Clinical associations of zonulin plasma levels -marker of intestinal permeability- in patients with alcohol use disorder admitted for inpatient treatment.

Aim

We aimed to analyze the associations between markers of monocyte activation (sCD163 and sCD14), of inflammation (Interleukin 6 [IL-6]) and of microbial translocation (lipopolysaccharide [LPS]) and zonulin (a marker of intestinal permeability) in a series of patients with severe Alcohol Use Disorder (AUD) admitted for hospital treatment.

Methods

Cross sectional study of patients admitted between 2021 and 2024 in two teaching hospitals in Barcelona, Spain. We gathered clinical information and assessed hematological, biochemical parameters and plasma markers on the second day of admission. We performed a multivariable logistic regression analysis adjusted by sex, age and the presence of advanced liver fibrosis (ALF) to detect associations with zonulin levels in the highest quartile.

Results

We enrolled 225 patients with AUD (77% male) with a median age was of 51 years Interquartile range [IQR] 43-56). Median alcohol intake was 185 g/day (IQR 100-250) and median duration of AUD was 20 years (IQR 10-30), and 25.9% had ALF. Median values of plasma markers were: sCD14 2096 ng/ml (IQR: 1714-2615), sCD163 was 618 ng/mL (IQR: 436-945), IL-6 4.43 pg/mL (IQR 2.69-8.76), LPS 24.4 pg/mL (IQR 17.8-37.3) and zonulin 5.0 ng/ml (IQR 3.8-7.5). In the multivariable regression analysis, levels of sCD163 and of LPS in the highest quartile were associated with higher zonulin levels [adjusted Odds Ratio (95% Confidence Interval of 2.66 (1.10-6.44) and 12.2 (5.49-27.12), respectively].

Conclusion

Levels of markers of increased intestinal permeability are associated with markers of monocyte activation and of microbial translocation in severe AUD patients admitted for hospital treatment.