Validation of Alcohol Flushing Questionnaires in Determining Inactive Aldehyde Dehydrogenase-2 and Its Clinical Implication in Alcohol-Related Diseases
Cheol Min Shin
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
Search for more papers by this authorCorresponding Author
Nayoung Kim
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
Reprint requests: Nayoung Kim, MD, PhD, Department of Internal Medicine, Seoul National University Bundang Hospital, 173-82, Gumi-ro, Bundang-gu, Seongnam, Gyeonggi-do 463-707, Korea; Tel.: + 82-31-787-7008; Fax: + 82-31-787-4051; E-mail: [email protected]
and
Sung-Il Cho, MD, ScD, Professor of Epidemiology, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea; Tel.: +82-2-880-2717 (O), 82-10-3477-8868 (M); Fax: +1-82-2-743-8240; E-mails: [email protected], [email protected]
Search for more papers by this authorCorresponding Author
Sung-Il Cho
School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea
Reprint requests: Nayoung Kim, MD, PhD, Department of Internal Medicine, Seoul National University Bundang Hospital, 173-82, Gumi-ro, Bundang-gu, Seongnam, Gyeonggi-do 463-707, Korea; Tel.: + 82-31-787-7008; Fax: + 82-31-787-4051; E-mail: [email protected]
and
Sung-Il Cho, MD, ScD, Professor of Epidemiology, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea; Tel.: +82-2-880-2717 (O), 82-10-3477-8868 (M); Fax: +1-82-2-743-8240; E-mails: [email protected], [email protected]
Search for more papers by this authorJoohon Sung
School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea
Search for more papers by this authorHee-Jung Lee
Incheon Research Institute of Public Health and Environment , Incheon, Korea
Search for more papers by this authorCheol Min Shin
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
Search for more papers by this authorCorresponding Author
Nayoung Kim
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
Reprint requests: Nayoung Kim, MD, PhD, Department of Internal Medicine, Seoul National University Bundang Hospital, 173-82, Gumi-ro, Bundang-gu, Seongnam, Gyeonggi-do 463-707, Korea; Tel.: + 82-31-787-7008; Fax: + 82-31-787-4051; E-mail: [email protected]
and
Sung-Il Cho, MD, ScD, Professor of Epidemiology, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea; Tel.: +82-2-880-2717 (O), 82-10-3477-8868 (M); Fax: +1-82-2-743-8240; E-mails: [email protected], [email protected]
Search for more papers by this authorCorresponding Author
Sung-Il Cho
School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea
Reprint requests: Nayoung Kim, MD, PhD, Department of Internal Medicine, Seoul National University Bundang Hospital, 173-82, Gumi-ro, Bundang-gu, Seongnam, Gyeonggi-do 463-707, Korea; Tel.: + 82-31-787-7008; Fax: + 82-31-787-4051; E-mail: [email protected]
and
Sung-Il Cho, MD, ScD, Professor of Epidemiology, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea; Tel.: +82-2-880-2717 (O), 82-10-3477-8868 (M); Fax: +1-82-2-743-8240; E-mails: [email protected], [email protected]
Search for more papers by this authorJoohon Sung
School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea
Search for more papers by this authorHee-Jung Lee
Incheon Research Institute of Public Health and Environment , Incheon, Korea
Search for more papers by this authorAbstract
Background
Our aim was to validate alcohol flushing questionnaires in detecting inactive ALDH2 (ALDH2*1/*2 or ALDH2*2/*2).
Methods
Two study sets were established; in study set 1, 210 healthy male subjects (age 22 to 59 years) were enrolled; in study set 2, 756 subjects were enrolled who received esophagogastroduodenoscopy to evaluate their dyspeptic symptoms or as part of a gastric cancer screening program. Subjects in study sets 1 and 2 completed the modified alcohol flushing questionnaires of Yokoyama and colleagues (1997, 2003). Polymerase chain reaction–restriction fragment length polymorphism method was used to determine ALDH2 genotype.
Results
In study set 1, 29.0% (61 of 210) had inactive ALDH2. The sensitivity and specificity of the modified alcohol flushing questionnaire for detecting inactive ALDH2 were 95.1 and 76.5%, respectively. Drinking problems negatively correlated with positive alcohol flushing response and inactive ALDH2 (all p-values < 0.05). In study set 2, the sensitivity and specificity of the alcohol flushing questionnaire for detecting inactive ALDH2 were 78.9 and 82.1%, respectively. Interestingly, drinking ≥7 units/wk in men or ≥3.5 units/wk in women significantly increased the risk of benign gastric ulcer (BGU) among positive alcohol flushers (odds ratio, 8.97; 95% confidence interval, 1.38 to 58.30), but not among negative alcohol flushers.
Conclusions
Simple flushing questionnaires may be administered to the Korean population as a screening tool in detecting individuals who carry inactive ALDH2. Alcohol flushing response negatively correlates with drinking problems and can modify the risk for BGU by alcohol intake.
Graphical Abstract
Amount of alcohol intake with regard to ALDH2 genotype (A) and the alcohol flushing response (B): All subjects with ALDH2*2/*2 were light drinkers with an average alcohol intake <4 units per week, but heterozygotes (ALDH2*1/*2) had a wider range of alcohol intake from 0 to 64 units per week (A). In addition, alcohol flushing evaluated by flushing questionnaire negatively correlated with alcohol intake (B). Data were presented as mean and standard deviation. One unit equals 14 g of ethanol.
Conflict of Interest
No author has any conflict of interest or financial arrangement that could potentially influence the presented research.
Supporting Information
| Filename | Description |
|---|---|
| acer13569-sup-0001-FigS1.pdfPDF document, 131.6 KB | Fig. S1. Amount of alcohol intake with regard to ALDH2 genotype (A) and the alcohol flushing response (B) in study set 2. |
| acer13569-sup-0002-TableS1-S6.docxWord document, 41.2 KB |
Table S1. Frequency of alcohol flushing in the subjects by the ALDH2 genotype in study set 1 (n = 210). Table S2. Baseline characteristics of subjects in study set 2 (n = 756) according to ALDH2 genotypes. Table S3. Baseline characteristics of subjects in study set 2 (n = 756) according to the alcohol flushing response. Table S4. Response frequency of the alcohol flushing questionnaire in study set 1 (n = 210). Table S5. Response frequency of the alcohol flushing questionnaire in study set 2 (n = 756). Table S6. Frequency of smoking and drinking statuses with regard to ALDH2 genotype or alcohol flushing response by gender in study set 2. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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