation at Chungnam National University Hospital between June and December of 2013. 98 of total were non-drinkers, 225 of them flushers, and the rest 258 of them were non-flushers. One standard drink is defined as any drink that contains 14 grams of alcohol. Criteria for immoderate drinking was applied to greater than 14 glasses/week and more than 8 glasses on any day for a non-flush group with reference to the United States' guideline (National Institute in Alcohol Abuse and Alcoholism, NIAAA) and South Korean guideline, and it was also applied to greater than seven glasses/week, and more than four glasses on any day for a flushing group. It was to investigate whether immoderate drinking would be predictable according to increased mean corpuscular volume (MCV), decreased hemoglobin (Hb), and decreased platelet (PLT). Our investigation was to find the correlation with the increased MCV, decreased Hb, and decreased PLT as a means of predictions for immoderate drinking. The study was to examine the CBC's predictability of immoderate drinking through a combination of increased MCV, decreased Hb, or decreased PLT. If one of these three items were abnormal: group A, if two of the three items were abnormal: group B.
- Results
- Predictability of group A was 23.1% in flushing drinkers and 21.7% in non-flushing drinkers for US NIAAA immoderate drinking, whereas 30.8% in flushing drinkers and 30.4% in non-flushing drinkers considering Korean guideline immoderate drinking. Predictability of B group was 100% in flushing and non-flushing drinkers for both NIAAA guidelines and Korean guidelines.
- Conclusions
- It is desirable for physicians to use any combination of the three CBC indicators (increased MCV, decreased Hb, or decreased PLT) for predicting immoderate drinking.
Table 1.
General characteristics of the subjects
| Parameter | Non drinker (n=98) | Flushing group (n=225) | Non flushing group (n=258) |
|---|---|---|---|
| Age, y | 55.71±11.06 | 50.50±9.72a | 47.60±10.04a |
| BMI, kg/m2 | 23.82±3.12 | 24.45±3.05 | 24.58±3.02 |
| Exercise time, min/week | 231.94±310.78 | 206.27±289.64 | 221.63±342.9 |
| Smoking | |||
| Non-smoker | 37 (37.8) | 45 (20.0)a | 56 (21.7)a |
| Ex-smoker | 41 (41.8) | 89 (39.6) | 87 (33.7) |
| Current-smoker | 20 (20.4) | 91 (40.4) | 115 (44.6) |
| Alcohol | |||
| Alcohol consumption, drinks/times | 0.00±0.00 | 4.18±5.91a | 5.14±7.99a |
| Alcohol frequency, times/week | 0.00±0.00 | 2.05±1.70a | 2.44±1.64a |
| Alcohol consumption, drinks/week | 0.00±0.00 | 8.56±10.05a | 12.55±13.10a |
| WBC, ×103/uL | 6.12±1.92 | 6.16±1.83 | 6.24±1.80 |
| Hb, g/dL | 14.99±1.18 | 15.20±1.07 | 15.24±1.03 |
| PLT, ×103/uL | 247.74±55.07 | 235.13±53.79 | 231.06±52.33a |
| ESR, mm/h | 12.63±9.81 | 10.60±9.74 | 10.62±10.57 |
| MCHC, g/dL | 34.14±1.07 | 34.15±0.86 | 34.36±0.86 |
| MCV, fL | 90.19±4.46 | 91.47±4.11a | 91.37±4.29a |
| Hct, % | 43.91±3.31 | 44.50±3.06 | 44.35±2.83 |
| RBC, ×103/uL | 4.87±0.39 | 4.87±0.37 | 4.86±0.36 |
Table 2.
Distributions of increased MCV, decreased Hb, and decreased PLT according to alcohol consumption state considering NIAAA guideline and Korean guideline
| Parameter | Non D (n=98) | NIAAA Guideline | Korean Guideline | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Flusher | Non flusher | Flusher | Non flusher | ||||||
| (n=225) | (n=258) | (n=225) | (n=258) | ||||||
| Moderatea | Heavyb | Moderatea | Heavyb | Moderatea | Heavyb | Moderatea | Heavyb | ||
| (n=137) | (n=88) | (n=172) | (n=86) | (n=114) | (n=111) | (n=127) | (n=131) | ||
| MCV, fL >100 | 0 (0.0) | 3 (2.2) | 3 (3.4) | 2 (1.2) | 6 (7.0)d | 2 (1.8) | 4 (3.6) | 0 (0) | 8 (6.1)c |
| Hb, g/dL <13.5 | 9 (9.2) | 5 (3.6) | 5 (5.7) | 4 (2.3)c | 3 (3.5) | 4 (3.5) | 6 (5.4) | 4 (3.1) | 3 (2.3)c |
| PLT, 1×103/uL <1.3×105 | 1 (1.0) | 2 (1.5) | 2 (2.3) | 2 (1.2) | 4 (4.7) | 2 (1.8) | 2 (1.8) | 2 (1.6) | 4 (3.1) |
Abbreviations: MCV, mean corpuscular volume; Hb, hemoglobin; PLT, platelet; NIAAA, National Institute on Alcohol Abuse and Alcoholism; Non D, non drinker. Values are presented as n (%).
aModerate drinkers: ≤7 units/week in flushers and ≤14 units/wk in non flusher considering NIAAA Guideline. ≤4 units/week in flushers and ≤8 units/wk in non flusher considering Korean Guideline.
Table 3.
Odds ratio of increased MCV, decreased Hb, and decreased PLT according to alcohol consumption considering NIAAA guideline and Korean guideline
| Drinking status by NIAAA guideline | Risk of abnormalities OR (95% CI) | Drinking status by Korean guideline | Risk of abnormalities OR (95% CI) | |
|---|---|---|---|---|
| Flusher | ||||
| MCV, fL >100 | Non drinker | 1 (reference) | Non drinker | 1 (reference) |
| (n=98) | (n=98) | |||
| Moderate drinkera | NA | Moderate drinkera | NA | |
| (n=137) b | (n=114) b | |||
| Heavy drinkerb | NA | Heavy drinkerb | NA | |
| (n=88) | (n=111) | |||
| Hb, g/dL <13.5 | Non drinker | 1 (reference) | Non drinker | 1 (reference) |
| (n=98) | (n=98) | |||
| Moderate drinkera | 0.42 (0.12–1.45) | Moderate drinkera | 0.35 (0.09–1.40) | |
| (n=137) | (n=114) | |||
| Heavy drinkerb | 1.10 (0.31–3.86) | Heavy drinkerb | 1.00 (0.31–3.05) | |
| (n=88) | (n=111) | |||
| PLT, /uL <1.30×105 | Non drinker | 1 (reference) | Non drinker | 1 (reference) |
| (n=98) | (n=98) | |||
| Moderate drinkera | 3.47 (0.25–47.86) | Moderate drinkera | 3.73 (0.27–51.54) | |
| (n=137) | (n=114) | |||
| Heavy drinkerb | 2.24 (0.12–41.68) | Heavy drinkerb | 1.90 (0.10–35.61) | |
| (n=88) | (n=111) | |||
| Non flusher | ||||
| MCV, fL >100 | Non drinker | 1 (reference) | Non drinker | 1 (reference) |
| (n=98) | (n=98) | |||
| Moderate drinkera | NA | Moderate drinkera | NA | |
| (n=172) b | (n=127) b | |||
| Heavy drinkerb | NA | Heavy drinkerb | NA | |
| (n=86) | (n=131) | |||
| Hb, g/dL <13.5 | Non drinker | 1 (reference) | Non drinker | 1 (reference) |
| (n=98) | (n=98) | |||
| Moderate drinkera | 0.44 (0.12–1.66) | Moderate drinkera | 0.63 (0.16–2.48) | |
| (n=172) | (n=127) | |||
| Heavy drinkerb | 0.39 (0.06–2.37) | Heavy drinkerb | 0.23 (0.04–1.31) | |
| (n=86) | (n=131) | |||
| PLT, /uL <1.30×105 | Non drinker | 1 (reference) | Non drinker | 1 (reference) |
| (n=98) a | (n=98) a | |||
| Moderate drinkera | 1.94 (0.13–28.95) | Moderate drinkera | 3.17 (0.18–55.35) | |
| (n=172) b | c | (n=127) b | ||
| Heavy drinkerb | 11.63 (1.03–130.89)c | Heavy drinkerb | 6.07 (0.57–65.13) | |
| (n=86) | (n=131) |
Abbreviations: MCV, mean corpuscular volume; Hb, hemoglobin; PLT, platelet; NIAAA, National Institute on Alcohol Abuse and Alcoholism; OR, odd ratio; CI, confidence interval; NA, not available.
aModerate drinkers: ≤7 units/week in flushers and ≤14 units/wk in non flusher considering NIAAA Guideline. ≤4 units/week in flushers and ≤8 units/wk in non flusher considering Korean guideline. 1 units=14 g of alcohol.
Table 5.
Predictability of CBC abnormality scores for heavy drinking considering NIAAA guideline and Korean guideline
| Heavy drinkerc | ||||
|---|---|---|---|---|
| NIAAA guideline | Korean guideline | |||
| Flusher | Non flusher | Flusher | Non flusher | |
| Aa (n=39) | ||||
| Non drinker (n=10) | 6/26 (23.1%) | 5/23 (21.7%) | 8/26 (30.8%) | 7/23 (30.4%) |
| Flushing (n=16) | ||||
| Non flushing (n=13) | ||||
| Bb (n=6) | ||||
| Non drinker (n=0) | 2/2 (100%) | 4/4 (100%) | 2/2 (100%) | 4/4 (100%) |
| Flushing (n=2) | ||||
| Non flushing (n=4) | ||||
Abbreviations: CBC, complete blood cell count; NIAAA, National Institute on Alcohol Abuse and Alcoholism; MCV, mean corpuscular volume; Hb, hemoglobin; PLT, platelet.
aA group applicable for one of the three biochemical indicators (increased MCV, decreased Hb, and decreased PLT).
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