Erythrocyte Turnover: Unaddressed Confounder of PEth Prognosis in Alcohol-Related Liver Disease
We read with great interest the article by Torp et al,1 which demonstrated that phosphatidylethanol (PEth) independently predicts hepatic decompensation in individuals at risk of alcohol-related liver disease and provides additional short-term prognostic value when combined with noninvasive tests (NITs) of liver fibrosis. One observation, however, merits further consideration. The discriminative accuracy of baseline PEth decreased markedly over time, with the area under the curve falling from 0.77 at 6 months to 0.62 at 2 years, whereas fibrosis-based NITs retained stable performance (area under the curve of ∼0.90) throughout follow-up.
