Keywords
artisanal alcohol
liver enzymes
Likasi
Democratic Republic of the Congo
How to Cite
Abstract
Introduction
Alcohol consumption is a major global public health concern due to its broad impact on individual and community health. In Likasi, Democratic Republic of the Congo, artisanal alcoholic beverages—such as lutuku, cinq cent, and homemade wine—exhibit variable ethanol concentrations due to non-standardized production processes. Repeated consumption among adolescents promotes oxidative stress and hepatocellular injury, leading to altered serum liver enzyme activities.
Purpose
To evaluate serum liver enzyme profiles (AST, ALT, GGT, ALP) in adolescents consuming artisanal alcohol in Likasi, Democratic Republic of Congo, and identify early hepatic biochemical alterations and associated risk factors.
Methods
A descriptive cross-sectional study with an analytical component was conducted among 116 adolescents (aged 15–19 years) in Likasi who consumed locally produced alcohol. The sample comprised 111 males (95.7%) and 5 females (4.3%). Serum activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP) were measured via spectrophotometry using a semi-automated biochemical analyzer (serial no. BS8N324E). Quantitative variables were evaluated for normality using the Shapiro-Wilk test (p < 0.05). Non-parametric comparisons were performed using the Mann-Whitney U test and Kruskal-Wallis test, and bivariate associations were evaluated using Spearman's rank correlation coefficient (ρ).
Results
Participants were predominantly male (95.7%), with a mean age of 17.82 ± 1.28 years; the largest age subgroup was 19 years (41.4%). The most frequently consumed artisanal alcoholic beverages were cinq cent (76.7%) and lutuku (65.5%). Mean serum liver enzyme activities were 84.67 ± 80.75 IU/L for AST, 69.17 ± 71.77 IU/L for ALT, 158.09 ± 95.08 IU/L for GGT, and 161.53 ± 85.87 IU/L for ALP. No statistically significant correlation was observed between the self-reported volume or frequency of alcohol consumption and serum liver enzyme levels. Significant positive correlations were observed between AST and GGT (ρ = 0.332, p < 0.01) and between ALT and ALP (ρ = 0.771, p < 0.01). Smoking status was significantly associated with elevated GGT rank scores (p = 0.032).
Conclusion
Serum elevations in AST, ALT, GGT, and ALP among adolescent consumers of artisanal alcohol indicate underlying hepatic biochemical alterations. Given the absence of a unexposed control group, controlled longitudinal studies incorporating specific bio-markers of alcohol exposure are recommended to establish causality.
References
Aiken, A., Chan, G., Yuen, W. S., Clare, P. J., Hutchinson, D., McBride, N., Najman, J. M., McCambridge, J., Upton, E., Slade, T., Boland, V. C., De Torres, C., Bruno, R., Kypri, K., Wadolowski, M., Mattick, R. P., & Peacock, A. (2022). Trajectories of parental and peer supply of alcohol in adolescence and associations with later alcohol consumption and harms: A prospective cohort study. Drug and Alcohol Dependence, 237, 109533. https://doi.org/10.1016/j.drugalcdep.2022.109533
Andersson, J., Berglund, K., Irmel, R., & Adermark, L. (2024). Prospective association between tobacco use and at-risk alcohol consumption among Swedish adolescents: Outlining the influence of tobacco product, frequency of use and gender in the LoRDIA cohort. Tobacco Use Insights, 17, 1179173X241298524. https://doi.org/10.1177/1179173X241298524
Axley, P. D., Richardson, C. T., & Singal, A. K. (2019). Epidemiology of alcohol consumption and societal burden of alcoholism and alcoholic liver disease. Clinics in Liver Disease, 23(1), 39–50. https://doi.org/10.1016/j.cld.2018.09.011
Bijani, M., Dehghan, A., Razavi, S., & Karimi, S. (2022). Examining the association between opium use, cigarette smoking and alcohol consumption with the liver enzyme levels in a population-based study: Fasa PERSIAN cohort data. BMC Research Notes, 15(1), 2. https://doi.org/10.1186/s13104-021-05891-3
Bijnens, E. M., Zeegers, M. P., & Derom, C. (2021). Biomarkers of alcohol consumption in population studies: A systematic review. Alcohol and Alcoholism, 56(4), 412–425. https://doi.org/10.1093/alcalc/agaa120
Binder, C., Knibbe, K., Kreissl, A., Repa, A., Thanhaeuser, M., Greber-Platzer, S., Berger, A., Jilma, B., & Haiden, N. (2016). Does acute alcohol intoxication cause transaminase elevations in children and adolescents? Alcohol, 51, 57–62. https://doi.org/10.1016/j.alcohol.2015.12.001
Bryman, A. (2016). Social research methods (5th ed.). Oxford University Press.
Carsi Kuhangana, T., Muta Musambo, T., Pyana Kitenge, J., Kayembe-Kitenge, T., Kazadi Ngoy, A., Musa Obadia, P., Banza Lubaba Nkulu, C., Kamugisha, A., Deconinck, E., Nemery, B., & Van Loco, J. (2021). Energy drink consumption among adolescents attending schools in Lubumbashi, Democratic Republic of Congo. International Journal of Environmental Research and Public Health, 18(14), 7617. https://doi.org/10.3390/ijerph18147617
Chapman, O., Djerboua, M., Rai, M., Bechara, R., & Flemming, J. A. (2025). Alcohol-associated pancreatitis and liver disease among adolescents and young adults. JAMA Network Open, 8(2), e2461990. https://doi.org/10.1001/jamanetworkopen.2024.61990
Choudhury, G., & Sanyal, A. J. (2020). Cellular mechanisms of liver injury in alcoholic liver disease. Clinical Liver Disease, 15(3), 95–100. https://doi.org/10.1007/s40139-020-00211-z
Corbière, M., & Larivière, N. (2020). Méthodes qualitatives, quantitatives et mixtes: Dans la recherche en sciences humaines, sociales et de la santé (2nd ed.). Presses de l'Université du Québec. https://doi.org/10.2307/j.ctv1c29qz7
Cosma, A., Elgar, F. J., De Looze, M., Canale, N., Lenzi, M., Inchley, J., & Vieno, A. (2022). Structural gender inequality and gender differences in adolescent substance use: A multilevel study from 45 countries. SSM - Population Health, 19, 101208. https://doi.org/10.1016/j.ssmph.2022.101208
Danpanichkul, P., Chen, V. L., Tothanarungroj, P., Kaewdech, A., Kanjanakot, Y., Fangsaard, P., Wattanachayakul, P., Duangsonk, K., Kongarin, S., Yang, J. D., Wong, R. J., Noureddin, M., Díaz, L. A., Arab, J. P., Liangpunsakul, S., & Wijarnpreecha, K. (2024). Global epidemiology of alcohol-associated liver disease in adolescents and young adults. Alimentary Pharmacology & Therapeutics, 60(3), 378–388. https://doi.org/10.1111/apt.18101
European Association for the Study of the Liver. (2018). EASL Clinical Practice Guidelines: Management of alcohol-related liver disease. Journal of Hepatology, 69(1), 154–181. https://doi.org/10.1016/j.jhep.2018.03.018
Fazili, A. (2026). Évaluation des d-dimères, international normalised ratio et ferritine au cours de la tuberculose dans la ville de Lubumbashi. Revue Congolaise des Sciences & Technologies, 5(2), 489–498. https://doi.org/10.59228/rcst.026.v5.i2.260
Gao, B., & Bataller, R. (2011). Alcoholic liver disease: Pathogenesis and new therapeutic targets. Gastroenterology, 141(5), 1572–1585. https://doi.org/10.1053/j.gastro.2011.09.002
Han, S., Yang, Z., Zhang, T., Ma, J., Chandler, K., & Liangpunsakul, S. (2021). Epidemiology of alcohol-associated liver disease. Clinics in Liver Disease, 25(3), 483–492. https://doi.org/10.1016/j.cld.2021.03.009
Haren, M. T., Li, M., Petkov, J., & McDermott, R. A. (2010). Alcohol, metabolic risk and elevated serum gamma-glutamyl transferase (GGT) in Indigenous Australians. BMC Public Health, 10(1), 454. https://doi.org/10.1186/1471-2458-10-454
Kounnavong, T., Vonglokham, M., Moji, K., & Okumura, J. (2022). Factors affecting alcohol drinking behaviour among secondary school students in Vientiane Province, Lao People's Democratic Republic: A cross-sectional study. International Health, 14(3), 319–328. https://doi.org/10.1093/inthealth/ihab047
Lachenmeier, D. W., Kanteres, F., & Rehm, J. (2018). Carcinogenicity of acetaldehyde in alcoholic beverages: Risk assessment outside ethanol metabolism. International Journal of Cancer, 143(9), 2271–2280. https://doi.org/10.1111/j.1360-0443.2009.02516.x
Leung, D. H., & Nieto, N. (2018). Cirrhosis and liver disease in children and adolescents: Current concepts and future perspectives. Clinical Liver Disease, 11(4), 87–91. https://doi.org/10.4254/wjh.v7.i3.392
Lombe Bukole, F., Muamba Dibondo, C., Lombe Mudilele, C., & Musema, M. A. G. (2025). Prevalence and factors associated with alcohol consumption among adolescents and young adults aged 15–24 years in the Limete and N'sele health zones, Kinshasa, Democratic Republic of Congo. Journal of Global Health Economics and Policy, 5, e153998. https://doi.org/10.7189/001c.153998
Martínez-Manrique, L., Berasaluce, M., Sureda, X., & Sandín Vázquez, M. (2022). Gender matters: Identity, risk perception and preventive interventions for alcohol consumption among adolescents using a qualitative approach. International Journal of Environmental Research and Public Health, 19(24), 16435. https://doi.org/10.3390/ijerph192416435
Mehanović, E., Virk, H. K., Ibanga, A., Pwajok, J., Prichard, G., Van Der Kreeft, P., Vigna-Taglianti, F., & the Unplugged Nigeria Coordination Group. (2022). Correlates of alcohol experimentation and drunkenness episodes among secondary-school students in Nigeria. Substance Abuse, 43(1), 371–379. https://doi.org/10.1080/08897077.2021.1944952
Mulenda, B., Tshilombo, A., & Kanyinda, J. (2021). Production artisanale et risques sanitaires des boissons alcoolisées traditionnelles en République Démocratique du Congo. Revue Congolaise de Santé Publique, 14(2), 45–53.
Murupa Mbo Jules, K., Tshitenge, S. T., & Ntambue, A. M. (2023). Consommation d'alcool en milieu scolaire à Lubumbashi: Ampleur et facteurs associés. Santé Publique, 35(1), 89–98.
Neumann, T., & Spies, C. (2003). Use of biomarkers for alcohol use disorders in clinical practice. Addiction, 98(s2), 81–91. https://doi.org/10.1046/j.1359-6357.2003.00587.x
Niemelä, O. (2016). Biomarker-based approaches for assessing alcohol use disorders. International Journal of Environmental Research and Public Health, 13(2), 166. https://doi.org/10.3390/ijerph13020166
Osna, N. A., Donohue, T. M., Jr., & Kharbanda, K. K. (2017). Alcoholic liver disease: Pathogenesis and current management. Alcohol Research: Current Reviews, 38(2), 147–161. https://doi.org/10.35946/arcr.v38.2.01
Pathology of Alcoholic Liver Disease. (2014). Journal of Clinical and Translational Hepatology, 2(2), 103–109. https://doi.org/10.14218/JCTH.2014.00010
Peterson, K. (2004). Biomarkers for alcohol use and abuse: A summary. Alcohol Research & Health, 28(1), 30–37.
Philips, C. A. (2024). A comprehensive review of diagnosis and management of alcohol-associated hepatitis. SAGE Open Medicine, 12, 20503121241297000. https://doi.org/10.1177/20503121241297000
Pratt, D. S., & Kaplan, M. M. (2000). Evaluation of abnormal liver-enzyme results in asymptomatic patients. New England Journal of Medicine, 342(17), 1266–1271. https://doi.org/10.1056/NEJM200004273421707
Rehm, J., Gmel, G., & Shield, K. D. (2022). Alcohol use and burden for gastrointestinal and liver diseases. The Lancet Gastroenterology & Hepatology, 7(6), 587–599. https://doi.org/10.1016/S2468-1253(21)00416-7
Rossow, I., Bye, E. K., & Moan, I. S. (2022). The declining trend in adolescent drinking: Do volume and drinking pattern go hand in hand? International Journal of Environmental Research and Public Health, 19(13), 7965. https://doi.org/10.3390/ijerph19137965
Shibiru, T., Arulandhu, A., Belete, A., Etana, J., & Amanu, W. (2023). Prevalence and factors associated with alcohol consumption among secondary school students in Nekemte, Ethiopia: A cross-sectional study. Substance Abuse and Rehabilitation, 14, 35–47. https://doi.org/10.2147/SAR.S408736
Smith, L., López Sánchez, G. F., Pizzol, D., Oh, H., Barnett, Y., Schuch, F., Butler, L., McDermott, D. T., Ball, G., Chandola-Saklani, A., Shin, J. I., & Koyanagi, A. (2024). Global trends in the prevalence of alcohol consumption among school-going adolescents aged 12–15 years. Journal of Adolescent Health, 74(3), 441–448. https://doi.org/10.1016/j.jadohealth.2023.10.007
Squeglia, L. M., Jacobus, J., & Tapert, S. F. (2009). The influence of substance use on adolescent brain development. Clinical EEG and Neuroscience, 40(1), 31–38. https://doi.org/10.1177/155005940904000110
Stewart, C. A., Malinchoc, M., & Kim, W. R. (2022). Utility of transaminase ratios in diagnosing alcohol-induced liver toxicity. Hepatology Communications, 6(5), 1012–1020.
Tawiah, K. D., Riley, S. B., & Budelier, M. M. (2022). Biomarkers and clinical laboratory detection of acute and chronic ethanol use. Clinical Chemistry, 68(5), 635–645. https://doi.org/10.1093/clinchem/hvac004
Taylor, S. A., & Miloh, T. (2019). Adolescent alcoholic liver disease. Clinics in Liver Disease, 23(1), 51–54. https://doi.org/10.1016/j.cld.2018.09.003
Thursz, M., & Lingford-Hughes, A. (2023). Advances in the understanding and management of alcohol-related liver disease. BMJ, 383, e077090. https://doi.org/10.1136/bmj-2023-077090
Thursz, M., Gual, A., Lackner, C., Mathurin, P., Moreno, C., Spahr, L., Sterneck, M., & Cortez-Pinto, H. (2018). EASL Clinical Practice Guidelines: Management of alcohol-related liver disease. Journal of Hepatology, 69(1), 154–181. https://doi.org/10.1016/j.jhep.2018.03.018
Travez Chuquitarco, L. M., Ramos Ramírez, M. C., Acosta Acosta, J., & Estrada Zamora, E. M. (2023). Estudio de las enzimas hepáticas frente al consumo de bebidas alcohólicas en estudiantes universitarios. Mediciencias UTA, 7(2), 75–85. https://doi.org/10.31243/mdc.uta.v7i2.1991.2023
Whitfield, J. B. (2001). Gamma glutamyl transferase. Critical Reviews in Clinical Laboratory Sciences, 38(4), 263–355. https://doi.org/10.1080/20014091084227
Whitfield, J. B., Zhu, G., Madden, P. A. F., Montgomery, G. W., Heath, A. C., & Martin, N. G. (2019). Biomarker and genomic risk factors for liver function test abnormality in hazardous drinkers. Alcoholism: Clinical and Experimental Research, 43(3), 473–482. https://doi.org/10.1111/acer.13949
World Health Organization. (2024). Global status report on alcohol and health 2024. World Health Organization. https://www.who.int/publications/i/item/9789240096745
Wulandari, O. N., & Aliviameita, A. (2025). Analysis of alkaline phosphatase (ALP) and gamma glutamyl transferase (GGT) levels in adolescents who consume alcoholic beverages. Umsida Progress Services, 7, 7736. https://doi.org/10.21070/ups.7736
Zdanowicz, K., Kowalczuk-Kryston, M., Olanski, W., Werpachowska, I., Mielech, W., & Lebensztejn, D. M. (2022). Increase in serum MMP-9 and TIMP-1 concentrations during alcohol intoxication in adolescents—A preliminary study. Biomolecules, 12(5), 710. https://doi.org/10.3390/biom12050710
Zdanowicz, K., Olanski, W., Kowalczuk-Kryston, M., Bobrus-Chociej, A., Werpachowska, I., & Lebensztejn, D. M. (2021). Total keratin-18 (M65) as a potential, early, non-invasive biomarker of hepatocyte injury in alcohol intoxicated adolescents—A preliminary study. Biomolecules, 11(6), 911. https://doi.org/10.3390/biom11060911
Zhang, S., Marsiglia, F. F., & Zhang, Y. (2024). Adolescents' substance use initiation and transitions across alcohol, tobacco, and illicit drugs: A survival analysis approach. Families in Society: The Journal of Contemporary Social Services, 105(4), 539–550. https://doi.org/10.1177/10443894231190251
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2026 Saleh, A. A, Ngbolua, K. N., Mudogo, V.