Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Original Article

Volume 11, Number 1, January 2019, pages 26-34


Alcohol Withdrawal: Possible Risk of Latent Scurvy Appearing as Tiredness: A STROBE-Compliant Study

Figures

Figure 1.
Figure 1. Distribution of plasma vitamin C concentration in patients withdrawing from alcohol. Vitamin C measures (µmol/L): severe deficiency < 3 µmol/L; deficiency: 3 - 11.4 µmol/L; depletion: 11.4 - 28.4 µmol/L; normal > 28.4 µmol/L.
Figure 2.
Figure 2. Distribution of plasma vitamin C concentration in patients withdrawing from alcohol by sex. Vitamin C measures (µmol/L): severe deficiency < 3 µmol/L; deficiency: 3 - 11.4 µmol/L; depletion: 11.4 - 28.4 µmol/L; normal > 28.4 µmol/L.
Figure 3.
Figure 3. Correlation between plasma vitamin C concentrations and the role of the sex, age and tobacco consumption. (a) Mann-Whitney rank sum test: role of the sex Spearman’s correlation coefficient test. (b) Role of age. (c) Tobacco consumption.
Figure 4.
Figure 4. Association between tobacco consumption and sex and vitamin C concentrations by multivariable linear regression. Hollow squares: individual observations (males). Solid triangles: individual observations (females). Solid line: quadratic fit of vitamin C levels by tobacco use in males. Dashed line: linear fit of vitamin C levels by tobacco use in females.
Figure 5.
Figure 5. Correlation between plasma vitamin C concentrations and scurvy symptoms by logistic regression analysis: (a) tiredness or weakness; (b) skin symptoms; (c) gum involvement.
Figure 6.
Figure 6. Correlation between plasma vitamin C concentrations and scurvy symptoms patient-individualized: In purple: tiredness or weakness; In red: skin symptoms (especially petechiae or purpura); In green: gum involvement. A transformation was applied to convert the status of tiredness, skin symptoms or gum involvement into binary variables. In regard to the binary variables: 0 corresponds to “absence of tiredness” whereas 1 means “presence of tiredness”. The same applies for the other symptoms such as skin symptoms and gum involvement.
Figure 7.
Figure 7. Study design for endpoint 3: follow-up of latent scurvy symptoms in patients supplemented with vitamin C for 3 months.

Table

Table 1. Clinical, Demographic and Biochemical Parameters of Enrolled Patients
 
MalesFemales
Number3314
Age (years)57.97 ± 1251.73 ± 8
Body mass index (kg/m2)25.7 ± 4.125.2 ± 6.9
AST (IU/L)70 ± 5493 ± 84
Gamma-GT (IU/L)251 ± 262385 ± 393
Corpuscular volume95.4 ± 8.7101.1 ± 8.4
Platelet count (109/L)189,393 ± 91,053224,057 ± 116,071
Prothrombin (%)90 ± 1385 ± 21
Albumin (g/L)40.1 ± 5.339.3 ± 12.2
Hepatic ultrasonography
  Normal12/332/14
  Steatosis15/337/14
  Compensated cirrhosis4/334/14
  Decompensated cirrhosis2/331/14