RELATIONSHIP BETWEEN ETHANOL-RELATED DISEASES AND NUTRITIONAL-STATUS IN CHRONICALLY ALCOHOLIC MEN

Two-hundred and fifty chronically alcoholic men (mean age, 41 +/- 11 y ears) entering an alcoholism treatment program were studied. Detailed clinical history, nutritional assessment and measurement of muscle str ength by electronic myometer were performed in each case. In addition, hepatic ultrasonography and liver biopsy, echocardiography and radion uclide cardiac scanning, and electrophysiological testing of periphera l nerves were performed when there was clinical evidence of liver dise ase, cardiomyopathy or neuropathy, respectively. Alcoholic cirrhosis w as diagnosed in 20 cases, skeletal myopathy in 117, dilated cardiomyop athy in 20 and peripheral neuropathy in 41 cases. No patients with chr onic myopathy or cardiomyopathy showed either clinical or laboratory e vidence of malnutrition. Patients with cirrhosis showed a significantl y lower lean body mass than controls (P = 0.03) and significantly lowe r nutritional protein levels than those alcoholics without cirrhosis. Alcoholics with peripheral neuropathy had significantly lower anthropo metric parameters and nutrition protein levels than their counterparts (P < 0.001). However, in the multivariate analysis, the only independ ent factor for developing these complications of alcoholism was the to tal lifetime dose of ethanol (P < 0.001). We conclude that alcohol-rel ated diseases are common in asymptomatic alcoholic men and these disea ses appear to be due to an accumulative toxic effect of ethanol. Age a nd nutritional status do not seem to play a part in the development of such diseases.