MicroRNA Dysregulation and Hepatic Involvement in Alcohol-Related Macrocytic Anaemia: Links to Severity Without...

Alcohol-related macrocytic anemia remains insufficiently characterized, particularly regarding molecular correlates of disease severity and treatment response. We evaluated the hepatic, inflammatory and microRNA profile of patients with alcohol-related macrocytic anemia and explored predictors of hematologic improvement.

This prospective single-center observational study included 60 adults with alcohol-related macrocytic anemia. Patients were stratified by baseline severity (mild, n = 21; moderate, n = 17; severe, n = 22) and by treatment response (no change, n = 18; improved, n = 42). Hematologic, iron, nutritional, inflammatory, hepatic and miRNA (miR-21, miR-34a, miR-451a) data were analyzed using non-parametric tests, Spearman correlations and exploratory logistic regression.

Greater anemia severity was associated with longer alcohol exposure, higher weekly alcohol intake, higher GGT, more frequent chronic liver disease and higher expression of all three miRNAs. Hemoglobin and hematocrit decreased across severity groups, whereas MCV increased. Vitamin B12, folate, iron indices, CRP and IL-6 did not differ significantly by severity. No variable significantly distinguished patients who improved from those without hematologic change. All three miRNAs correlated inversely with hemoglobin and positively with MCV, GGT and alcohol-consumption measures.

Alcohol-related macrocytic anemia shows a severity gradient linked to alcohol burden, hepatic involvement and distinct miRNA dysregulation. Predictors of treatment response were weak, supporting larger validation studies.