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Farnbach S, Foley C, Gates P, Seccull A, Henderson A, Zocco A, Farrell M, Shakeshaft A. Enhancing the SUSTAINable uptake of evidence to minimise harms from alcohol and other drugs in New South Wales, Australia. Drug Alcohol Rev 2024. [PMID: 38634165 DOI: 10.1111/dar.13843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/20/2024] [Accepted: 03/15/2024] [Indexed: 04/19/2024]
Abstract
Although alcohol and other drug use is increasingly the focus of policy and research efforts, there are challenges identifying and applying evidence-based strategies to minimise harms for alcohol and other drugs in health care and community settings. These challenges include limited available research, variability across settings, and lack of 'fit' between research evidence and their intended settings. In this commentary, we describe a novel approach to develop and evaluate tailored, sustainable strategies to enhance the uptake of evidence-based activities into health services and community settings. Our approach involves four key principles: (i) identifying evidence-based alcohol and other drug harm minimisation strategies; (ii) partnering with local experts to identify and tailor strategies; (iii) implementing strategies into existing practice/infrastructure to build in sustainability; and (iv) using sustainable co-designed outcome measures including value-based health-care principles to measure uptake, feasibility and acceptability, health outcomes and economic implications. We propose that this approach offers a way forward to enhance the relevance and suitability of research in health services and community settings and has potential to be applied in other sectors.
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Affiliation(s)
- Sara Farnbach
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Catherine Foley
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Peter Gates
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Alison Seccull
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Alexandra Henderson
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
- Centre for Alcohol and Other Drugs, NSW Ministry of Health, Sydney, Australia
| | - Andrea Zocco
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, Australia
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King L, Aplin R, Gill C, Naimi T. A State-of-the-Science Review of Alcoholic Beverages and Polycyclic Aromatic Hydrocarbons. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:16001. [PMID: 38241192 PMCID: PMC10798427 DOI: 10.1289/ehp13506] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 12/08/2023] [Accepted: 12/19/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND The association between alcohol and certain cancers is well established, yet beyond ethanol and its metabolite acetaldehyde, little is known about the presence of other carcinogenic compounds in alcoholic beverages, including polycyclic aromatic hydrocarbons (PAHs), such as benzo[a]pyrene (a Group I carcinogen). OBJECTIVES We summarized the published literature on PAH levels in alcoholic beverages to identify potential gaps in knowledge to inform future research. METHODS Medline and Scopus were searched for primary research published from January 1966 to November 2023 that quantified PAH levels among various types of alcoholic beverages, including whisky, rum, brandy, gin, vodka, wine, and beer. Studies that were not primary literature were excluded; only studies that quantified PAH content in the specified alcoholic beverages were included. RESULTS Ten studies published from 1966 to 2019 met the criteria for review. Other than beverage type, no publication reported selection criteria for their samples of tested alcohol products. Studies used a variety of analytical methods to detect PAHs. Of the 10 studies, 7 were published after 2000, and 6 assessed < 20 products. Of the studies, 7 examined spirits; 3, beer; and 4, wines. Benzo[a]pyrene was most prevalent among spirit products, particularly whisky, with values generally exceeding acceptable levels for drinking water. Some beer and wine products also contained PAHs, albeit at lower levels and less frequently than spirit products. DISCUSSION PAHs are found in some alcohol products and appear to vary by beverage type. However, there is an incomplete understanding of their presence and levels among large, representative samples from the range of currently available alcohol products. Addressing this gap could improve understanding of alcohol-cancer relationships and may have important implications for public health and the regulation of alcohol products. In addition, novel methods, such as direct mass spectroscopy, may facilitate more thorough testing of samples to further investigate this relationship. https://doi.org/10.1289/EHP13506.
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Affiliation(s)
- Liam King
- University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Rebekah Aplin
- Applied Environmental Research Laboratories, Department of Chemistry, Vancouver Island University, Nanaimo, British Columbia, Canada
| | - Chris Gill
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
- Applied Environmental Research Laboratories, Department of Chemistry, Vancouver Island University, Nanaimo, British Columbia, Canada
- Department of Chemistry, University of Victoria, Victoria, British Columbia, Canada
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia, Canada
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Timothy Naimi
- University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
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Ye F, Du Y, Cao W, Jiang R, Qi Q, Sun H, Zhou J, Wang L. Higher serum AMH level is associated with better pregnancy outcomes of IVF/ICSI assisted pregnancy in infertile patients under 35 years old. Drug Discov Ther 2023; 17:299-303. [PMID: 37587050 DOI: 10.5582/ddt.2023.01044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
This study aimed to investigate the effect of anti-Mullerian hormone (AMH) on the pregnancy outcome of infertility assisted by IVF/Micro-Insemination/Embryo Transfer Infertility Assistance (IVF/ICSI-ET). A total of 324 patients under the age of 35 who received IVF/ICSI-ET assistance in our center were included in this analysis. AMH levels of these patients were measured by chemiluminescence method and divided into clinical pregnancy group (175 cases) and non-pregnancy group (149 cases) according to the final pregnancy outcome. The relationship between the two groups' pregnancy outcomes and AMH levels was analyzed. The above association was re-evaluated after excluding patients with polycystic ovary syndrome. There was no significant difference in age, body mass index (BMI), follicle-stimulating hormone (FSH), and 2 pronucleus (PN) between clinical and non-clinical pregnancy groups. Compared with the clinical pregnancy group, the level of AMH in the non-pregnancy group was significantly lower (p < 0.05). A higher AMH level was closely related to better IVF/ICSI-ET assisted pregnancy outcome in vitro. After excluding AMH abnormalities, the AMH level was still significantly associated with pregnancy outcomes of in vitro IVF/ICSI-ET-assisted pregnancy. Our results show a correlation between AMH level and pregnancy outcome of in vitro IVF/ICSI-ET assisted pregnancy. For women under age 35, lower AMH levels may be one of the predictors of adverse pregnancy outcomes. For patients with low AMH level, it is suggested to strengthen monitoring to ensure the safety and smoothness of the pregnancy process.
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Affiliation(s)
- Feijun Ye
- Reproductive Medicine Center, Zhoushan Maternal and Child Health Care Hospital, Zhoushan, Zhejiang, China
| | - Yan Du
- Clinical Research Unit, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Wenli Cao
- Reproductive Medicine Center, Zhoushan Maternal and Child Health Care Hospital, Zhoushan, Zhejiang, China
| | - Ruhe Jiang
- Clinical Research Unit, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qing Qi
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- The Academy of Integrative Medicine, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Hongmei Sun
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- The Academy of Integrative Medicine, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Jing Zhou
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- The Academy of Integrative Medicine, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Ling Wang
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- The Academy of Integrative Medicine, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
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Raza SA, Sokale IO, Thrift AP. Burden of high-risk phenotype of heavy alcohol consumption among obese U.S. population: results from National Health and Nutrition Examination Survey, 1999-2020. LANCET REGIONAL HEALTH. AMERICAS 2023; 23:100525. [PMID: 37293391 PMCID: PMC10245110 DOI: 10.1016/j.lana.2023.100525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/10/2023]
Abstract
Background The phenotype of combined heavy alcohol consumption and obesity has the potential to pose as a considerable health burden in the U.S. No studies using nationally representative data in the U.S. have reported their secular joint prevalence trends. We estimated the prevalence and examined the joint trends of heavy alcohol use and obesity over time among adult U.S. men and women in different age groups and according to race/ethnicity. Methods Using data from 10 cycles of the U.S. National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020, we examined secular trends in the combined phenotype of heavy drinking and obesity overall and by age-group, sex, and race/ethnicity. The main outcome measures were prevalence of heavy alcohol consumption (>14 drinks/week in men and >7 drinks/week in women) and obesity (BMI ≥30). Findings In 45,292 adults (22,684 men, mean age 49.26 years; and 22,608 women, mean age 49.86), the overall weighted prevalence of combined heavy alcohol drinking and obesity increased from 1.8% (95% CI: 1.2%, 3.1%) in 1999-2000 to 3.1% (95% CI: 2.7%, 3.7%) in 2017-2020 representing an increase of 72% over time. In the joinpoint regression, the combined phenotype of heavy alcohol consumption and obesity increased by 3.25% (95% CI: 1.67%, 4.85%) per year overall from 1999 to 2017. An increasing trend of 9.94% (95% CI: 2.37%, 18.06%) per year was observed among adults aged between 40 and 59 years from 2007 onwards. Prevalence of heavy alcohol consumption in obesity increased at a faster rate among women (APC, 3.96%; 95% CI: 2.14%, 5.82%) than men (APC, 2.47%; 95% CI: 0.63%, 4.35%), and increased among non-Hispanic Whites (APC, 4.12%; 95% CI: 1.50%, 6.82%) and non-Hispanic Blacks (APC, 2.78%; 95% CI: 0.47%, 5.14%), but not Hispanics. Interpretation The prevalence of combined heavy alcohol consumption and obesity increased overall in the U.S., but the rate of increase differed by age, sex, and race/ethnic groups. Given their independent and potential synergistic effects on premature mortality, public health policies on alcohol consumption need to reflect the background obesity epidemic. Funding Cancer Prevention & Research Institute of Texas (CPRIT) for the Systems Epidemiology of Cancer Training (SECT) Program (RP210037; PI: A. Thrift).
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Affiliation(s)
- Syed Ahsan Raza
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Itunu O. Sokale
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Aaron P. Thrift
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
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Alcohol consumption and metabolic syndrome: Clinical and epidemiological impact on liver disease. J Hepatol 2023; 78:191-206. [PMID: 36063967 DOI: 10.1016/j.jhep.2022.08.030] [Citation(s) in RCA: 50] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/04/2022] [Accepted: 08/19/2022] [Indexed: 02/01/2023]
Abstract
Alcohol use and metabolic syndrome are highly prevalent in the population and frequently co-exist. Both are implicated in a large range of health problems, including chronic liver disease, hepatocellular carcinoma, and liver-related outcomes (i.e. decompensation or liver transplantation). Studies have yielded mixed results regarding the effects of mild-moderate alcohol consumption on the risk of metabolic syndrome and fatty liver disease, possibly due to methodological differences. The few available prospective studies have indicated that mild-moderate alcohol use is associated with an increase in liver-related outcomes. This conclusion was substantiated by systems biology analyses suggesting that alcohol and metabolic syndrome may play a similar role in fatty liver disease, potentiating an already existing dysregulation of common vital homeostatic pathways. Alcohol and metabolic factors are independently and jointly associated with liver-related outcomes. Indeed, metabolic syndrome increases the risk of liver-related outcomes, regardless of alcohol intake. Moreover, the components of metabolic syndrome appear to have additive effects when it comes to the risk of liver-related outcomes. A number of population studies have implied that measures of central/abdominal obesity, such as the waist-to-hip ratio, can predict liver-related outcomes more accurately than BMI, including in individuals who consume harmful quantities of alcohol. Many studies even point to synergistic interactions between harmful alcohol use and many metabolic components. This accumulating evidence showing independent, combined, and modifying effects of alcohol and metabolic factors on the onset and progression of chronic liver disease highlights the multifactorial background of liver disease in the population. The available evidence suggests that more holistic approaches could be useful for risk prediction, diagnostics and treatment planning.
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Li X, Zhao K, Chen J, Ni Z, Yu Z, Hu L, Qin Y, Zhao J, Peng W, Lu L, Gao X, Sun H. Diurnal changes of the oral microbiome in patients with alcohol dependence. Front Cell Infect Microbiol 2022; 12:1068908. [PMID: 36579346 PMCID: PMC9791055 DOI: 10.3389/fcimb.2022.1068908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
Background Saliva secretion and oral microbiota change in rhythm with our biological clock. Dysbiosis of the oral microbiome and alcohol consumption have a two-way interactive impact, but little is known about whether the oral microbiome undergoes diurnal changes in composition and function during the daytime in patients with alcohol dependence (AD). Methods The impact of alcohol consumption on the diurnal salivary microbiome was examined in a case-control study of 32 AD patients and 21 healthy control (HC) subjects. We tested the changes in microbial composition and individual taxon abundance by 16S rRNA gene sequencing. Results The present study is the first report showing that alcohol consumption enhanced the richness of the salivary microbiome and lowered the evenness. The composition of the oral microbiota changed significantly in alcohol-dependent patients. Additionally, certain genera were enriched in the AD group, including Actinomyces, Leptotrichia, Sphaerochaeta and Cyanobacteria, all of which have pathogenic effects on the host. There is a correlation between liver enzymes and oral microbiota. KEGG function analysis also showed obvious alterations during the daytime. Conclusion Alcohol drinking influences diurnal changes in the oral microbiota, leading to flora disturbance and related functional impairment. In particular, the diurnal changes of the oral microbiota may open avenues for potential interventions that can relieve the detrimental consequences of AD.
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Affiliation(s)
- Xiangxue Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Kangqing Zhao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jie Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhaojun Ni
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhoulong Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Lingming Hu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Ying Qin
- Addiction Medicine Department, The Second People’s Hospital of Guizhou Province, Guizhou, China
| | - Jingwen Zhao
- Addiction Medicine Department, The Second People’s Hospital of Guizhou Province, Guizhou, China
| | - Wenjuan Peng
- Addiction Medicine Department, The Second People’s Hospital of Guizhou Province, Guizhou, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xuejiao Gao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China,*Correspondence: Xuejiao Gao, ; Hongqiang Sun,
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China,*Correspondence: Xuejiao Gao, ; Hongqiang Sun,
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Uusitalo L, Nevalainen J, Rahkonen O, Erkkola M, Saarijärvi H, Fogelholm M, Lintonen T. Changes in alcohol purchases from grocery stores after authorising the sale of stronger beverages: The case of the Finnish alcohol legislation reform in 2018. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 39:589-604. [PMID: 36452445 PMCID: PMC9703366 DOI: 10.1177/14550725221082364] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/07/2022] [Indexed: 08/17/2023] Open
Abstract
Aims: The Finnish alcohol law was reformed in January 2018. The availability of alcoholic beverages in grocery stores increased as the legal limit for retail sales of alcoholic drinks was raised from 4.7% to 5.5% alcohol, and the requirement of production by fermentation was abolished. We analysed how the inclusion of strong beers, ciders, and ready-to-drink beverages in grocery stores was reflected in alcohol purchases, and how these changes differed by age, sex, level of education and household income. Design: The study sample included 47,066 loyalty card holders from the largest food retailer in Finland. The data consisted of longitudinal, individual-level information on alcohol purchases from grocery stores, covering the time period between 1 January 2017 and 31 December 2018. The volumes of absolute alcohol during a calendar year from beers, ciders, ready-to-drink beverages, and in total, were calculated. Alcohol purchases in 2017 and 2018 were compared. Results: There was no overall change in the total alcohol (0.04 [95% CI -0.03, 0.11] litres/year) or beer purchases (-0.05 [95% CI -0.11, 0.02] litres/year). Purchases of ready-to-drink beverages increased by 0.10 [95% CI 0.09, 0.11] litres/year (+ 84%). Total alcohol purchases increased in the three highest income groups, whereas they decreased in the two lowest groups (p for the interaction < 0.0001). Conclusions: The increased purchases of alcohol as ready-to-drink beverages were, on the average, compensated for by a decrease in purchases of other alcoholic beverages. Higher prices probably limited the purchases among lower income groups and younger consumers, while the increase was sharper in higher income groups.
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Affiliation(s)
| | | | | | | | | | | | - Tomi Lintonen
- Finnish Foundation for Alcohol Studies c/o THL,
Helsinki, Finland
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Rao W, Li Y, Li N, Yao Q, Li Y. The association between caffeine and alcohol consumption and IVF/ICSI outcomes: A systematic review and dose-response meta-analysis. Acta Obstet Gynecol Scand 2022; 101:1351-1363. [PMID: 36259227 PMCID: PMC9812114 DOI: 10.1111/aogs.14464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/10/2022] [Accepted: 09/14/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION The objective of this study was to evaluate the association between caffeine and alcohol consumption and in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) outcomes. MATERIAL AND METHODS The protocol was registered in the PROSPERO database on May 23, 2021 (registration number: CRD42021256649), and updated on August 4, 2022. Two researchers performed a literature search in the PubMed, Embase, and MEDLINE databases for articles published before July 15, 2022 independently. Studies investigating the association between caffeine and alcohol consumption and IVF/ICSI outcomes were included, and studies reporting the consumption amount were analyzed using a one-stage robust error meta-regression-based method to explore potential dose-response relation. Funnel plot was used to assess publication bias if more than 10 studies were included. RESULTS Twelve studies on caffeine consumption and 14 studies on alcohol consumption were included in the systematic review, of which seven and nine were eligible for the meta-analysis. These studies included 26 922 women and/or their spouses who underwent IVF/ICSI treatment. Women's and men's caffeine consumption was not significantly associated with the pregnancy rate (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.85-1.12; OR 0.93, 95% CI 0.75-1.14; respectively) and the live birth rate (OR 0.98, 95% CI 0.89-1.08; OR 0.98, 95% CI 0.86-1.12; respectively) of IVF/ICSI. Maternal alcohol consumption was negatively associated with pregnancy after IVF/ICSI treatment (OR 0.83, 95% CI 0.69-1.01). Paternal alcohol consumption was negatively associated with partner's live birth after IVF/ICSI treatment (OR 0.88, 95% CI 0.79-0.99). Compared with abstainers, the chance of achieving a pregnancy after IVF/ICSI treatment decreased by 7% for women who consumed 84 g alcohol per week (OR 0.93, 95% CI 0.90-0.98), and the chance of partners achieving a live birth decreased by 9% for men who consumed 84 g alcohol per week (OR 0.91, 95% CI 0.88-0.94). CONCLUSIONS There was no association between caffeine consumption and pregnancy or live birth rate of IVF/ICSI. Women's alcohol consumption was associated with decreased pregnancy rate after IVF/ICSI treatment when weekly consumption was greater than 84 g. Men's alcohol consumption was associated with decreased live birth rate after IVF/ICSI treatment when weekly consumption was greater than 84 g.
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Affiliation(s)
- Wentao Rao
- Huazhong University of Science and TechnologyTongji Medical College, Tongji Hospital, Reproductive Medicine CenterWuhanChina
| | - Yuying Li
- Huazhong University of Science and TechnologyTongji Medical College, Tongji Hospital, Reproductive Medicine CenterWuhanChina
| | - Nijie Li
- Huazhong University of Science and TechnologyTongji Medical College, Tongji Hospital, Reproductive Medicine CenterWuhanChina
| | - Qingyun Yao
- Huazhong University of Science and TechnologyTongji Medical College, Tongji Hospital, Reproductive Medicine CenterWuhanChina
| | - Yufeng Li
- Huazhong University of Science and TechnologyTongji Medical College, Tongji Hospital, Reproductive Medicine CenterWuhanChina
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Zhang J, Liu H, Bu X, Lu Q, Cheng L, Ma A, Wang T. The burden of alcoholic cardiomyopathy in China and different regions around the world. J Glob Health 2022; 12:04041. [PMID: 35861492 PMCID: PMC9304924 DOI: 10.7189/jogh.12.04041] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Alcoholic cardiomyopathy (ACM) remains a significant public health issue with a growing global burden. The burden of ACM in China and different regions remains poorly understood. Methods Data on ACM deaths, disability-adjusted life years (DALYs), the corresponding global age-standardized death rate (ASDR), age-standardized DALY rate and estimated annual percentage change (EAPC) were analysed based on age, sex, socio-demographic index (SDI) quintiles, different regions and in China from the Global Burden of Disease (GBD) study 2019. Results Globally, the death rate and DALYs due to ACM were 71 723 and 2 441 108 in 2019, 33.06% and 38.79% increase from 1990, respectively. The corresponding ASDR and age-standardized DALY rate decreased with EAPC of -1.52 (95% uncertainty interval (UI) = -2.39, -0.65) and -1.12 (95% UI = -2.14, -0.10). The high-middle SDI regions, especially Eastern Europe, showed the highest number of ACM-related deaths and DALYs. The ACM-related deaths and DALYs were 2545 and 87823 in China in 2019, 171.03% and 147.17% increase from 1990, respectively. Unlike the world level, ASDR and age-standardized DALY rate also increased in China. The ACM burden is higher in men, and people with 50 to 69 years old accounted for the most. Conclusions ACM burden in China and across the world increased substantially from 1990 to 2019. The greatest burden was borne by the high-middle SDI regions, especially by men aged 50-69 years old. Geographically and gender-age tailored strategies were needed to prevent ACM.
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Affiliation(s)
- Jing Zhang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Key Laboratory of Molecular Cardiology, Xi'an, Shaanxi, China.,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, China
| | - Hailing Liu
- Department of Pediatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiang Bu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qun Lu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Key Laboratory of Molecular Cardiology, Xi'an, Shaanxi, China.,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, China
| | - Lu Cheng
- Department of Cardiovascular Medicine, The Affiliated Cardiovascular Hospital of Qingdao University, Qingdao, Shandong, China
| | - Aiqun Ma
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Key Laboratory of Molecular Cardiology, Xi'an, Shaanxi, China.,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, China
| | - Tingzhong Wang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Key Laboratory of Molecular Cardiology, Xi'an, Shaanxi, China.,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, China
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Gilmore W, Gilmore SI. Has the pandemic exacerbated alcohol harm? TRENDS IN UROLOGY & MEN'S HEALTH 2022. [PMCID: PMC9349633 DOI: 10.1002/tre.863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- William Gilmore
- National Drug Research Institute and enAble Institute, Faculty of Health Sciences Curtin University Perth Australia
| | - Sir Ian Gilmore
- National Drug Research Institute and enAble Institute, Faculty of Health Sciences Curtin University Perth Australia
- Liverpool Centre for Alcohol Research, Institute of Translational Medicine University of Liverpool UK
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Association between Bar Closing Time, Alcohol Use Disorders and Blood Alcohol Concentration: A Cross-Sectional Observational Study of Nightlife-Goers in Perth, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127026. [PMID: 35742275 PMCID: PMC9223176 DOI: 10.3390/ijerph19127026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 02/01/2023]
Abstract
Introduction and aims: Associations between bar trading hours, a government lever for controlling alcohol availability, nightlife-goer intoxication levels and their likelihood of alcohol use disorder (AUD) have not been explored. We investigated whether: (i) participant AUD was associated with blood alcohol concentration (BAC); and, (ii) any association between AUD and BAC was moderated by participant preferred bar (i.e., venue spent most time at) closing time. Design and methods: A cross-sectional observational study using a sample of nightlife-goers who went out drinking in Perth, Western Australia, on weekends in 2015-16. Participants who reported alcohol use that night and spent most time in a bar (n = 667) completed street intercept surveys including AUDIT-C (n = 459) and provided a breath sample to estimate BAC (n = 651). We used gender-specific multinomial logistic regression models to explore associations between participant AUDIT-C score (1−4, lower risk; 5−7, hazardous; 8−12, active AUD), preferred bar type (standard vs. late closing time based on absence or presence of an extended trading permit) and BAC (male: 0−0.049, 0.05−0.099, ≥0.1 g/100 mL; female: 0−0.049, 0.05−0.079, ≥0.08 g/100 mL). Results: Males with active AUD (RR = 3.31; 95% CI 1.30−8.42; p = 0.01) and females with hazardous/active AUD (RR = 9.75; 95% CI 2.78−34.21; p < 0.001) were both more likely to have high-range BAC than their counterparts typically drinking at lower risk. We also found preferred bar type moderated the association between AUDIT-C score and BAC for some males but no females. Males with active AUD and high-range BAC were less likely to prefer late closing bars than males usually drinking at lower risk and high-range BAC (RR = 0.12; 95% CI 0.02−0.96; p = 0.046). Discussion and conclusions: Our study provides evidence of positive associations between AUD and acute intoxication among nightlife-goers and on the moderating effect of bar closing times among males.
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Yang Z, Han S, Zhang T, Kusumanchi P, Huda N, Tyler K, Chandler K, Skill NJ, Tu W, Shan M, Jiang Y, Maiers JL, Perez K, Ma J, Liangpunsakul S. Transcriptomic Analysis Reveals the Messenger RNAs Responsible for the Progression of Alcoholic Cirrhosis. Hepatol Commun 2022; 6:1361-1372. [PMID: 35134262 PMCID: PMC9134803 DOI: 10.1002/hep4.1903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/19/2021] [Accepted: 12/17/2021] [Indexed: 11/18/2022] Open
Abstract
Alcohol-associated liver disease is the leading cause of chronic liver disease. We hypothesized that the expression of specific coding genes is critical for the progression of alcoholic cirrhosis (AC) from compensated to decompensated states. For the discovery phase, we performed RNA sequencing analysis of 16 peripheral blood RNA samples, 4 healthy controls (HCs) and 12 patients with AC. The DEGs from the discovery cohort were validated by quantitative polymerase chain reaction in a separate cohort of 17 HCs and 48 patients with AC (17 Child-Pugh A, 16 Child-Pugh B, and 15 Child-Pugh C). We observed that the numbers of differentially expressed messenger RNAs (mRNAs) were more pronounced with worsening disease severity. Pathway analysis for differentially expressed genes for patients with Child-Pugh A demonstrated genes involved innate immune responses; those in Child-Pugh B belonged to genes related to oxidation and alternative splicing; those in Child-Pugh C related to methylation, acetylation, and alternative splicing. We found significant differences in the expression of heme oxygenase 1 (HMOX1) and ribonucleoprotein, PTB binding 1 (RAVER1) in peripheral blood of those who died during the follow-up when compared to those who survived. Conclusion: Unique mRNAs that may implicate disease progression in patients with AC were identified by using a transcriptomic approach. Future studies to confirm our results are needed, and comprehensive mechanistic studies on the implications of these genes in AC pathogenesis and progression should be further explored.
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Affiliation(s)
- Zhihong Yang
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Sen Han
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
- Key Laboratory of Carcinogenesis and Translational ResearchPeking University Cancer HospitalBeijingChina
| | - Ting Zhang
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Praveen Kusumanchi
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Nazmul Huda
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Kelsey Tyler
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Kristina Chandler
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Nicholas J. Skill
- Department of SurgeryLouisiana State University Health Science CenterNew OrleansLAUSA
| | - Wanzhu Tu
- Department of Biostatistics and Health Data SciencesIndiana University School of MedicineIndianapolisINUSA
| | - Mu Shan
- Department of Biostatistics and Health Data SciencesIndiana University School of MedicineIndianapolisINUSA
| | - Yanchao Jiang
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Jessica L. Maiers
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Kristina Perez
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Jing Ma
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Suthat Liangpunsakul
- Division of Gastroenterology and HepatologyDepartment of MedicineIndiana University School of MedicineIndianapolisINUSA
- Department of Biochemistry and Molecular BiologyIndiana University School of MedicineIndianapolisINUSA
- Roudebush Veterans Administration Medical CenterIndianapolisINUSA
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13
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Di Ciaula A, Bonfrate L, Krawczyk M, Frühbeck G, Portincasa P. Synergistic and Detrimental Effects of Alcohol Intake on Progression of Liver Steatosis. Int J Mol Sci 2022; 23:ijms23052636. [PMID: 35269779 PMCID: PMC8910376 DOI: 10.3390/ijms23052636] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 02/07/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) are the most common liver disorders worldwide and the major causes of non-viral liver cirrhosis in the general population. In NAFLD, metabolic abnormalities, obesity, and metabolic syndrome are the driving factors for liver damage with no or minimal alcohol consumption. ALD refers to liver damage caused by excess alcohol intake in individuals drinking more than 5 to 10 daily units for years. Although NAFLD and ALD are nosologically considered two distinct entities, they show a continuum and exert synergistic effects on the progression toward liver cirrhosis. The current view is that low alcohol use might also increase the risk of advanced clinical liver disease in NAFLD, whereas metabolic factors increase the risk of cirrhosis among alcohol risk drinkers. Therefore, special interest is now addressed to individuals with metabolic abnormalities who consume small amounts of alcohol or who binge drink, for the role of light-to-moderate alcohol use in fibrosis progression and clinical severity of the liver disease. Evidence shows that in the presence of NAFLD, there is no liver-safe limit of alcohol intake. We discuss the epidemiological and clinical features of NAFLD/ALD, aspects of alcohol metabolism, and mechanisms of damage concerning steatosis, fibrosis, cumulative effects, and deleterious consequences which include hepatocellular carcinoma.
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Affiliation(s)
- Agostino Di Ciaula
- Clinica Medica “Augusto Murri”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School—Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.D.C.); (L.B.)
| | - Leonilde Bonfrate
- Clinica Medica “Augusto Murri”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School—Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.D.C.); (L.B.)
| | - Marcin Krawczyk
- Department of Medicine II Saarland University Medical Center, Saarland University, 66424 Homburg, Germany;
- Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Centre for Preclinical Research, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Gema Frühbeck
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, 31009 Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31009 Pamplona, Spain
| | - Piero Portincasa
- Clinica Medica “Augusto Murri”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School—Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.D.C.); (L.B.)
- Correspondence:
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Li W, Syed F, Yu R, Yang J, Xia Y, Relich RF, Russell PM, Zhang S, Khalili M, Huang L, Kacena MA, Zheng X, Yu Q. Soluble Immune Checkpoints Are Dysregulated in COVID-19 and Heavy Alcohol Users With HIV Infection. Front Immunol 2022; 13:833310. [PMID: 35281051 PMCID: PMC8904355 DOI: 10.3389/fimmu.2022.833310] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/28/2022] [Indexed: 01/08/2023] Open
Abstract
Immune checkpoints (ICPs) consist of paired receptor-ligand molecules that exert inhibitory or stimulatory effects on immune defense, surveillance, regulation, and self-tolerance. ICPs exist in both membrane and soluble forms in vivo and in vitro. Imbalances between inhibitory and stimulatory membrane-bound ICPs (mICPs) in malignant cells and immune cells in the tumor immune microenvironment (TIME) have been well documented. Blockades of inhibitory mICPs have emerged as an immense breakthrough in cancer therapeutics. However, the origin, structure, production regulation, and biological significance of soluble ICPs (sICPs) in health and disease largely remains elusive. Soluble ICPs can be generated through either alternative mRNA splicing and secretion or protease-mediated shedding from mICPs. Since sICPs are found in the bloodstream, they likely form a circulating immune regulatory system. In fact, there is increasing evidence that sICPs exhibit biological functions including (1) regulation of antibacterial immunity, (2) interaction with their mICP compartments to positively or negatively regulate immune responses, and (3) competition with their mICP compartments for binding to the ICP blocking antibodies, thereby reducing the efficacy of ICP blockade therapies. Here, we summarize current data of sICPs in cancer and infectious diseases. We particularly focus on sICPs in COVID-19 and HIV infection as they are the two ongoing global pandemics and have created the world's most serious public health challenges. A "storm" of sICPs occurs in the peripheral circulation of COVID-19 patients and is associated with the severity of COVID-19. Similarly, sICPs are highly dysregulated in people living with HIV (PLHIV) and some sICPs remain dysregulated in PLHIV on antiretroviral therapy (ART), indicating these sICPs may serve as biomarkers of incomplete immune reconstitution in PLHIV on ART. We reveal that HIV infection in the setting of alcohol misuse exacerbates sICP dysregulation as PLHIV with heavy alcohol consumption have significantly elevated plasma levels of many sICPs. Thus, both stimulatory and inhibitory sICPs are present in the bloodstream of healthy people and their balance can be disrupted under pathophysiological conditions such as cancer, COVID-19, HIV infection, and alcohol misuse. There is an urgent need to study the role of sICPs in immune regulation in health and disease.
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Affiliation(s)
- Wei Li
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Fahim Syed
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Richard Yu
- Department of Internal Medicine, School of Medicine, University of Nevada, Reno, NV, United States
| | - Jing Yang
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Ying Xia
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, United States
- School of Laboratory Medicine, Wenzhou Medical University, Wenzhou, China
| | - Ryan F. Relich
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Patrick M. Russell
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Shanxiang Zhang
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Mandana Khalili
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Laurence Huang
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Melissa A. Kacena
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Xiaoqun Zheng
- School of Laboratory Medicine, Wenzhou Medical University, Wenzhou, China
- Department of Clinical Laboratory, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qigui Yu
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, United States
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15
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Association between Nightlife Goers' Likelihood of an Alcohol Use Disorder and Their Preferred Bar's Closing Time: A Cross-Sectional Observational Study in Perth, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413040. [PMID: 34948660 PMCID: PMC8700896 DOI: 10.3390/ijerph182413040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/05/2021] [Accepted: 12/08/2021] [Indexed: 12/03/2022]
Abstract
Introduction and aims: Associations between longer-term alcohol-related conditions and licensed outlet trading hours are not well understood. We investigated the association between nightlife-goers’ likelihood of an alcohol use disorder (AUD) and their preference for bars with special permits to remain open ‘late’ (i.e., spent more time there compared to any other venue) until 2 a.m. or 3 a.m. (Friday; Saturday) or midnight (Sunday) compared to bars with ‘standard’ closing times of midnight (Friday; Saturday) or 10 p.m. (Sunday). Design and methods: A cross-sectional observational study was conducted in four major nightlife areas of Perth, Australia, in 2015–2016. We conducted weekend street intercept surveys outside bars between 8 p.m. and 3 a.m. and screened participants who reported alcohol use prior to the survey and spent more time in a bar than any other venue type (n = 667) regarding their past year drinking pattern using AUDIT-C (n = 459). We used gender-specific logistic regression models to estimate associations between AUDIT-C categories (1–4, low risk; 5–7, hazardous; 8–12, active AUD) and preference for bars with different closing times (late vs. standard). Results: A large proportion of participants were hazardous drinkers or had active AUD (83% males; 65% females), and over half preferred a late to a standard closing bar. We found evidence of a positive association between preference for late closing bars and hazardous drinking females (OR = 3.48; 95% CI 1.47–8.23; p = 0.01), but not for females with active AUD, male hazardous drinkers, nor males with active AUD. Discussion and conclusions: Our study adds new evidence on associations between likelihood of AUD among nightlife-goers and trading hours. With increasing international relaxation of trading hours, evidence that late closing bars may be preferred by hazardous drinking females will be of concern to policymakers wanting to curb alcohol-related harms in the community.
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16
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Baumeister SE, Freuer D, Baurecht H, Reckelkamm SL, Ehmke B, Holtfreter B, Nolde M. Understanding the consequences of educational inequalities on periodontitis: Mendelian randomization study. J Clin Periodontol 2021; 49:200-209. [PMID: 34866211 DOI: 10.1111/jcpe.13581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/11/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022]
Abstract
AIM Higher educational attainment is associated with a lower risk of periodontitis, but the extent to which this association is causal and mediated by intermediate factors is unclear. METHODS AND MATERIALS Using summary data from genetic association studies from up to 1.1 million participants of European descent, univariable and multivariable Mendelian randomization analyses were performed to infer the total effect of educational attainment on periodontitis and to estimate the degree to which income, smoking, alcohol consumption, and body mass index mediate the association. RESULTS The odds ratio of periodontitis per one standard deviation increment in genetically predicted education was 0.78 (95% CI: 0.68-0.89). The proportions mediated of the total effect of genetically predicted education on periodontitis were 64%, 35%, 15%, and 46% for income, smoking, alcohol consumption, and body mass index, respectively. CONCLUSIONS Using a genetic instrumental variable approach, this study triangulated evidence from existing observational epidemiological studies and suggested that higher educational attainment lowers periodontitis risk. Measures to reduce the burden of educational disparities in periodontitis risk may tackle downstream risk factors, particularly income, smoking, and obesity.
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Affiliation(s)
| | - Dennis Freuer
- Chair of Epidemiology, University of Augsburg, Augsburg, Germany
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Stefan Lars Reckelkamm
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | - Benjamin Ehmke
- Clinic for Periodontology and Conservative Dentistry, University of Münster, Münster, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Michael Nolde
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
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17
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Yang Z, Smalling RV, Huang Y, Jiang Y, Kusumanchi P, Bogaert W, Wang L, Delker DA, Skill NJ, Han S, Zhang T, Ma J, Huda N, Liangpunsakul S. The role of SHP/REV-ERBα/CYP4A axis in the pathogenesis of alcohol-associated liver disease. JCI Insight 2021; 6:e140687. [PMID: 34423788 PMCID: PMC8410014 DOI: 10.1172/jci.insight.140687] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/14/2021] [Indexed: 12/20/2022] Open
Abstract
Alcohol-associated liver disease (ALD) represents a spectrum of histopathological changes, including alcoholic steatosis, steatohepatitis, and cirrhosis. One of the early responses to excessive alcohol consumption is lipid accumulation in the hepatocytes. Lipid ω-hydroxylation of medium- and long-chain fatty acid metabolized by the cytochrome P450 4A (CYP4A) family is an alternative pathway for fatty acid metabolism. The molecular mechanisms of CYP4A in ALD pathogenesis have not been elucidated. In this study, WT and Shp−/− mice were fed with a modified ethanol-binge, National Institute on Alcohol Abuse and Alcoholism model (10 days of ethanol feeding plus single binge). Liver tissues were collected every 6 hours for 24 hours and analyzed using RNA-Seq. The effects of REV-ERBα agonist (SR9009, 100 mg/kg/d) or CYP4A antagonist (HET0016, 5 mg/kg/d) in ethanol-fed mice were also evaluated. We found that hepatic Cyp4a10 and Cyp4a14 expression were significantly upregulated in WT mice, but not in Shp−/− mice, fed with ethanol. ChIP quantitative PCR and promoter assay revealed that REV-ERBα is the transcriptional repressor of Cyp4a10 and Cyp4a14. Rev-Erbα−/− hepatocytes had a marked induction of both Cyp4a genes and lipid accumulation. REV-ERBα agonist SR9009 or CYP4A antagonist HET0016 attenuated Cyp4a induction by ethanol and prevented alcohol-induced steatosis. Here, we have identified a role for the SHP/REV-ERBα/CYP4A axis in the pathogenesis of ALD. Our data also suggest REV-ERBα or CYP4A as the potential therapeutic targets for ALD.
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Affiliation(s)
- Zhihong Yang
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Rana V Smalling
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Yi Huang
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, Connecticut, USA
| | - Yanchao Jiang
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Praveen Kusumanchi
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Will Bogaert
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, Connecticut, USA
| | - Li Wang
- Department of Internal Medicine, Section of Digestive Diseases, Yale University, New Haven, Connecticut, USA
| | - Don A Delker
- Divisions of Gastroenterology, University of Utah, Salt Lake City, Utah, USA
| | - Nicholas J Skill
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sen Han
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ting Zhang
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jing Ma
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Nazmul Huda
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Suthat Liangpunsakul
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA.,Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Falkner C, Neave H. The behaviour of alcohol-dependent drinkers of spirits during level 4 COVID-19 lockdown in Auckland, New Zealand. Drug Alcohol Rev 2021; 41:9-12. [PMID: 34008272 PMCID: PMC8239928 DOI: 10.1111/dar.13309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 12/03/2022]
Abstract
Introduction Behaviour of alcohol drinkers during previous major public health or economic crises has varied, with reductions in use generally occurring during periods of reduced availability. This study aimed to discover the behaviour of a group of dependent drinkers of spirits during a 33‐day period of complete closure of physical stores selling spirits during COVID‐19 lockdown in Auckland, New Zealand, March 2020. Methods Electronic clinical records of drinkers waitlisted to complete an alcohol detox at the in‐patient service were followed from day 1 of lockdown and outcomes at the end of the period analysed. Results Drinkers of spirits were statistically more successful in stopping drinking (P = 0.002) than those of wine or beer. Only 26% chose to switch to an alternate alcohol type initially. Discussion and Conclusion A sudden reduction in availability of spirits resulted in positive behaviour change in spirits drinkers compared to those of other alcohol types, aided by the support of detox services. Internet alcohol purchasing, while not used by this group, deserves close future scrutiny due to its potential to increase alcohol availability in dependent drinkers.
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Affiliation(s)
- Carolyn Falkner
- Research and Knowledge Centre, Waitemata District Health Board, Auckland, New Zealand
| | - Hamish Neave
- Research and Knowledge Centre, Waitemata District Health Board, Auckland, New Zealand
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19
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Gut Microbiota at the Intersection of Alcohol, Brain, and the Liver. J Clin Med 2021; 10:jcm10030541. [PMID: 33540624 PMCID: PMC7867253 DOI: 10.3390/jcm10030541] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 12/12/2022] Open
Abstract
Over the last decade, increased research into the cognizance of the gut-liver-brain axis in medicine has yielded powerful evidence suggesting a strong association between alcoholic liver diseases (ALD) and the brain, including hepatic encephalopathy or other similar brain disorders. In the gut-brain axis, chronic, alcohol-drinking-induced, low-grade systemic inflammation is suggested to be the main pathophysiology of cognitive dysfunctions in patients with ALD. However, the role of gut microbiota and its metabolites have remained unclear. Eubiosis of the gut microbiome is crucial as dysbiosis between autochthonous bacteria and pathobionts leads to intestinal insult, liver injury, and neuroinflammation. Restoring dysbiosis using modulating factors such as alcohol abstinence, promoting commensal bacterial abundance, maintaining short-chain fatty acids in the gut, or vagus nerve stimulation could be beneficial in alleviating disease progression. In this review, we summarize the pathogenic mechanisms linked with the gut-liver-brain axis in the development and progression of brain disorders associated with ALD in both experimental models and humans. Further, we discuss the therapeutic potential and future research directions as they relate to the gut-liver-brain axis.
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20
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Lee Y, Kim Y, Leatherdale ST, Chung H. Multilevel Latent Class Profile Analysis: An Application to Stage-Sequential Patterns of Alcohol Use in a Sample of Canadian Youth. Eval Health Prof 2021; 44:50-60. [PMID: 33511854 DOI: 10.1177/0163278721989547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recently, latent class analysis (LCA) and its variants have been proposed to identify subgroups of individuals who follow similar sequential patterns of latent class membership for longitudinal study. A primary assumption underlying the family of LCA is that individual observations are independent. In many applications, however, particularly in research on adolescent substance use, individuals are often dependent because of multilevel data structure, where the unit of observation (e.g., students) is nested in higher level units (e.g., schools). In this study, we propose multilevel latent class profile analysis (MLCPA), which will allow us to analyze the longitudinal data with a multilevel structure under the framework of LCA. We apply an MLCPA using data from the COMPASS study, a 9-year study funded by the Canadian Institutes of Health Research and Health Canada, in order to identify representative sequential drinking patterns of Canadian youth and investigate whether these sequential patterns vary across schools. The MLCPA identified three common student-level drinking behaviors: non-drinker, ever lifetime, and binge drinker. The sequence of drinking behaviors can be classified into one of three longitudinal sequential patterns: non-drinking stayer, light drinking advancer, and heavy drinking advancer. In addition, MLCPA uncovered two latent clusters (low-use school and high-use school) out of 64 schools in Ontario and Alberta based on the prevalences of sequential drinking patterns.
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Affiliation(s)
- Yunah Lee
- Department of Statistics, 34973Korea University, Seoul, South Korea
| | - Youngsun Kim
- Department of Statistics, 34973Korea University, Seoul, South Korea
| | - Scott T Leatherdale
- School of Public Health and Health Systems, 8430University of Waterloo, Canada
| | - Hwan Chung
- Department of Statistics, 34973Korea University, Seoul, South Korea
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21
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Jasilionis D, Leon DA, Pechholdová M. Impact of alcohol on mortality in Eastern Europe: Trends and policy responses. Drug Alcohol Rev 2020; 39:785-789. [PMID: 33222293 DOI: 10.1111/dar.13167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 08/24/2020] [Indexed: 12/19/2022]
Abstract
Within the global context, Eastern Europe has been repeatedly identified as the area with the highest levels of alcohol-related health harms. Although the Berlin Wall fell in 1989, and the Soviet Union collapsed soon afterwards, alcohol-related mortality in Eastern Europe remains far higher than in Western Europe. However, despite the high burden of alcohol harm and mortality in Eastern Europe, with the partial exception of Russia, relatively little is known about the country-specific impact of alcohol on health and mortality and the various policy responses to it. In response to this, an international symposium was held in Vilnius, Lithuania in June 2017 entitled Persisting burden of alcohol in Central and Eastern Europe: recent evidence and measurement issues. This special section of Drug and Alcohol Review is based on a selection of the papers presented at this symposium, providing for the first time a broad overview of the problem of alcohol-related mortality in a diverse range of Eastern European countries linked to a description and analysis of alcohol control initiatives that have been developed. While there is strong evidence of the influence of history, culture and education across European countries having a profound and persistent effect on differences in drinking patterns and preferences, there is, nevertheless, evidence that effective policy responses have been mounted in a range of countries.
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Affiliation(s)
- Domantas Jasilionis
- Max Planck Institute for Demographic Research, Rostock, Germany.,Demographic Research Centre, Vytautas Magnus University, Kaunas, Lithuania
| | - David A Leon
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.,Department of Community Medicine, UiT Arctic University of Norway, Tromsø, Norway
| | - Markéta Pechholdová
- Department of Demography, Faculty of Informatics and Statistics, University of Economics, Prague, Czech Republic
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Ames NJ, Barb JJ, Schuebel K, Mudra S, Meeks BK, Tuason RTS, Brooks AT, Kazmi N, Yang S, Ratteree K, Diazgranados N, Krumlauf M, Wallen GR, Goldman D. Longitudinal gut microbiome changes in alcohol use disorder are influenced by abstinence and drinking quantity. Gut Microbes 2020; 11:1608-1631. [PMID: 32615913 PMCID: PMC7527072 DOI: 10.1080/19490976.2020.1758010] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/26/2020] [Accepted: 04/13/2020] [Indexed: 02/08/2023] Open
Abstract
Many patients with alcohol use disorder (AUD) consume alcohol chronically and in large amounts that alter intestinal microbiota, damage the gastrointestinal tract, and thereby injure other organs via malabsorption and intestinal inflammation. We hypothesized that alcohol consumption and subsequent abstinence would change the gut microbiome in adults admitted to a treatment program. Stool and oral specimens, diet data, gastrointestinal assessment scores, anxiety, depression measures and drinking amounts were collected longitudinally for up to 4 weeks in 22 newly abstinent inpatients with AUD who were dichotomized as less heavy drinkers (LHD, <10 drinks/d) and very heavy drinkers (VHD, 10 or more drinks/d). Next-generation 16 S rRNA gene sequencing was performed to measure the gut and oral microbiome at up to ten time points/subject and LHD and VHD were compared for change in principal components, Shannon diversity index and specific genera. The first three principal components explained 46.7% of the variance in gut microbiome diversity across time and all study subjects, indicating the change in gut microbiome following abstinence. The first time point was an outlier in three-dimensional principal component space versus all other time points. The gut microbiota in LHD and VHD were significantly dissimilar in change from day 1 to day 5 (p = .03) and from day 1 to week 3 (p = .02). The VHD drinking group displayed greater change from baseline. The Shannon diversity index of the gut microbiome changed significantly during abstinence in five participants. In both groups, the Shannon diversity was lower in the oral microbiome than gut. Ten total genera were shared between oral and stool in the AUD participants. These data were compared with healthy controls from the Human Microbiome Project to investigate the concept of a core microbiome. Rapid changes in gut microbiome following abstinence from alcohol suggest resilience of the gut microbiome in AUD and reflects the benefits of refraining from the highest levels of alcohol and potential benefits of abstinence.
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Affiliation(s)
- Nancy J. Ames
- Clinical Center Nursing Department, NIH, Bethesda, MD, USA
| | - Jennifer J. Barb
- Clinical Center Nursing Department, NIH, Bethesda, MD, USA
- Center for Information Technology, NIH, Bethesda, MD, USA
| | - Kornel Schuebel
- Office of the Clinical Director, Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Sarah Mudra
- Clinical Center Nursing Department, NIH, Bethesda, MD, USA
| | | | - Ralph Thadeus S. Tuason
- Clinical Center Nursing Department, NIH, Bethesda, MD, USA
- Unites States Public Health Service Commissioned Corps, Bethesda, MD, USA
| | | | - Narjis Kazmi
- Clinical Center Nursing Department, NIH, Bethesda, MD, USA
| | - Shanna Yang
- Clinical Center Nutrition Department, NIH, Bethesda, MD, USA
| | - Kelly Ratteree
- Unites States Public Health Service Commissioned Corps, Bethesda, MD, USA
- Clinical Center Nutrition Department, NIH, Bethesda, MD, USA
| | - Nancy Diazgranados
- Office of the Clinical Director, Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Michael Krumlauf
- Clinical Center Nursing Department, NIH, Bethesda, MD, USA
- Unites States Public Health Service Commissioned Corps, Bethesda, MD, USA
| | | | - David Goldman
- Office of the Clinical Director, Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
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Pechholdová M, Jasilionis D. Contrasts in alcohol-related mortality in Czechia and Lithuania: Analysis of time trends and educational differences. Drug Alcohol Rev 2020; 39:846-856. [PMID: 32909686 PMCID: PMC7756221 DOI: 10.1111/dar.13157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/18/2020] [Accepted: 07/29/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Globally, Czechia and Lithuania are among the top-ranking countries in terms of high alcohol consumption. This study highlights notable contrasts in temporal trends in alcohol-related mortality and identifies country-specific patterns in educational differences. DESIGN AND METHODS The study uses harmonised cause-of-death series from the Human Cause of Death Database. Mortality disparities by education were assessed using census-linked mortality data. Directly standardised death rates were used to estimate levels of national and group-specific mortality. Relative and absolute mortality differences by education were assessed by range-type measures (Poisson regression mortality ratios and rate differences) and Gini-type measures. RESULTS Between 1994-1995 and 2016, the absolute difference between Czechia and Lithuania in terms of alcohol-related age-standardised death rates (per 1 000 000) decreased from 450 for males and 130 for females to 76 in males and 11 in females. In both countries, alcohol-related mortality was markedly higher among persons of lower education levels. Lithuanian males experienced the highest absolute inequalities measured by rate difference between the low and high educated (740 per million), while Lithuanian females showed the most pronounced relative inequalities (6.70-fold difference between low and high educated). The corresponding figures were less than half for Czechia. DISCUSSION AND CONCLUSIONS Reducing educational disparities in alcohol-related mortality within both countries would have a substantial impact on overall levels. Policies aimed at targeting the lowest priced and illegal alcohols and reducing levels of harmful drinking should be a priority, especially in Lithuania.
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Affiliation(s)
- Markéta Pechholdová
- Department of Demography, Faculty of Informatics and Statistics, University of Economics, Prague, Czech Republic
| | - Domantas Jasilionis
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany.,Demographic Research Centre, Faculty of Social Sciences, Vytautas Magnus University, Kaunas, Lithuania
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24
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Moeller SJ, Platt JM, Wu M, Goodwin RD. Perception of treatment need among adults with substance use disorders: Longitudinal data from a representative sample of adults in the United States. Drug Alcohol Depend 2020; 209:107895. [PMID: 32078975 PMCID: PMC7418940 DOI: 10.1016/j.drugalcdep.2020.107895] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 01/31/2020] [Accepted: 02/04/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Most individuals with substance use disorders (SUDs) do not seek treatment. Lack of perceived treatment need (PTN) is one contributing factor, but little is known about PTN over time. We estimated whether PTN changed over three years among those with SUDs in the United States and identified select variables, including sociodemographics and symptom burden, that predict malleability vs. stability of PTN. METHODS Data were from Waves 1 (collected 2001-2002) and 2 (collected 2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC); 1695 adults who met DSM criteria for alcohol or non-alcohol SUD at Wave 1 and maintained ≥1 diagnostic symptom at Wave 2 were included. RESULTS Most individuals with SUDs (77.2%) did not perceive a need for treatment at Wave 1 baseline. Only about 1 in 8 individuals not perceiving a need for treatment in Wave 1 came to perceive a need in Wave 2 (adjusted odds ratio = 0.18, 99% confidence interval = 0.11-0.29). In contrast, about half the individuals who perceived a need for treatment in Wave 1 no longer did so in Wave 2, despite maintaining ≥1 SUD symptom. Married respondents, and respondents with more SUD symptoms, were more likely to transition from low- to high-PTN status three years later. Respondents with incomes >$35,000 were less likely to transition to high-PTN status three years later. CONCLUSIONS PTN was more likely to decline than increase over time. Low PTN appears to be stable among adults with SUDs in the United States, presenting a potentially enduring barrier to treatment-seeking.
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Affiliation(s)
- Scott J. Moeller
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY 11794, USA
| | - Jonathan M. Platt
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Melody Wu
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Renee D. Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA,Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY 10027, USA
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Meier BJ, El-Gabri D, Friedman K, Mvungi M, Mmbaga BT, Nickenig Vissoci JR, Staton CA. Perceptions of alcohol use among injury patients and their family members in Tanzanian society. Alcohol 2020; 83:9-15. [PMID: 31195127 PMCID: PMC7197291 DOI: 10.1016/j.alcohol.2019.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 11/16/2022]
Abstract
Alcohol is one of the leading causes of death and disability worldwide. Rates of alcohol abuse in Moshi, Tanzania, are about 2.5 times higher than the Tanzanian average. We sought to qualitatively assess the perceptions of alcohol use among injury patients in Moshi, including availability, consumption patterns, abuse, and treatments. Participants were Emergency Department injury patients, their families, and community advisory board members. Participants were included if they were ≥18 years of age, a patient or patient's family member seeking care at the Kilimanjaro Christian Medical Center Emergency Department, Moshi, Tanzania, for an acute injury, clinically sober at the time of enrollment, medically stable, able to communicate in Swahili and consented to participate. Focus group discussions were audiotaped, transcribed, translated, and analyzed in parallel using an inductive thematic content analysis approach. Resultant themes were then reanalyzed to ensure internal homogeneity and external heterogeneity. Fourteen focus group discussions, with a total of 104 participants (40 patients, 50 family members, 14 community advisory board members), were conducted. Major themes resulting from the analysis included: 1) Early/repeated exposure; 2) Moderate use as a social norm with positive attributes; 3) Complications of abuse are widely stigmatized; and 4) Limited knowledge of availability of treatment. Our findings suggest that, among our unique injury population and their families, despite the normalization of alcohol-related behaviors, there is strong stigma toward complications stemming from excess alcohol use. Overall, resources for alcohol treatment and cessation, although broadly desired, are unknown to the injury population.
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Affiliation(s)
- Brian J Meier
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA; Duke Emergency Medicine, Duke University Medical Center, 2301 Erwin Road, DUMC Box 3096, Durham, NC, 27710, USA
| | - Deena El-Gabri
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA
| | - Kaitlyn Friedman
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA
| | - Mark Mvungi
- Kilimanjaro Christian Medical Center, P.O. Box 3010, Moshi, Tanzania
| | - Blandina T Mmbaga
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA; Kilimanjaro Christian Medical Center, P.O. Box 3010, Moshi, Tanzania; Kilimanjaro Clinical Research Institute and Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - João Ricardo Nickenig Vissoci
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA; Duke Emergency Medicine, Duke University Medical Center, 2301 Erwin Road, DUMC Box 3096, Durham, NC, 27710, USA; Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Duke University Medical Center, Durham, NC, 27710, USA
| | - Catherine A Staton
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA; Duke Emergency Medicine, Duke University Medical Center, 2301 Erwin Road, DUMC Box 3096, Durham, NC, 27710, USA; Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Duke University Medical Center, Durham, NC, 27710, USA.
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26
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Gilmore W, Chikritzhs T, McManus H, Kaldor J, Guy R. The Association between the Australian Alcopops Tax and National Chlamydia Rates among Young People-an Interrupted Time Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1343. [PMID: 32093092 PMCID: PMC7068511 DOI: 10.3390/ijerph17041343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 01/28/2023]
Abstract
A national tax increase, which became known as the "alcopops tax", was introduced in Australia on the 27th April 2008 on ready-to-drink alcoholic beverages, which are consumed predominantly by young people. The affordability of alcohol has been identified as the strongest environmental driver of alcohol consumption, and alcohol consumption is a well-known risk factor in the spread of sexually transmitted infections via its association with sexual risk-taking. We conducted a study to investigate whether there was any association between the introduction of the tax and changes in national chlamydia rates: (i) notification rates (diagnoses per 100,000 population; primary outcome and standard approach in alcohol taxation studies), and (ii) test positivity rates (diagnoses per 100 tests; secondary outcome) among 15-24 and 25-34-year-olds, using interrupted time series analysis. Gender- and age-specific chlamydia trends among those 35 and older were applied as internal control series and gender- and age-specific consumer price index-adjusted per capita income trends were controlled for as independent variables. We hypothesised that the expected negative association between the tax and chlamydia notification rates might be masked due to increasing chlamydia test counts over the observation period (2000 to 2016). We hypothesised that the association between the tax and chlamydia test positivity rates would occur as an immediate level decrease, as a result of a decrease in alcohol consumption, which, in turn, would lead to a decrease in risky sexual behaviour and, hence, chlamydia transmission. None of the gender and age-specific population-based rates indicated a significant immediate or lagged association with the tax. However, we found an immediate decrease in test positivity rates for 25-34-year-old males (27% reduction-equivalent to 11,891 cases prevented post-tax) that remained detectable up to a lag of six months and a decrease at a lag of six months for 15-24-year-old males (31% reduction-equivalent to 16,615 cases prevented) following the tax. For no other gender or age combination did the change in test positivity rates reach significance. This study adds to the evidence base supporting the use of alcohol taxation to reduce health-related harms experienced by young people and offers a novel method for calculating sexually transmitted infection rates for policy evaluation.
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Affiliation(s)
- William Gilmore
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Australia;
| | - Tanya Chikritzhs
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Australia;
| | - Hamish McManus
- Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, High Street, Kensington NSW 2052, Australia; (H.M.); (J.K.); (R.G.)
| | - John Kaldor
- Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, High Street, Kensington NSW 2052, Australia; (H.M.); (J.K.); (R.G.)
| | - Rebecca Guy
- Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, High Street, Kensington NSW 2052, Australia; (H.M.); (J.K.); (R.G.)
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27
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Gohari MR, Cook RJ, Dubin JA, Leatherdale ST. Identifying patterns of alcohol use among secondary school students in Canada: A multilevel latent class analysis. Addict Behav 2020; 100:106120. [PMID: 31622948 DOI: 10.1016/j.addbeh.2019.106120] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Harm from alcohol use depend not only on the volume of consumption but also on drinking patterns. This study identifies patterns of alcohol consumption in youth and investigates how these patterns vary across schools and whether individual- and school-level factors are associated with engagement in patterns of alcohol consumption. METHODS The sample consists of 45,298 grade 9 to 12 students attending 89 secondary schools across Ontario and Alberta (Canada), who participated in the COMPASS study during the school year 2013-14. The frequency of drinking, the frequency of binge drinking, and age of alcohol-use initiation were used to characterize alcohol use patterns. RESULTS The multilevel latent class analysis identified 4 student-level latent groups and 2 school-level latent groups. Student-level groups of youth were characterized as non-drinkers (44.2%), light drinkers (41.8%), regular drinkers (11.1%), and heavy drinkers (2.9%). Two groups of schools were characterized as either low-use (44.9%) or high-use (55.1%) schools, with significantly different probability of membership in each student-level group. Male students (OR 1.30) and upper grades (OR 1.93) were significantly associated with membership in higher use groups of individuals. The median household income and the number of off-premise alcohol outlets had no significant association with patterns of alcohol consumption within schools. CONCLUSIONS A large proportion of students reported a level of drinking, suggesting that, in addition to delaying the onset of alcohol use, interventions need to encourage drinker students to quit drinking or lower their consumption. Schools may need to select and/or alter external interventions according to the dominant patterns of alcohol use among their students.
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Affiliation(s)
- Mahmood R Gohari
- School of Public Health and Health Systems, University of Waterloo, Canada.
| | - Richard J Cook
- Department of Statictics and Actuarial Science, University of Waterloo, Canada.
| | - Joel A Dubin
- Department of Statistics and Actuarial Science And School of Public Health and Health Systems, University of Waterloo, Canada.
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Mair C, Frankeberger J, Gruenewald PJ, Morrison CN, Freisthler B. Space and Place in Alcohol Research. CURR EPIDEMIOL REP 2019; 6:412-422. [PMID: 34295613 PMCID: PMC8294477 DOI: 10.1007/s40471-019-00215-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW To summarize the recent literature on social and physical environments and their links to alcohol use and identify empirical research strategies that will lead to a better understanding of alcohol use in contexts. RECENT FINDINGS Recent research has continued to describe the importance of neighborhood and regional contexts on alcohol use, while a smaller emerging scientific literature assesses the impacts of contexts on drinking. SUMMARY The dynamic, longitudinal, and multiscale processes by which social and physical structures affect social interactions and substance use have not yet been uncovered or quantified. In order to understand and quantify these processes, assessments of exposures (e.g., how individuals use space) and risks within specific locations are essential. Methods to better assess these exposures and risks include model-based survey approaches, ecological momentary assessment (EMA) and other forms of ecologically- and temporally-specific analyses, affiliation network analyses, simulation models, and qualitative/multi-methods studies.
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Affiliation(s)
- Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
| | - Jessica Frankeberger
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
| | - Paul J Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation
| | - Christopher N Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University
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29
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Distinct metabolic adaptation of liver circadian pathways to acute and chronic patterns of alcohol intake. Proc Natl Acad Sci U S A 2019; 116:25250-25259. [PMID: 31757851 DOI: 10.1073/pnas.1911189116] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Binge drinking and chronic exposure to ethanol contribute to alcoholic liver diseases (ALDs). A potential link between ALDs and circadian disruption has been observed, though how different patterns of alcohol consumption differentially impact hepatic circadian metabolism remains virtually unexplored. Using acute versus chronic ethanol feeding, we reveal differential reprogramming of the circadian transcriptome in the liver. Specifically, rewiring of diurnal SREBP transcriptional pathway leads to distinct hepatic signatures in acetyl-CoA metabolism that are translated into the subcellular patterns of protein acetylation. Thus, distinct drinking patterns of alcohol dictate differential adaptation of hepatic circadian metabolism.
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30
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Maguire D, Talwar D, Burns A, Catchpole A, Stefanowicz F, Robson G, Ross DP, Young D, Ireland A, Forrest E, Galloway P, Adamson M, Colgan E, Bell H, Orr L, Kerr JL, Roussis X, McMillan DC. A prospective evaluation of thiamine and magnesium status in relation to clinicopathological characteristics and 1-year mortality in patients with alcohol withdrawal syndrome. J Transl Med 2019; 17:384. [PMID: 31752901 PMCID: PMC6873772 DOI: 10.1186/s12967-019-02141-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/15/2019] [Indexed: 12/12/2022] Open
Abstract
Background Alcohol withdrawal syndrome (AWS) is routinely treated with B-vitamins. However, the relationship between thiamine status and outcome is rarely examined. The aim of the present study was to examine the relationship between thiamine and magnesium status in patients with AWS. Methods Patients (n = 127) presenting to the Emergency Department with AWS were recruited to a prospective observational study. Blood samples were drawn to measure whole blood thiamine diphosphate (TDP) and serum magnesium concentrations. Routine biochemistry and haematology assays were also conducted. The Glasgow Modified Alcohol Withdrawal Score (GMAWS) measured severity of AWS. Seizure history and current medications were also recorded. Results The majority of patients (99%) had whole blood TDP concentration within/above the reference interval (275–675 ng/gHb) and had been prescribed thiamine (70%). In contrast, the majority of patients (60%) had low serum magnesium concentrations (< 0.75 mmol/L) and had not been prescribed magnesium (93%). The majority of patients (66%) had plasma lactate concentrations above 2.0 mmol/L. At 1 year, 13 patients with AWS had died giving a mortality rate of 11%. Male gender (p < 0.05), BMI < 20 kg/m2 (p < 0.01), GMAWS max ≥ 4 (p < 0.05), elevated plasma lactate (p < 0.01), low albumin (p < 0.05) and elevated serum CRP (p < 0.05) were associated with greater 1-year mortality. Also, low serum magnesium at time of recruitment to study and low serum magnesium at next admission were associated with higher 1-year mortality rates, (84% and 100% respectively; both p < 0.05). Conclusion The prevalence of low circulating thiamine concentrations were rare and it was regularly prescribed in patients with AWS. In contrast, low serum magnesium concentrations were common and not prescribed. Low serum magnesium was associated more severe AWS and increased 1-year mortality.
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Affiliation(s)
- Donogh Maguire
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK. .,Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK.
| | - Dinesh Talwar
- The Scottish Trace Element and Micronutrient Diagnostic and Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
| | - Alana Burns
- The Scottish Trace Element and Micronutrient Diagnostic and Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK.,Department of Biochemistry, Queen Elizabeth University Hospital, Glasgow, G51 4TF, Scotland, UK
| | - Anthony Catchpole
- The Scottish Trace Element and Micronutrient Diagnostic and Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
| | - Fiona Stefanowicz
- The Scottish Trace Element and Micronutrient Diagnostic and Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
| | - Gordon Robson
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - David P Ross
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK.,Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
| | - David Young
- Department of Mathematics and Statistics, University of Strathclyde, 26 Richmond Street, Glasgow, G1 1XH, Scotland, UK
| | - Alastair Ireland
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Ewan Forrest
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, G4 0SF, Scotland, UK
| | - Peter Galloway
- Department of Biochemistry, Queen Elizabeth University Hospital, Glasgow, G51 4TF, Scotland, UK
| | - Michael Adamson
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Eoghan Colgan
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Hannah Bell
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Lesley Orr
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Joanna-Lee Kerr
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Xen Roussis
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
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Maguire D, Ross DP, Talwar D, Forrest E, Naz Abbasi H, Leach JP, Woods M, Zhu LY, Dickson S, Kwok T, Waterson I, Benson G, Scally B, Young D, McMillan DC. Low serum magnesium and 1-year mortality in alcohol withdrawal syndrome. Eur J Clin Invest 2019; 49:e13152. [PMID: 31216056 DOI: 10.1111/eci.13152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/31/2019] [Accepted: 06/17/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND In 2014, the WHO reported that 6% of all deaths were attributable to excess alcohol consumption. The aim of the present study was to examine the relationship between serum magnesium concentrations and mortality in patients with alcohol withdrawal syndrome (AWS). MATERIALS AND METHODS A retrospective review of 700 patients with documented evidence of previous AWS indicating a requirement for benzodiazepine prophylaxis or evidence of alcohol withdrawal syndrome between November 2014 and March 2015. RESULTS Of 380 patients included in the sample analysis, 64 (17%) were dead at 1 year following the time of treatment for AWS. The majority of patients had been prescribed thiamine (77%) and a proton pump inhibitor (66%). In contrast, the majority of patients had low circulating magnesium concentrations (<0.75 mmol/L) (64%) and had not been prescribed magnesium (90%). The median age of death at one year was 55 years (P = 0.002). On univariate analysis, age (P < 0.05), GMAWS (P < 0.05), BDZ (P < 0.05), bilirubin (P < 0.001), alkaline phosphatase (P < 0.001), albumin (P < 0.001), CRP (P < 0.05), AST:ALT ratio >2 (P < 0.001), sodium (P < 0.05), magnesium (P < 0.001), platelets (P < 0.05) and the use of proton pump inhibitor medication (P < 0.001) were associated with death at 1 year. On multivariate binary logistic regression analysis, age > 50 years (OR 3.37, 95% CI 1.52-7.48, P < 0.01), AST:ALT ratio >2 (OR 3.10, 95% CI 1.38-6.94, P < 0.01) and magnesium < 0.75 mmol/L (OR 4.11, 95% CI 1.3-12.8, P < 0.05) remained independently associated with death at 1 year. CONCLUSION Overall, 1-year mortality was significantly higher among those patients who were magnesium deficient (<0.75 mmol/L) when compared to those who were replete (≥0.75 mmol/L; P < 0.001).
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Affiliation(s)
- Donogh Maguire
- Emergency Medicine Department, Glasgow Royal Infirmary, Glasgow, UK.,Academic Unit of Surgery, School of Medicine, Royal Infirmary, University of Glasgow, Glasgow, UK
| | - David P Ross
- Emergency Medicine Department, Glasgow Royal Infirmary, Glasgow, UK.,Academic Unit of Surgery, School of Medicine, Royal Infirmary, University of Glasgow, Glasgow, UK
| | - Dinesh Talwar
- The Scottish Trace Elements and Micronutrient Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, UK
| | - Ewan Forrest
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - Hina Naz Abbasi
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK
| | - John-Paul Leach
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK.,School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Marylynne Woods
- School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Luke Y Zhu
- School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Scott Dickson
- School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Tong Kwok
- School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Isla Waterson
- School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - George Benson
- Alcohol and Drug Recovery Service, Greater Glasgow and Clyde, Dykebar hospital, Glasgow, UK
| | - Benjamin Scally
- Emergency Department, Edinburgh Royal Infirmary, Edinburgh, UK
| | - David Young
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, Royal Infirmary, University of Glasgow, Glasgow, UK
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Abstract
Both acute intoxication and longer-term cumulative ingestion of alcohol negatively impact the metabolic phenotype of both skeletal and cardiac muscle, independent of overt protein calorie malnutrition, resulting in loss of skeletal muscle strength and cardiac contractility. In large part, these alcohol-induced changes are mediated by a decrease in protein synthesis that in turn is governed by impaired activity of a protein kinase, the mechanistic target of rapamycin (mTOR). Herein, we summarize recent advances in understanding mTOR signal transduction, similarities and differences between the effects of alcohol on this central metabolic controller in skeletal muscle and in the heart, and the effects of acute versus chronic alcohol intake. While alcohol-induced alterations in global proteolysis via activation of the ubiquitin-proteasome pathway are equivocal, emerging data suggest alcohol increases autophagy in muscle. Further studies are necessary to define the relative contributions of these bidirectional changes in protein synthesis and autophagy in the etiology of alcoholic myopathy in skeletal muscle and the heart.
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Affiliation(s)
- Scot R Kimball
- Department of Cellular and Molecular Physiology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, USA; ,
| | - Charles H Lang
- Department of Cellular and Molecular Physiology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, USA; ,
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Gilmore IT. Influence of Societal Restraints on Alcohol Use and Alcohol-Related Liver Disease. Clin Liver Dis (Hoboken) 2019; 13:128-130. [PMID: 31236259 PMCID: PMC6544413 DOI: 10.1002/cld.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 09/22/2018] [Indexed: 02/04/2023] Open
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Tobias JSP, da Silva DLF, Ferreira PAM, da Silva AAM, Ribeiro RS, Ferreira ASP. Alcohol use and associated factors among physicians and nurses in northeast Brazil. Alcohol 2019; 75:105-112. [PMID: 30640073 DOI: 10.1016/j.alcohol.2018.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 07/06/2018] [Accepted: 07/06/2018] [Indexed: 12/16/2022]
Abstract
The consequences of alcohol use are closely related to its pattern of intake. The aim of this study is to analyze the pattern of alcohol use by doctors and nurses. Associated co-factors have also been considered. We calculated a representative sample of doctors and nurses from two hospitals in Maranhão, Northeastern Brazil. The Alcohol Use Disorders Identification Test (AUDIT) was employed to assess patterns of alcohol consumption. A score ≥8 was defined as alcohol misuse, and an answer to question number 3 > 1 was indicative of heavy episodic drinking (HED). In order to identify factors associated with HED and alcohol misuse, bivariate and multiple logistic regression analyses were performed with SPSS v20.0. A sample of 510 professionals was examined and 25% of those were abstainers; among those who had drinks containing alcohol, 86% were classified as low-risk alcohol use, scoring lower than 8, while 10.6% of the whole sample was categorized as alcohol misusers, scoring more than 8. The habit of smoking (OR = 6.02; CI: 1.71-21.16), following the Catholic religion (OR = 3.55; CI: 2.47-8.58), and also gender (OR = 3.09; CI: 1.68-5.71) were independently associated with alcohol misuse. HED was found in 14.3%. Younger age (OR = 0.96; CI: 0.92-0.98), male gender (OR = 5.13; CI: 2.55-10.30), the Catholic religion (OR = 3.22; CI: 1.44-7.21), and smoking habits (OR = 5.25; CI: 1.26-21.75) were associated with HED. Therefore, physicians and nurses have a lesser prevalence of abstainers, similar rates of alcohol misuse, and greater prevalence of HED when compared to the general Brazilian adult population. More studies involving these professionals need to be carried out in other Brazilian states in order to determine whether the results can be understood as widespread throughout the country.
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Epidemiology of Alcohol Consumption and Societal Burden of Alcoholism and Alcoholic Liver Disease. Clin Liver Dis 2019; 23:39-50. [PMID: 30454831 DOI: 10.1016/j.cld.2018.09.011] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Alcohol abuse is a major determinant of public health outcomes. Worldwide data from 2016 indicate that alcohol is the seventh leading risk factor in terms of disability-adjusted life years, an increase of more than 25% from 1990 to 2016. Understanding the epidemiology of alcoholic liver disease, including the regional variations in consumption and public policy, is an area of active research. In countries where the per capita consumption of alcohol decreases, there appears to be an associated decrease in disease burden. Given alcohol's health burden, an increased focus on alcohol control policies is needed.
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Hydes T, Gilmore W, Sheron N, Gilmore I. Treating alcohol-related liver disease from a public health perspective. J Hepatol 2019; 70:223-236. [PMID: 30658724 DOI: 10.1016/j.jhep.2018.10.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 02/06/2023]
Abstract
Herein, we describe the evolving landscape of alcohol-related liver disease (ALD) including the current global burden of disease and cost to working-aged people in terms of death and disability, in addition to the larger spectrum of alcohol-related heath complications and its wider impact on society. We further review the most effective and cost-effective public health policies at both a population and individual level. Currently, abstinence is the only effective treatment for ALD, and yet because the majority of ALD remains undetected in the community abstinence is initiated too late to prevent premature death in the majority of cases. We therefore hope that this review will help inform clinicians of the "public health treatment options" for ALD to encourage engagement with policy makers and promote community-based hepatology as a speciality, expanding our patient cohort to allow early detection, and thereby a reduction in the enormous morbidity and mortality associated with this disease.
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Affiliation(s)
- Theresa Hydes
- Department of Gastroenterology and Hepatology, University Hospital Southampton NHS Foundation Trust, United Kingdom
| | - William Gilmore
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Australia
| | - Nick Sheron
- Department of Gastroenterology and Hepatology, University Hospital Southampton NHS Foundation Trust, United Kingdom.
| | - Ian Gilmore
- University of Liverpool, Liverpool Science Park, United Kingdom
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37
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Ezaz G, Tapper EB. Driving in the dark: cirrhosis in young adults. Lancet Gastroenterol Hepatol 2018; 4:189-190. [PMID: 30573391 DOI: 10.1016/s2468-1253(18)30419-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Ghideon Ezaz
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Elliot B Tapper
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
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38
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Stockings E, Bartlem K, Hall A, Hodder R, Gilligan C, Wiggers J, Sherker S, Wolfenden L. Whole-of-community interventions to reduce population-level harms arising from alcohol and other drug use: a systematic review and meta-analysis. Addiction 2018; 113:1984-2018. [PMID: 29806876 DOI: 10.1111/add.14277] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/08/2018] [Accepted: 05/23/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Whole-of-community interventions aim to reduce alcohol and other drug (AOD) use and harms by mobilizing community leaders, organizations and policy-makers to respond effectively to AOD use. The aim of this review is to estimate the effectiveness of whole-of-community interventions in reducing population-level harms arising from AOD use. DESIGN A systematic review of electronic databases CENTRAL, Embase, Medline, Medline in Process and PsycINFO was conducted from database inception to August 2017. Eligible trials had a parallel comparison group, implemented interventions in two or more community settings, and reported data on AOD use or harms. SETTING Intervention settings included schools, sporting clubs, police and law enforcement agencies, community centres, local media and retail premises. PARTICIPANTS Twenty-four trials from 63 publications were included (n = 249 125 participants). MEASUREMENTS Outcomes from AOD consumption (quantity and frequency), AOD-related crime and AOD-related accidents, injuries and hospital admissions. Data were pooled using random-effects inverse variance meta-analysis in Review Manager version 5.3. FINDINGS Risk of bias was mostly high, due to lack of random allocation, selective reporting and significant attrition. Meta-analyses indicated significant reductions in risky drinking [Alcohol Use Disorders Identification Scale (AUDIT) > 8; three trials (7 data points), relative risk (RR) = 0.78, 95% confidence interval (CI) = 0.62-0.99)], but found no impact on past-month alcohol use (five trials, RR = 0.95, 95% CI = 0.89-1.02), binge drinking (five trials, RR = 0.97, 95% CI = 0.89-1.06) or 12-month marijuana use (two trials, RR = 0.98, 95% CI = 0.86-1.11). Narrative synthesis indicated some reductions in AOD-related assault rates and arrests, but were equivocal for quantity of alcohol consumed, 12-month illicit drug use, assault or abuse, motor vehicle accidents and hospital admissions. CONCLUSIONS Interventions to reduce alcohol and other drug use and harms applied to whole communities have resulted so far in small reductions in risky alcohol consumption, but have had little impact upon past month alcohol use, binge drinking or 12-month marijuana use and the studies have been subject to high risk of bias.
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Affiliation(s)
- Emily Stockings
- National Drug and Alcohol Research Centre, UNSW Sydney, Randwick, NSW, Australia
| | - Kate Bartlem
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Psychology, University of Newcastle, Callaghan, NSW, Australia
| | - Alix Hall
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia
| | - Rebecca Hodder
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia
| | - Conor Gilligan
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia
| | - John Wiggers
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia
| | - Shauna Sherker
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Alcohol and Drug Foundation, North Melbourne, Victoria, Australia
| | - Luke Wolfenden
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia
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39
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Xu D, Han H, He Y, Lee H, Wu D, Liu F, Liu X, Liu Y, Lu Y, Ji C. A Hepatocyte-Mimicking Antidote for Alcohol Intoxication. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2018; 30:e1707443. [PMID: 29638019 PMCID: PMC6386471 DOI: 10.1002/adma.201707443] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/13/2018] [Indexed: 05/24/2023]
Abstract
Alcohol intoxication causes serious diseases, whereas current treatments are mostly supportive and unable to remove alcohol efficiently. Upon alcohol consumption, alcohol is sequentially oxidized to acetaldehyde and acetate by the endogenous alcohol dehydrogenase and aldehyde dehydrogenase, respectively. Inspired by the metabolism of alcohol, a hepatocyte-mimicking antidote for alcohol intoxication through the codelivery of the nanocapsules of alcohol oxidase (AOx), catalase (CAT), and aldehyde dehydrogenase (ALDH) to the liver, where AOx and CAT catalyze the oxidation of alcohol to acetaldehyde, while ALDH catalyzes the oxidation of acetaldehyde to acetate. Administered to alcohol-intoxicated mice, the antidote rapidly accumulates in the liver and enables a significant reduction of the blood alcohol concentration. Moreover, blood acetaldehyde concentration is maintained at an extremely low level, significantly contributing to liver protection. Such an antidote, which can eliminate alcohol and acetaldehyde simultaneously, holds great promise for the treatment of alcohol intoxication and poisoning and can provide therapeutic benefits.
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Affiliation(s)
- Duo Xu
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, CA 90095, USA,
| | - Hui Han
- Department of Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA,
| | - Yuxin He
- Department of Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA,
| | - Harrison Lee
- Department of Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA,
| | - Di Wu
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, CA 90095, USA,
| | - Fang Liu
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, CA 90095, USA,
| | - Xiangsheng Liu
- California NanoSystem Institute, Los Angeles, CA 90095, USA
| | - Yang Liu
- State Key Laboratory of Medicinal Chemical Biology, Institute of Polymer Chemistry, College of Chemistry, Nankai University, Tianjin 300071, China
| | - Yunfeng Lu
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, CA 90095, USA,
| | - Cheng Ji
- Department of Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA,
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Koyyada R, Latchooman N, Jonaitis J, Ayoub SS, Corcoran O, Casalotti SO. Naltrexone Reverses Ethanol Preference and Protein Kinase C Activation in Drosophila melanogaster. Front Physiol 2018; 9:175. [PMID: 29593550 PMCID: PMC5861182 DOI: 10.3389/fphys.2018.00175] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 02/20/2018] [Indexed: 12/13/2022] Open
Abstract
Alcohol use disorder (AUD) is a major health, social and economic problem for which there are few effective treatments. The opiate antagonist naltrexone is currently prescribed clinically with mixed success. We have used naltrexone in an established behavioral assay (CAFE) in Drosophila melanogaster that measures the flies' preference for ethanol-containing food. We have confirmed that Drosophila exposed to ethanol develop a preference toward this drug and we demonstrate that naltrexone, in a dose dependant manner, reverses the ethanol-induced ethanol preference. This effect is not permanent, as preference for alcohol returns after discontinuing naltrexone. Additionally, naltrexone reduced the alcohol-induced increase in protein kinase C activity. These findings are of interest because they confirm that Drosophila is a useful model for studying human responses to addictive drugs. Additionally because of the lack of a closely conserved opiate system in insects, our results could either indicate that a functionally related system does exist in insects or that in insects, and potentially also in mammals, naltrexone binds to alternative sites. Identifying such sites could lead to improved treatment strategies for AUD.
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Affiliation(s)
- Rajeswari Koyyada
- Medicines Research Group, School of Health, Sport and Bioscience, University of East London, London, United Kingdom
| | - Nilesh Latchooman
- Medicines Research Group, School of Health, Sport and Bioscience, University of East London, London, United Kingdom
| | - Julius Jonaitis
- Medicines Research Group, School of Health, Sport and Bioscience, University of East London, London, United Kingdom
| | - Samir S Ayoub
- Medicines Research Group, School of Health, Sport and Bioscience, University of East London, London, United Kingdom
| | - Olivia Corcoran
- Medicines Research Group, School of Health, Sport and Bioscience, University of East London, London, United Kingdom
| | - Stefano O Casalotti
- Medicines Research Group, School of Health, Sport and Bioscience, University of East London, London, United Kingdom
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41
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The contribution of alcohol use disorder to decompensated cirrhosis among people with hepatitis C: An international study. J Hepatol 2018; 68:393-401. [PMID: 29107152 DOI: 10.1016/j.jhep.2017.10.019] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/21/2017] [Accepted: 10/07/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS The advent of direct-acting antivirals (DAAs) has led to ambitious targets for hepatitis C virus (HCV) elimination. However, in the context of alcohol use disorder the ability of DAAs to achieve these targets may be compromised. The aim of this study was to evaluate the contribution of alcohol use disorder to HCV-related decompensated cirrhosis in three settings. METHODS HCV notifications from British Columbia, Canada; New South Wales, Australia, and Scotland (1995-2011/2012/2013, respectively) were linked to hospital admissions (2001-2012/2013/2014, respectively). Alcohol use disorder was defined as non-liver-related hospitalisation due to alcohol use. Age-standardised decompensated cirrhosis incidence rates were plotted, associated factors were assessed using Cox regression, and alcohol use disorder-associated population attributable fractions (PAFs) were computed. RESULTS Among 58,487, 84,529, and 31,924 people with HCV in British Columbia, New South Wales, and Scotland, 2,689 (4.6%), 3,169 (3.7%), and 1,375 (4.3%) had a decompensated cirrhosis diagnosis, and 28%, 32%, and 50% of those with decompensated cirrhosis had an alcohol use disorder, respectively. Age-standardised decompensated cirrhosis incidence rates were considerably higher in people with alcohol use disorder in New South Wales and Scotland. Decompensated cirrhosis was independently associated with alcohol use disorder in British Columbia (aHR 1.92; 95% CI 1.76-2.10), New South Wales (aHR 3.68; 95% CI 3.38-4.00) and Scotland (aHR 3.88; 95% CI 3.42-4.40). The PAFs of decompensated cirrhosis-related to alcohol use disorder were 13%, 25%, and 40% in British Columbia, New South Wales and Scotland, respectively. CONCLUSIONS Alcohol use disorder was a major contributor to HCV liver disease burden in all settings, more distinctly in Scotland. The extent to which alcohol use would compromise the individual and population-level benefits of DAA therapy needs to be closely monitored. Countries, where appropriate, must develop strategies combining promotion of DAA treatment uptake with management of alcohol use disorders, if World Health Organization 2030 HCV mortality reduction targets are going to be achieved. LAY SUMMARY The burden of liver disease has been rising among people with hepatitis C globally. The recent introduction of highly effective medicines against hepatitis C (called direct-acting antivirals or DAAs) has brought renewed optimism to the sector. DAA scale-up could eliminate hepatitis C as a public health threat in the coming decades. However, our findings show heavy alcohol use is a major risk factor for liver disease among people with hepatitis C. If continued, heavy alcohol use could compromise the benefits of new antiviral treatments at the individual- and population-level. To tackle hepatitis C as a public health threat, where needed, DAA therapy should be combined with management of heavy alcohol use.
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42
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Knott CS, Britton A, Bell S. Trajectories of alcohol consumption prior to the diagnosis of type 2 diabetes: a longitudinal case-cohort study. Int J Epidemiol 2018; 47:953-965. [PMID: 29342257 PMCID: PMC6005149 DOI: 10.1093/ije/dyx274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/03/2017] [Accepted: 12/18/2017] [Indexed: 12/22/2022] Open
Abstract
Background Non-linear associations have been reported between baseline measures of alcohol consumption and type 2 diabetes (T2DM). However, given that drinking varies over the adult life course, we investigated whether differences existed in the longitudinal trajectory of alcohol consumption according to T2DM status. Methods For a case–cohort (916 incident cases; 7376 controls) of British civil servants nested within the Whitehall II cohort, the self-reported weekly volume of alcohol consumption was traced backwards from the date of diagnosis or censoring to the beginning of the study, covering a period of up to 28 years. Mean trajectories of alcohol intake were estimated separately by diagnosis status using random-effects models. Results Drinking increased linearly among male cases before diagnosis, but declined among male non-cases prior to censoring. At the time of diagnosis or censoring, consumption among those who developed T2DM was 33.4 g/week greater on average. These patterns were not apparent among women. Here, alcohol intake among female cases was consistently below that of non-cases, with the difference in consumption most pronounced around 15 years prior to diagnosis or censoring, at ∼28.0 g/week. Disparities by diagnosis status were attenuated following adjustment for potential confounders, including the frequency of consumption and metabolic factors. Drinking among male and female cases declined following diagnosis. Conclusions Differences in the weekly volume of alcohol consumption are reported in the years leading up to diagnosis or censoring. Although male and female cases predominantly consumed alcohol at volumes lower than or equal to those who were not diagnosed, these disparities appear to be largely explained by a range of socio-demographic and lifestyle factors. Where disparities are observed between cases and non-cases, adjusted absolute differences are small in magnitude. The decision to drink alcohol should not be motivated by a perceived benefit to T2DM risk.
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Affiliation(s)
- Craig S Knott
- Research Department of Epidemiology and Public Health, University College London, London, UK.,MRC Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK and
| | - Annie Britton
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Steven Bell
- Research Department of Epidemiology and Public Health, University College London, London, UK.,Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge, UK
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Carvalho CAMD, Tirapelli DPDC, Rodrigues AR, Lizarte FS, Novais PC, Silva JP, Carlotti CG, Colli BO, Tirapelli LF. Morphological and immunohistochemical analysis of apoptosis in the cerebellum of rats subjected to focal cerebral ischemia with or without alcoholism model. Acta Cir Bras 2017; 31:629-637. [PMID: 27737349 DOI: 10.1590/s0102-865020160090000009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 08/18/2016] [Indexed: 01/08/2023] Open
Abstract
PURPOSE: To evaluated histopathological changes, morphometric and expression of proteins CASPASE-3, BCL-2 and XIAP related to apoptosis in the cerebellum after induction of temporary focal cerebral ischemia followed by reperfusion, with or without a model of chronic alcoholism. METHODS: Fifty Wistar rats were used and divided into: control group (C), sham group (S), ischemic group (I), alcoholic group (A), and ischemic and alcoholic group (IA). The cerebellum samples collected were stained for histopathological and morphometric analysis and immunohistochemistry study. RESULTS: Histopathological changes were observed a greater degree in animals in groups A and IA. The morphometric study showed no difference in the amount of cells in the granular layer of the cerebellum between the groups. The expression of CASPASE-3 was higher than BCL-2 and XIAP in the groups A and IA. CONCLUSION: We observed correlation between histopathological changes and the occurrence of apoptosis in cerebellar cortex.
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Affiliation(s)
- Camila Albuquerque Melo de Carvalho
- Assistant Professor, Institute of Biological and Health Sciences, Universidade Federal de Alagoas (UFAL). Fellow PhD degree, Clinical Surgery Postgraduate Program, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, Universidade de São Paulo (USP), Ribeirao Preto-SP, Brazil. Acquisition and interpretation of data, manuscript writing
| | - Daniela Pretti da Cunha Tirapelli
- Associate Professor, Department of Surgery and Anatomy, Surgical Clinic Program, School of Medicine of Ribeirao Preto, USP, Brazil. Intellectual, conception and design of the study; manuscript writing
| | - Andressa Romualdo Rodrigues
- Fellow PhD degree, Clinical Surgery Postgraduate Program, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Brazil. Technical procedures, manuscript writing
| | - Fermino Sanches Lizarte
- Fellow Pos-doctoral degree, Clinical Surgery Postgraduate Program, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Brazil.Technical procedures, manuscript writing
| | - Paulo Cézar Novais
- Assistant Professor, Department of Health Sciences, Universidade de Marília (UNIMAR). Fellow Pos-doctoral degree, Clinical Surgery Postgraduate Program, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Brazil. Technical procedures, manuscript writing
| | - Jairo Pinheiro Silva
- Fellow PhD degree, Clinical Surgery Postgraduate Program, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Brazil. Technical procedures, manuscript writing
| | - Carlos Gilberto Carlotti
- Full Professor, Division of Neurosurgery, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Brazil. Scientific and intellectual content of the study, manuscript writing
| | - Benedicto Oscar Colli
- Full Professor, Division of Neurosurgery, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Brazil. Scientific and intellectual content of the study, manuscript writing
| | - Luís Fernando Tirapelli
- Associate Professor, Department of Surgery and Anatomy, School of Medicine of Ribeirao Preto, USP, Brazil. Conception, design, intellectual and scientific content of the study; manuscript writing, critical revision; supervision of all phases of the study
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Chang JS, Hsiao JR, Chen CH. ALDH2 polymorphism and alcohol-related cancers in Asians: a public health perspective. J Biomed Sci 2017; 24:19. [PMID: 28253921 PMCID: PMC5335829 DOI: 10.1186/s12929-017-0327-y] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/26/2017] [Indexed: 12/15/2022] Open
Abstract
The occurrence of more than 200 diseases, including cancer, can be attributed to alcohol drinking. The global cancer deaths attributed to alcohol-consumption rose from 243,000 in 1990 to 337,400 in 2010. In 2010, cancer deaths due to alcohol consumption accounted for 4.2% of all cancer deaths. Strong epidemiological evidence has established the causal role of alcohol in the development of various cancers, including esophageal cancer, head and neck cancer, liver cancer, breast cancer, and colorectal cancer. The evidence for the association between alcohol and other cancers is inconclusive. Because of the high prevalence of ALDH2*2 allele among East Asian populations, East Asians may be more susceptible to the carcinogenic effect of alcohol, with most evidence coming from studies of esophageal cancer and head and neck cancer, while data for other cancers are more limited. The high prevalence of ALDH2*2 allele in East Asian populations may have important public health implications and may be utilized to reduce the occurrence of alcohol-related cancers among East Asians, including: 1) Identification of individuals at high risk of developing alcohol-related cancers by screening for ALDH2 polymorphism; 2) Incorporation of ALDH2 polymorphism screening into behavioral intervention program for promoting alcohol abstinence or reducing alcohol consumption; 3) Using ALDH2 polymorphism as a prognostic indicator for alcohol-related cancers; 4) Targeting ALDH2 for chemoprevention; and 5) Setting guidelines for alcohol consumption among ALDH2 deficient individuals. Future studies should evaluate whether these strategies are effective for preventing the occurrence of alcohol-related cancers.
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Affiliation(s)
- Jeffrey S Chang
- National Institute of Cancer Research, National Health Research Institutes, 1F. No 367, Sheng-Li Road, Tainan, 70456, Taiwan.
| | - Jenn-Ren Hsiao
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70456, Taiwan
| | - Che-Hong Chen
- Department of Chemical and Systems Biology, Stanford University, School of Medicine, 269 Campus Drive, CCSR Building, Rm. 3140, Stanford, CA, 94305, USA.
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