1
|
López-Herrera JA, Castillo AN, Ordoñez-Betancourth JE, Martínez Quiroz WDJ, Higuita-Gutiérrez LF, Suarez-Ortegon MF. Metabolically Unhealthy Normal Weight: Prevalence and Associated Factors in an Adult Population from Northwest Colombia. Diabetes Metab Syndr Obes 2024; 17:1337-1357. [PMID: 38525161 PMCID: PMC10959303 DOI: 10.2147/dmso.s449213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/11/2024] [Indexed: 03/26/2024] Open
Abstract
Background and Aim Individuals with a normal weight may have metabolic alterations at risk for chronic non-communicable diseases. The prevalence of this condition and associated factors have not been reported in Latin American populations. We aimed to estimate the presence and associated factors of Metabolically Unhealthy Normal Weight (MUNW) in adults from a public program for the control and prevention of chronic diseases in Medellín, Colombia. Methods Cross-sectional study. Overweight and normal weight were characterized according to the absence or presence of one or more components of the metabolic syndrome, obtaining four phenotypes: Metabolically Healthy Normal Weight (MHNW), MUNW (phenotype of interest), Metabolically Healthy Overweight (MHO), and Metabolically Unhealthy Overweight (MUO). The association of these phenotypes with sociodemographic variables of lifestyles and increased waist circumference was conducted by using logistic regression. Results In 37,558 individuals (72.7% women), the prevalence of MUNW was 23.3%. Among the additional phenotypes, MUO was found to be more prevalent (71.6%), while MHNW and MHO were very slightly common, 2% and 3.1%, respectively. In a multiple model, the factors associated with MUNW were age over 60 years (trend [OR 1.56 95% CI 0.97-2.52] p-value = 0.066), living in a rural area ([OR 1.58 95% CI 1.09-2.29] p-value = 0.015), and increased waist circumference ([OR 1.68 95% CI 1.45-1.95] p-value < 0.001). Male gender was inversely associated with all phenotypes (P < 0.05). Conclusion Almost a quarter of the analyzed population presented MUNW. People living in a rural area and over 60 years old were more likely to present MUNW. Men were less likely to present the weight phenotypes studied, although they could have been underrepresented.
Collapse
Affiliation(s)
- Julián Andrés López-Herrera
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana Seccional Cali, Cali, Colombia
| | - Adriana Nathaly Castillo
- Departamento de nutrición y dietética, Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia
| | | | | | - Luis Felipe Higuita-Gutiérrez
- School of Medicine, Universidad Cooperativa de Colombia, Medellín, Colombia
- School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Milton F Suarez-Ortegon
- Departamento de Alimentación y Nutrición, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana Seccional Cali, Cali, Colombia
| |
Collapse
|
2
|
Langås JR, Eskild A, Hofvind S, Bjelland EK. The dose-response relationship of pre-menopausal alcohol consumption with age at menopause: a population study of 280 497 women in Norway. Int J Epidemiol 2023; 52:1951-1958. [PMID: 37789587 PMCID: PMC10749754 DOI: 10.1093/ije/dyad129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 09/12/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Previous research suggests that alcohol consumption is associated with high age at menopause. Yet, knowledge about the dose-response relationship is inconsistent. Thus, we studied the pattern of the association of pre-menopausal alcohol consumption with age at natural menopause. METHODS We performed a retrospective population-based study using self-reported data from 280 497 women aged 50-69 years attending the Norwegian breast cancer screening programme (BreastScreen Norway) during 2006-15. Associations of weekly alcohol consumption between the age of 20 and 49 years with age at menopause were estimated as hazard ratios (HRs) using Cox proportional hazard models with restricted cubic splines to allow for non-linear associations. We adjusted for year and place of birth, number of childbirths, educational level, body mass index and smoking habits. RESULTS Mean age at natural menopause was 51.20 years (interquartile range: 49-54 years). The adjusted HR of reaching menopause was highest for women with no alcohol consumption (reference) and the HR decreased by alcohol consumption up to 50 grams per week (adjusted HR 0.87; 95% CI: 0.86-0.88). Above 50 grams, there was no further decrease in the HR of reaching menopause (P for non-linearity of <0.001). CONCLUSIONS Women who did not consume alcohol were youngest at menopause. The lack of a dose-response association among alcohol consumers implies virtually no relation of alcohol consumption with age at menopause. Our findings may suggest that characteristics of the women who did not consume alcohol, not accounted for in the data analyses, explain their younger age at menopause.
Collapse
Affiliation(s)
- Julie R Langås
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Anne Eskild
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Lørenskog, Norway
| | - Solveig Hofvind
- Section of Mammographic Screening, Cancer Registry of Norway, Oslo, Norway
- Department of Health and Care Sciences, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Elisabeth K Bjelland
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway
| |
Collapse
|
3
|
Bui TT, Han M, Luu NM, Tran TPT, Lim MK, Oh JK. Cancer Risk According to Alcohol Consumption Trajectories: A Population-based Cohort Study of 2.8 Million Korean Men. J Epidemiol 2023; 33:624-632. [PMID: 36436924 PMCID: PMC10635810 DOI: 10.2188/jea.je20220175] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Alcohol drinking behaviors change temporally and can lead to changes in related cancer risks; previous studies have been unable to identify the association between the two using a single-measurement approach. Thus, this study aimed to investigate the association of drinking trajectories with the cancer risk in Korean men. METHODS A trajectory analysis using group-based trajectory modeling was performed on 2,839,332 men using data on alcohol drinking levels collected thrice during the Korean National Health Insurance Service's general health screening program conducted between 2002 and 2007. Cox proportional hazards regression was performed to evaluate the associations between drinking trajectories and cancer incidence, after adjustments for age, income, body mass index, smoking status, physical activity, family history of cancer, and comorbidities. RESULTS During 10.5 years of follow-up, 189,617 cancer cases were recorded. Six trajectories were determined: non-drinking, light, moderate, decreasing-heavy, increasing-heavy, and steady-heavy. Light-to-heavy alcohol consumption increased the risk for all cancers combined in a dose-dependent manner (adjusted hazard ratio [aHR] 1.03; 95% confidence interval [CI], 1.02-1.05 for light drinking, aHR 1.06; 95% CI 1.05-1.08 for moderate drinking, aHR 1.19; 95% CI, 1.16-1.22 for decreasing-heavy drinking, aHR 1.23; 95% CI, 1.20-1.26 for increasing-heavy drinking, and aHR 1.33; 95% CI, 1.29-1.38 for steady-heavy drinking [P-trend <0.001]). Light-to-heavy alcohol consumption was linked to lip, oral cavity, pharyngeal, esophageal, colorectal, laryngeal, stomach, and gallbladder and biliary tract cancer risks, while heavy alcohol consumption was associated with hepatic, pancreatic, and lung cancer risks. An inverse association was observed for thyroid cancer. The cancer risks were lower for decreasing-heavy drinkers, compared to steady-heavy drinkers. CONCLUSION No safe drinking limits were identified for cancer risks; reduction in heavy intake had protective effects.
Collapse
Affiliation(s)
- Thi Tra Bui
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Minji Han
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Ngoc Minh Luu
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Thi Phuong Thao Tran
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Min Kyung Lim
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| |
Collapse
|
4
|
Ananth CV, Rutherford C, Rosenfeld EB, Brandt JS, Graham H, Kostis WJ, Keyes KM. Epidemiologic trends and risk factors associated with the decline in mortality from coronary heart disease in the United States, 1990-2019. Am Heart J 2023; 263:46-55. [PMID: 37178994 DOI: 10.1016/j.ahj.2023.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Despite the decline in the rate of coronary heart disease (CHD) mortality, it is unknown how the 3 strong and modifiable risk factors - alcohol, smoking, and obesity -have impacted these trends. We examine changes in CHD mortality rates in the United States and estimate the preventable fraction of CHD deaths by eliminating CHD risk factors. METHODS We performed a sequential time-series analysis to examine mortality trends among females and males aged 25 to 84 years in the United States, 1990-2019, with CHD recorded as the underlying cause of death. We also examined mortality rates from chronic ischemic heart disease (IHD), acute myocardial infarction (AMI), and atherosclerotic heart disease (AHD). All underlying causes of CHD deaths were classified based on the International Classification of Disease 9th and 10th revisions. We estimated the preventable fraction of CHD deaths attributable to alcohol, smoking, and high body-mass index (BMI) through the Global Burden of Disease. RESULTS Among females (3,452,043 CHD deaths; mean [standard deviation, SD] age 49.3 [15.7] years), the age-standardized CHD mortality rate declined from 210.5 in 1990 to 66.8 per 100,000 in 2019 (annual change -4.04%, 95% CI -4.05, -4.03; incidence rate ratio [IRR] 0.32, 95% CI, 0.41, 0.43). Among males (5,572,629 CHD deaths; mean [SD] age 47.9 [15.1] years), the age-standardized CHD mortality rate declined from 442.4 to 156.7 per 100,000 (annual change -3.74%, 95% CI, -3.75, -3.74; IRR 0.36, 95% CI, 0.35, 0.37). A slowing of the decline in CHD mortality rates among younger cohorts was evident. Correction for unmeasured confounders through a quantitative bias analysis slightly attenuated the decline. Half of all CHD deaths could have been prevented with the elimination of smoking, alcohol, and obesity, including 1,726,022 female and 2,897,767 male CHD deaths between 1990 and 2019. CONCLUSIONS The decline in CHD mortality is slowing among younger cohorts. The complex dynamics of risk factors appear to shape mortality rates, underscoring the importance of targeted strategies to reduce modifiable risk factors that contribute to CHD mortality.
Collapse
Affiliation(s)
- Cande V Ananth
- Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Cardiovascular Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ.
| | - Caroline Rutherford
- Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY
| | - Emily B Rosenfeld
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Justin S Brandt
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Hillary Graham
- Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Clinical Epidemiology Division, Faculty of Medicine at Solna, Karolinska Institute, Stockholm, Sweden
| | - William J Kostis
- Cardiovascular Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Katherine M Keyes
- Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY
| |
Collapse
|
5
|
Liu Z, Gu C, Lei J. Meta-analysis of Shugan Jieyu Capsule for depression in patients with coronary heart disease. Medicine (Baltimore) 2023; 102:e34685. [PMID: 37653746 PMCID: PMC10470748 DOI: 10.1097/md.0000000000034685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 09/02/2023] Open
Abstract
INTRODUCTION Shugan Jieyu Capsule (SGJYC) has been prescribed to treat primary and secondary depression; however, whether it can benefit depression of patients with coronary heart disease (CHD) remains controversial. This meta-analysis aimed to evaluate the efficacy and safety of SGJYC in treating depression in patients with CHD. PATIENT CONCERNS A total of 644 CHD patients with depression were selected from China National Knowledge Infrastructure, Wanfang, China Biomedical Database, MEDLINE, the Cochrane library from their inceptions until June, 2021. DIAGNOSIS All patients with CHD or coronary artery disease were confirmed to suffer from depression based on recognized criteria. INTERVENTION Patients were assigned randomly to receive SGJYC-based regimens or conventional antidepressants alone. OUTCOMES Meta-analysis of 6 studies showed that antidepressants (MD, 2.12; 95% confidence interval [CI], 0.73~3.50) or sertraline (MD, 2.15; 95%CI, 0.61~3.68) significantly alleviated depression level compared to SGJYC; however, SGJYC plus antihypertensive drugs (AHD) (MD, -8.33; 95%CI, -13.90 ~ -2.75) significantly improved depression symptoms compared to AHD. A significant difference in risk of adverse cardiac events (risk ratios [RR], 2.72; 95%CI, 1.07~6.94) between SGJYC and sertraline was detected in patients with simple CHD. CONCLUSIONS SGJYC has a poor effect on depressive symptoms, and the effect of combination with AHD is better than AHD but its efficacy and cardiac safety are inferior to antidepressants.
Collapse
Affiliation(s)
- Zhen Liu
- Department of Internal Medicine, Bao ‘an Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong, China
| | - Chunhua Gu
- Emergency Department, Baoan District People’s Hospital, Shenzhen, Guangdong, China
| | - Jian Lei
- Department of Cardiology, Wuhan First Hospital, Wuhan Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, Hubei, China
| |
Collapse
|
6
|
Sidorchuk A, Engström K, Möller J, Gémes K. Predictors of beverage-specific, alcohol consumption trajectories: A Swedish population-based cohort study. NORDIC STUDIES ON ALCOHOL AND DRUGS 2023; 40:233-249. [PMID: 37255610 PMCID: PMC10225962 DOI: 10.1177/14550725221124386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/22/2022] [Indexed: 09/30/2023] Open
Abstract
Aim: The aim of the study was to examine whether changes in alcohol consumption over time differ according to beverage types, and to what extent socioeconomic, lifestyle and health-related factors predict beverage-specific trajectories in Sweden. Study design: We included participants from the Stockholm Public Health Cohort who were surveyed repeatedly in 2002, 2010 and 2014. Alcohol consumption trajectories were constructed for 13,152 individuals with valid information on amount and frequency of drinking. Preferred beverage types (i.e., beer, wine or spirits) were defined based on the most consumed beverages. Multinomial logistic regression was used to quantify individual predictors of different trajectories, overall and by beverage type. Results: Overall 56.9% of respondents were women, the mean age was 49.2 years, SD (13.1). Wine was cited as the preferred beverage for 72.4% of participants, and stable moderate drinking was the most common trajectory regardless of beverage type (68.2%, 54.9% and 54.2% in individuals with wine, beer and spirits as preferred beverages, respectively). Associations between drinking trajectories and baseline lifestyle factors did not differ by beverage type. Lower socioeconomic position (SEP) was associated with unstable moderate wine drinking (for unskilled manual SEP: adjusted odds ratio [aOR] 1.54, 95% confidence interval [CI] 1.23, 1.93), unstable heavy beer drinking (for skilled manual SEP: aOR 1.99, 95% CI 1.14, 3.52; and unskilled manual SEP: aOR 1.72, 95% CI 1.05, 2.82), and former beer drinking trajectory (for skilled manual SEP: aOR 1.81; 95% CI 1.21, 2.72; and unskilled manual SEP: aOR 1.66; 95% CI 1.17, 2.37). Conclusion: Lower SEP was associated with unstable heavy drinking of beer, former beer drinking, and unstable moderate wine drinking trajectories indicating that targeted alcohol prevention programmes need to focus on these groups.
Collapse
Affiliation(s)
- Anna Sidorchuk
- Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | | | | | | |
Collapse
|
7
|
Luo Z, Cheng J, Wang Y. Effects of the genetic variants of alcohol-metabolizing enzymes on lipid levels in Asian populations: a systematic review and meta-analysis. Nutr Rev 2022:6960646. [PMID: 36565468 DOI: 10.1093/nutrit/nuac100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
CONTEXT Emerging evidence indicates that variants of alcohol-metabolizing enzymes may influence lipid metabolism. OBJECTIVE This study aimed to investigate whether the rs671 and rs1229984 variants affect lipid levels in East Asian individuals. DATA SOURCES PubMed, Foreign Medical Journal Service, Embase, Cochrane Library, Scopus, MEDLINE, Web of Science, Web of Knowledge, Wanfang, and Chinese Biomedical Literature databases were searched until December 31, 2021. DATA EXTRACTION Meta-analyses of studies that examined the effects of alcohol-metabolizing enzyme variants on lipid levels, as well as the interaction with alcohol intake, were selected. Data extraction was conducted independently by two investigators and confirmed by the third. DATA ANALYSIS In total, 86 studies (179 640 individuals) were analyzed. The A allele of rs671 (a functional variant in the ALDH2 gene) was linked to higher levels of low-density lipoprotein cholesterol (LDL-C) and lower levels of triglycerides and high-density lipoprotein cholesterol. In contrast, the A allele of the rs1229984 (a functional variant in the ADH2 gene) was associated only with lower levels of LDL-C. The effects of rs671 and rs1229984 on lipid levels were much stronger in Japanese than in Chinese individuals and in males than in females. Regression analysis indicated that the effects of rs671 on lipid levels were independent of alcohol intake in an integrated East Asian population (ie, Japanese, Chinese, and Korean individuals). Intriguingly, alcohol intake had a statistical influence on lipid levels when the sample analyzed was restricted to Japanese individuals or to males. CONCLUSIONS The rs671 and rs1229984 variants of alcohol-metabolizing enzymes have significant effects on lipid levels and may serve as genetic markers for lipid dyslipidemia in East Asian populations. Circulating lipid levels in Japanese individuals and in males were modulated by the interaction between rs671 and alcohol intake.
Collapse
Affiliation(s)
- Zhi Luo
- Department of General Medicine and Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Jun Cheng
- Department of General Medicine and Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China.,Medical Research Institute of Wuhan University, Wuhan University, Wuhan, China
| | - Yanggan Wang
- Department of General Medicine and Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China.,Medical Research Institute of Wuhan University, Wuhan University, Wuhan, China
| |
Collapse
|
8
|
Qiu W, Cai A, Li L, Feng Y. Longitudinal Trajectories of Alcohol Consumption with All-Cause Mortality, Hypertension, and Blood Pressure Change: Results from CHNS Cohort, 1993-2015. Nutrients 2022; 14:nu14235073. [PMID: 36501103 PMCID: PMC9739068 DOI: 10.3390/nu14235073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Previous studies have demonstrated a J-shaped association of alcohol consumption with all-cause mortality and hypertension, but the majority of these studies focus on a single measurement of alcohol intake and were conducted in a Western population. Whether long-term trajectories of alcohol consumption are associated with all-cause mortality, hypertension, and a change in blood pressure remains to be elucidated. METHODS In the large, population-based China Health and Nutrition Survey cohort from between 1993 and 2015, group-based trajectory modeling was conducted to identify distinct alcohol-consumption trajectory classes. We investigated their association with all-cause mortality and hypertension using Cox regression and binary logistics regression models. A restricted cubic spline was performed to determine the nonlinear relationships of mean alcohol intake with mortality and hypertension. Multivariate-adjusted generalized linear mixed-effects models were conducted to assess the change in blood pressure among alcohol-consumption trajectory classes. RESULTS Among the 5298 participants, 48.4% were women and the mean age was 62.6 years. After 22 years of follow-up, 568 (10.7%) of the participants died and 1284 (24.2%) developed hypertension. Long-term light and moderate drinkers had a lower risk of death than the non-drinkers, and a restricted cubic spline showed a J-shaped relationship between mean alcohol intake and mortality. Although blood pressure increased slower in light and moderate drinkers, a reduced risk of hypertension was only observed in the former. The long-term heavy drinkers had the highest blood pressure and death rate. CONCLUSIONS Light alcohol intake might be protective even in the long run, while heavy drinking reversed the beneficial effect. The causality of such a connection needs to be further investigated.
Collapse
Affiliation(s)
- Weida Qiu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China
| | - Anping Cai
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China
| | - Liwen Li
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China
| | - Yingqing Feng
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China
- Correspondence:
| |
Collapse
|
9
|
Ding C, O'Neill D, Britton A. Trajectories of alcohol consumption in relation to all-cause mortality in patients with cardiovascular disease: a 35-year prospective cohort study. Addiction 2022; 117:1920-1930. [PMID: 35188300 PMCID: PMC9314067 DOI: 10.1111/add.15850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/04/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Research into alcohol consumption and cardiovascular disease (CVD) patients' prognosis has largely ignored the longitudinal dynamics in drinking behaviour. This study measured the association between alcohol consumption trajectories and mortality risk in CVD patients. DESIGN Prospective cohort study. SETTING UK-based Whitehall II Study. PARTICIPANTS A total of 1306 participants with incident non-fatal CVD (coronary heart disease/stroke) events. MEASUREMENTS Up to eight repeated measures of alcohol intake were available for each patient from the most recent assessment phase pre-incident CVD and all subsequent phases post-incident CVD, spanning up to three decades. Six trajectory groups of alcohol consumption were identified using group-based trajectory modelling and related to the risk of all-cause mortality, adjusting for demographics and changes in life-style and health status. FINDINGS Three hundred and eighty deaths were recorded during a median follow-up of 5 years after patients' last alcohol assessment. Compared with patients who consistently drank moderately (≤ 14 units/week), former drinkers had a greater risk of mortality (hazard ratio = 1.74, 95% confidence interval = 1.19-2.54) after adjustment for covariates. There was no significantly increased risk of mortality in long-term abstainers, reduced moderate drinkers, stable or unstable heavy drinkers. Cross-sectional analyses based only on drinking information at patients' last assessment found no significant differences in mortality risk for abstainers, former or heavy drinkers versus moderate drinkers. CONCLUSIONS Cardiovascular disease patients who consistently drink ≤ 14 units/week appear to have a similar risk of mortality to those who are long-term abstainers, which does not support a protective effect of moderate drinking on total mortality. Cardiovascular disease patients who stop drinking appear to have increased mortality risk compared with continuous moderate drinkers, but this may be linked to poor self-rated health before cardiovascular disease onset.
Collapse
Affiliation(s)
- Chengyi Ding
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - Dara O'Neill
- CLOSER, UCL Social Research InstituteUniversity College LondonLondonUK
| | - Annie Britton
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| |
Collapse
|
10
|
Meza V, Arnold J, Díaz LA, Ayala Valverde M, Idalsoaga F, Ayares G, Devuni D, Arab JP. Alcohol Consumption: Medical Implications, the Liver and Beyond. Alcohol Alcohol 2022; 57:283-291. [PMID: 35333295 DOI: 10.1093/alcalc/agac013] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/25/2022] [Accepted: 02/16/2022] [Indexed: 12/12/2022] Open
Abstract
Alcohol consumption represents a major factor of morbidity and mortality, with a wide range of adverse medical implications that practically affect every organ system. It is the fifth major cause of deaths in men and women and causes up to 139 million disability-adjusted life years. Solid evidence places the risk as undoubtedly correlated to the length of time and amount of alcohol consumption. While alcohol-related liver disease represents one of the most studied and well-known consequences of alcohol use, the term itself embodies a wide spectrum of progressive disease stages that are responsible for almost half of the liver-related mortality worldwide. We discuss the staged alcohol-related fatty liver, alcohol-related steatohepatitis and, finally, fibrosis and cirrhosis, which ultimately may end up in a hepatocellular carcinoma. Other comorbidities such as acute and chronic pancreatitis; central nervous system; cardiovascular, respiratory and endocrine system; renal disease; urological pathologies; type 2 diabetes mellitus and even infectious diseases are reviewed in their relation to alcohol consumption. This article reviews the impact of alcohol use on different systems and organs, summarizing available evidence regarding its medical implications. It examines current basic and clinical data regarding mechanisms to highlight factors and processes that may be targetable to improve patient outcomes. Although alcohol use is a part of many cultural and social practices, as healthcare providers we must identify populations at high risk of alcohol abuse, educate patients about the potential alcohol-related harm and provide appropriate treatment.
Collapse
Affiliation(s)
- Víctor Meza
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Arnold
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Luis Antonio Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | | | - Francisco Idalsoaga
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Gustavo Ayares
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Deepika Devuni
- Division of Gastroenterology, Department of Medicine, UMass Chan Medical School l, Worcester, MA 01655, USA
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| |
Collapse
|
11
|
Stevens D, Lane DA, Harrison SL, Lip GYH, Kolamunnage-Dona R. Modelling of longitudinal data to predict cardiovascular disease risk: a methodological review. BMC Med Res Methodol 2021; 21:283. [PMID: 34922465 PMCID: PMC8684210 DOI: 10.1186/s12874-021-01472-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/15/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The identification of methodology for modelling cardiovascular disease (CVD) risk using longitudinal data and risk factor trajectories. METHODS We screened MEDLINE-Ovid from inception until 3 June 2020. MeSH and text search terms covered three areas: data type, modelling type and disease area including search terms such as "longitudinal", "trajector*" and "cardiovasc*" respectively. Studies were filtered to meet the following inclusion criteria: longitudinal individual patient data in adult patients with ≥3 time-points and a CVD or mortality outcome. Studies were screened and analyzed by one author. Any queries were discussed with the other authors. Comparisons were made between the methods identified looking at assumptions, flexibility and software availability. RESULTS From the initial 2601 studies returned by the searches 80 studies were included. Four statistical approaches were identified for modelling the longitudinal data: 3 (4%) studies compared time points with simple statistical tests, 40 (50%) used single-stage approaches, such as including single time points or summary measures in survival models, 29 (36%) used two-stage approaches including an estimated longitudinal parameter in survival models, and 8 (10%) used joint models which modelled the longitudinal and survival data together. The proportion of CVD risk prediction models created using longitudinal data using two-stage and joint models increased over time. CONCLUSIONS Single stage models are still heavily utilized by many CVD risk prediction studies for modelling longitudinal data. Future studies should fully utilize available longitudinal data when analyzing CVD risk by employing two-stage and joint approaches which can often better utilize the available data.
Collapse
Affiliation(s)
- David Stevens
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, L7 8TX, UK.,Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, L7 8TX, UK. .,Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK. .,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, L7 8TX, UK.,Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, L7 8TX, UK.,Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ruwanthi Kolamunnage-Dona
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, UK
| |
Collapse
|
12
|
Hughes RA, Tilling K, Lawlor DA. Combining Longitudinal Data From Different Cohorts to Examine the Life-Course Trajectory. Am J Epidemiol 2021; 190:2680-2689. [PMID: 34215868 PMCID: PMC8634562 DOI: 10.1093/aje/kwab190] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/24/2021] [Accepted: 06/25/2021] [Indexed: 12/17/2022] Open
Abstract
Longitudinal data are necessary to reveal changes within an individual as he or she ages. However, rarely will a single cohort study capture data throughout a person's entire life span. Here we describe in detail the steps needed to develop life-course trajectories from cohort studies that cover different and overlapping periods of life. Such independent studies are probably from heterogenous populations, which raises several challenges, including: 1) data harmonization (deriving new harmonized variables from differently measured variables by identifying common elements across all studies); 2) systematically missing data (variables not measured are missing for all participants in a cohort); and 3) model selection with differing age ranges and measurement schedules. We illustrate how to overcome these challenges using an example which examines the associations of parental education, sex, and race/ethnicity with children's weight trajectories. Data were obtained from 5 prospective cohort studies (carried out in Belarus and 4 regions of the United Kingdom) spanning data collected from birth to early adulthood during differing calendar periods (1936-1964, 1972-1979, 1990-2012, 1996-2016, and 2007-2015). Key strengths of our approach include modeling of trajectories over wide age ranges, sharing of information across studies, and direct comparison of the same parts of the life course in different geographical regions and time periods. We also introduce a novel approach of imputing individual-level covariates of a multilevel model with a nonlinear growth trajectory and interactions.
Collapse
Affiliation(s)
- Rachael A Hughes
- Correspondence to Dr. Rachael Hughes, MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom (e-mail: )
| | | | | |
Collapse
|
13
|
Golder S, McCambridge J. Alcohol, cardiovascular disease and industry funding: A co-authorship network analysis of systematic reviews. Soc Sci Med 2021; 289:114450. [PMID: 34607052 PMCID: PMC8586735 DOI: 10.1016/j.socscimed.2021.114450] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/14/2021] [Accepted: 09/29/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Alcohol's effects on heart health is the site of a major scientific controversy. We conducted a co-authorship network analysis of systematic reviews on the impacts on alcohol on cardiovascular disease (CVD) in order to investigate patterns of co-authorship in the literature, with particular attention given to industry funding. METHODS We used Epistemonikos to identify systematic reviews. Review characteristics, influential authors, co-authorship subnetworks, prior histories of alcohol industry funding, study outcomes and citations were investigated. RESULTS 60 systematic reviews with 231 unique authors met our inclusion criteria. 14 systematic reviews were undertaken by authors with histories of alcohol industry funding, including 5 that were funded directly by the alcohol industry itself. All 14 such reviews identified a cardioprotective effect of alcohol. These formed distinct co-authorship subnetworks within the literature. Of reviews by authors with no prior histories of alcohol industry funding, the findings were mixed, with 54% (25/46) concluding there was evidence of health protective effects. These two groups of reviews differed in other respects. Those with industry funding were more likely to study broader outcomes such as 'cardiovascular disease' or 'coronary heart disease' as opposed to specific CVD issues such as hypertension or stroke (93% [13/14] versus 41% [19/46]) (chi-squared 12.4, p < 0.001) and have more included studies (mean of 29 versus 20). They were also more widely cited by others. Over time the proportions of systematic reviews on CVD and alcohol undertaken by authors with no prior histories of alcohol industry funding has increased. CONCLUSIONS Systematic reviews undertaken by authors with histories of alcohol industry funding were more likely to study broader outcomes, and be cited more widely, and exclusively reported favorable conclusions.
Collapse
Affiliation(s)
- Su Golder
- Department of Health Sciences, University of York, York, United Kingdom.
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, United Kingdom
| |
Collapse
|
14
|
Fernandes GS, Spiers A, Vaidya N, Zhang Y, Sharma E, Holla B, Heron J, Hickman M, Murthy P, Chakrabarti A, Basu D, Subodh BN, Singh L, Singh R, Kalyanram K, Kartik K, Kumaran K, Krishnaveni G, Kuriyan R, Kurpad S, Barker GJ, Bharath RD, Desrivieres S, Purushottam M, Orfanos DP, Toledano MB, Schumann G, Benegal V. Adverse childhood experiences and substance misuse in young people in India: results from the multisite cVEDA cohort. BMC Public Health 2021; 21:1920. [PMID: 34686158 PMCID: PMC8539836 DOI: 10.1186/s12889-021-11892-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/07/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) increases vulnerability to externalising disorders such as substance misuse. The study aims to determine the prevalence of ACEs and its association with substance misuse. METHODS Data from the Consortium on Vulnerability to Externalising Disorders and Addictions (cVEDA) in India was used (n = 9010). ACEs were evaluated using the World Health Organisation (WHO) Adverse Childhood Experiences International Questionnaire whilst substance misuse was assessed using the WHO Alcohol, Smoking and Substance Involvement Screening Test. A random-effects, two-stage individual patient data meta-analysis explained the associations between ACEs and substance misuse with adjustments for confounders such as sex and family structure. RESULTS 1 in 2 participants reported child maltreatment ACEs and family level ACEs. Except for sexual abuse, males report more of every individual childhood adversity and are more likely to report misusing substances compared with females (87.3% vs. 12.7%). In adolescents, family level ACEs (adj OR 4.2, 95% CI 1.5-11.7) and collective level ACEs (adj OR 6.6, 95% CI 1.4-31.1) show associations with substance misuse whilst in young adults, child level ACEs such as maltreatment show similar strong associations (adj OR 2.0, 95% CI 1.1-3.5). CONCLUSION ACEs such as abuse and domestic violence are strongly associated with substance misuse, most commonly tobacco, in adolescent and young adult males in India. The results suggest enhancing current ACE resilience programmes and 'trauma-informed' approaches to tackling longer-term impact of ACEs in India. FUNDING Newton Bhabha Grant jointly funded by the Medical Research Council, UK (MR/N000390/1) and the Indian Council of Medical Research (ICMR/MRC-UK/3/M/2015-NCD-I).
Collapse
Affiliation(s)
- G S Fernandes
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
| | - A Spiers
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - N Vaidya
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India.,Centre for Population Neuroscience and Precision Medicine, Kings College London, London, UK
| | - Y Zhang
- Centre for Innovation in Mental Health, Department of Psychology, University of Southampton, Southampton, UK
| | - E Sharma
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - B Holla
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - J Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - M Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - P Murthy
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - A Chakrabarti
- ICMR-Centre on Non-Communicable Diseases, Kolkata, India
| | - D Basu
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - B N Subodh
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - L Singh
- Department of Psychiatry, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India
| | - R Singh
- Department of Psychiatry, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India
| | - K Kalyanram
- Rishi Valley Rural Health Centre, Madanapalle, Chittoor, Andhra Pradesh, India
| | - K Kartik
- Rishi Valley Rural Health Centre, Madanapalle, Chittoor, Andhra Pradesh, India
| | - K Kumaran
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - G Krishnaveni
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - R Kuriyan
- Department of Psychiatry and Medical Ethics, St John's Medical College & Hospital, Bangalore, India
| | - S Kurpad
- Department of Psychiatry & Department of Medical Ethics, St. John's Medical College & Hospital, Bangalore, India
| | - G J Barker
- Centre for Population Neuroscience and Precision Medicine, Kings College London, London, UK.,Department of Neuroimaging, King's College London, London, UK
| | - R D Bharath
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - S Desrivieres
- Centre for Population Neuroscience and Precision Medicine, Kings College London, London, UK
| | - M Purushottam
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - D P Orfanos
- NeuroSpin, CEA, Université Paris-Saclay, Paris, France
| | - M B Toledano
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - G Schumann
- Centre for Population Neuroscience and Precision Medicine, Kings College London, London, UK
| | - V Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| |
Collapse
|
15
|
Interaction between eNOS gene polymorphism and current smoking on susceptibility to coronary heart disease in Chinese people. Coron Artery Dis 2021; 31:87-91. [PMID: 31567371 DOI: 10.1097/mca.0000000000000780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aims to explore the relation between endothelial nitric oxide synthase (eNOS) single-nucleotide polymorphisms (SNPs) and the risk of coronary heart disease (CHD). METHODS SNPstats (online software: http://bioinfo.iconcologia.net/SNPstats) was performed to test Hardy-Weinberg equilibrium in controls. Generalized multifactor dimensionality reduction (GMDR) was adopted to screen the preferable interaction between eNOS SNPs and smoking. RESULTS The frequency for the rs1799983-T allele was 31.1% in CHD patients, which was significantly higher than that of 19.8% in controls (P < 0.05). The frequency for the rs891512-A allele was 28.8% in cases, which was also significantly higher than that of 20.1% in controls (P < 0.05). Logistic regression analysis showed that both rs1799983-T and rs891512-A alleles were related with increased risk of CHD, and the odds ratios (ORs) [95% confidence interval (CI)] were 1.71 (1.31-2.15) and 1.57 (1.14-2.07), respectively. High-order interactions were investigated among SNPs and environmental factors using the GMDR method. The data showed that a two-locus model (rs1799983 × smoking) had a testing accuracy of 0.60 (P = 0.001). We found that current smokers with rs1799983-GT or TT within eNOS gene have the highest CHD risk, compared to never smokers with rs1799983-GG genotype, OR (95% CI) = 2.74 (1.78-3.85), after covariates adjustment for age, gender, BMI, and alcohol drinking. CONCLUSION The rs1799983-T and rs891512-A alleles and interaction between rs1799983 and smoking were all risk factors of CHD.
Collapse
|
16
|
Yang X, Gao LY, Qin S, Ma KH, Luo SX, Qin CC. Alcohol consumption may not affect the diameter of the coronary arteries in men with chest pain. J Int Med Res 2021; 48:300060520913781. [PMID: 32316821 PMCID: PMC7177991 DOI: 10.1177/0300060520913781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective The effect of alcohol consumption on the risk of coronary heart disease is
controversial. Several studies have assessed the effects of alcohol on the
formation of atherosclerotic plaques, but few studies have evaluated the
chronic effects of alcohol consumption on the coronary artery diameter. We
investigated whether alcohol consumption affects the coronary artery
diameter. Methods This prospective study enrolled men who were undergoing coronary angiography
at the First Affiliated Hospital of Chongqing Medical University from
November 2016 to December 2017. The participants were categorized into three
groups based on their drinking behavior: heavy drinking (>175 g/week in
the last 2 years, n = 70), moderate drinking (>42 to ≤175 g/week in the
last 2 years, n = 53), and nondrinking (lifetime alcohol consumption of
<98 g, n = 79). The diameters of the left and right coronary arteries
were compared among the three groups. Results No significant differences in the diameters of the left and right coronary
arteries were observed among the three groups. Conclusions Alcohol consumption may not affect the diameter of the coronary arteries.
Collapse
Affiliation(s)
- Xin Yang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Department of Cardiology, the People's Hospital of Rongchang District, Chongqing, China
| | - Ling-Yun Gao
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shu Qin
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kang-Hua Ma
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Su-Xin Luo
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chun-Chang Qin
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
17
|
Ma Q, Liu J, Li C, Wang D. Effects of off-pump coronary artery bypass grafting on clinical efficacy, cardiac function and the incidence of major adverse cardiovascular events in patients with coronary heart disease. Am J Transl Res 2021; 13:1742-1749. [PMID: 33841697 PMCID: PMC8014410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the effects of off-pump coronary artery bypass grafting (OPC) on clinical efficacy, cardiac function and the occurrence of major adverse cardiovascular events (MACE) in patients with coronary heart disease. METHODS According to different surgical methods, 93 patients with coronary heart disease who were hospitalized and treated in our hospital were collapsed into the off-pump coronary artery bypass grafting group (OPC group) and the extracorporeal circulation coronary artery bypass grafting group (PC group). The perioperative indexes, cardiac function indexes, postoperative recovery, quality of life, the incidence of MACE and adverse reactions and the survival rate of patients in PC group and OPC group were analyzed and compared. RESULTS Compared with the PC group, the operation time and blood transfusion volume of OPC group were both largely decreased (P<0.05), but the number of bypass grafts was similar (P>0.05). The cardiac function index of OPC group was much higher than that of PC group (P<0.05). The postoperative recovery after operation of OPC group was better than that of PC group (P<0.05). The scores of quality of life scale in OPC group were markedly higher than those in PC group (P<0.05). The incidence of MACE in OPC group was obviously lower than that in PC group (P<0.05). Patients in in the OPC group had slightly lower incidence of adverse reactions, and slightly higher survival rate than the PC group, but there was no statistical difference (P>0.05). CONCLUSION Compared with PC, OPC has a significantly better therapeutic effect on patients with coronary heart disease, which can significantly improve the perioperative indices and cardiac function, and enhance the quality of life of patients.
Collapse
Affiliation(s)
- Qing Ma
- The First Department of Cardiac Surgery, Tangshan Gongren Hospital Tangshan, Hebei Province, China
| | - Jiancheng Liu
- The First Department of Cardiac Surgery, Tangshan Gongren Hospital Tangshan, Hebei Province, China
| | - Chunbo Li
- The First Department of Cardiac Surgery, Tangshan Gongren Hospital Tangshan, Hebei Province, China
| | - Dong Wang
- The First Department of Cardiac Surgery, Tangshan Gongren Hospital Tangshan, Hebei Province, China
| |
Collapse
|
18
|
Jankhotkaew J, Bundhamcharoen K, Suphanchaimat R, Waleewong O, Chaiyasong S, Markchang K, Wongworachate C, Vathesatogkit P, Sritara P. Associations between alcohol consumption trajectory and deaths due to cancer, cardiovascular diseases and all-cause mortality: a 30-year follow-up cohort study in Thailand. BMJ Open 2020; 10:e038198. [PMID: 33361071 PMCID: PMC7768972 DOI: 10.1136/bmjopen-2020-038198] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES This study examined the association between alcohol consumption trajectory and deaths due to cancer, cardiovascular diseases (CVDs) and all-cause mortality in Thailand. DESIGN Data were obtained from a Thai prospective cohort study with more than 30 years of follow-up (n=1961). SETTING All participants resided in Bangkok and its vicinity. PARTICIPANTS Employees from the Electricity Generating Authority of Thailand aged between 35 and 54 years old were randomly selected. MAIN OUTCOME MEASURES Exposure was alcohol consumption trajectory over the study period from 1985 to 2012. The main outcomes were all-cause mortality, and deaths due to cancer and CVDs recorded in national vital registries between 2002 and 2015. Cox's proportional hazard regression was used to determine the associations between alcohol consumption trajectory and each outcome adjusting for sample characteristics, health behaviours and health conditions. RESULTS From a total of 59 312 person years, 276 deaths were observed. Compared with drinkers who drank occasionally or most occasional over their lifetime, consistent regular or mostly consistent-regular drinkers had higher rates of all-cause mortality (HR: 1.53; 95% CI 1.09 to 2.16) and cancer mortality (HR: 2.05; 95% CI 1.13 to 3.74). The study did not find a significant association between trajectory of alcohol consumption and deaths due to CVDs. CONCLUSIONS Regular drinking of alcohol increased risk for all-cause and cancer mortality. Effective interventions should be implemented to reduce number of regular drinkers in order to saves life of individuals.
Collapse
Affiliation(s)
- Jintana Jankhotkaew
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Orratai Waleewong
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Surasak Chaiyasong
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
- Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Kamolphat Markchang
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Prin Vathesatogkit
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Piyamitr Sritara
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| |
Collapse
|
19
|
Liu J. Alcohol consumption combined with dietary low-carbohydrate/high-protein intake increased the left ventricular systolic dysfunction risk and lethal ventricular arrhythmia susceptibility in apolipoprotein E/low-density lipoprotein receptor double-knockout mice. Alcohol 2020; 89:63-74. [PMID: 32702503 DOI: 10.1016/j.alcohol.2020.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/21/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022]
Abstract
Alcohol abuse is positively associated with cardiovascular disease. Dietary low-carbohydrate/high-protein (LCHP) intake confers a greater mortality risk. Here, the impact of ethanol consumption in combination with dietary LCHP intake on left ventricular (LV) systolic function and lethal ventricular arrhythmia susceptibility were investigated in apolipoprotein E/low-density lipoprotein receptor double-knockout (AL) mice. The underlying mechanisms, cardiac sympathovagal balance, beta-adrenergic receptor (ADRB) levels, and gap junction channel protein connexin 43 (Cx43) expression, were examined. Male AL mice fed an LCHP diet with or without ethanol were bred for 16 weeks. Age-matched male AL and wild-type mice received standard chow diet and served as controls. The following were used to assess LV systolic function, lethal ventricular arrhythmia susceptibility, cardiac sympathovagal balance, Cx43 expression, and ADRB levels: The results demonstrated that ethanol consumption in combination with dietary LCHP intake worsened LCHP-induced LV systolic dysfunction in AL mice and enhanced their susceptibility in the ventricular arrhythmia-evoked test. There were concomitant increases in LV weight, LF/HF ratio shown by HRV, TH, ADRB1, ADRB2, and Cx43 expressions by LV fluorescence immunohistochemistry, and LV Cx43 messenger ribonucleic acid expression by PCR. In AL mice, alcohol consumption combined with dietary LCHP intake may thus promote a shift in cardiac sympathovagal balance toward sympathetic predominance, the increases in beta-adrenergic receptors (ADRB1 and ADRB2), and then affect the gap junction channel protein Cx43, which in turn could contribute to increased risks of LV systolic dysfunction and susceptibility to lethal ventricular arrhythmia.
Collapse
|
20
|
Ng Fat L, Bell S, Britton A. A life-time of hazardous drinking and harm to health among older adults: findings from the Whitehall II prospective cohort study. Addiction 2020; 115:1855-1866. [PMID: 32233123 PMCID: PMC7487058 DOI: 10.1111/add.15013] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 07/19/2019] [Accepted: 02/12/2020] [Indexed: 01/20/2023]
Abstract
AIMS To investigate associations of life-time hazardous and binge drinking with biomarkers of cardiometabolic health, liver function, cardiovascular disease (CVD) and mortality. DESIGN Prospective cohort study with median follow-up time to CVD incidence of 4.5 years. SETTING London, UK: civil servants within the Whitehall II Study. PARTICIPANTS A total of 4820 drinkers aged 59-83 years with biological measurements during the 2011-12 survey. MEASUREMENTS Hazardous drinking was defined as having an AUDIT-C score ≥ 5 calculated at each decade of life, forming the following groups: never hazardous drinker, former early (stopping before age 50), former later (stopping after age 50), current hazardous drinker and consistent hazardous drinker (hazardous drinker at each decade of life). FINDINGS More than half the sample had been hazardous drinkers at some point during their life-time, comprising former early (< age 50) (19%), former later (≥ age 50) (11%), current (21%) and consistent hazardous drinker (AUDIT-C ≥ 5 across life (5%). After adjusting for covariates, waist circumference was larger with more persistent hazardous drinking (e.g. compared with never hazardous drinkers, former early had increased waist circumference by 1.17 cm [95% confidence interval (CI) = 0.25-2.08]; former later by 1.88 cm (CI = 0.77-2.98); current by 2.44 cm (CI = 1.50-3.34) and consistent hazardous drinker by 3.85 cm (CI = 2.23-5.47). Current hazardous drinkers had higher systolic blood pressure (2.44 mmHg, CI = 1.19-3.68) and fatty liver index scores (4.05 mmHg, CI = 2.92-5.18) than never hazardous drinkers. Current hazardous drinkers [hazard ratio (HR) = 2.75, CI = 1.44-5.22) had an elevated risk of stroke, and former later hazardous drinkers had an elevated risk of non-CVD mortality (HR = 1.93, CI = 1.19-3.14) than never hazardous drinkers. Life-time binge drinking was associated with larger waist circumferences and poorer liver function compared with never binge drinkers. CONCLUSION Hazardous drinking may increase cardiometabolic risk factors; this is made worse by persistent hazardous drinking throughout life, particularly in relation to weight gain, suggesting benefits of early intervention.
Collapse
Affiliation(s)
- Linda Ng Fat
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - Steven Bell
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary CareUniversity of Cambridge, Strangeways Research LaboratoryCambridgeUK,National Institute for Health Research Blood and Transplant Unit in Donor Health and Genomics at the University of Cambridge, Strangeways Research LaboratoryCambridgeUK,Stroke Research Group, Department of Clinical NeurosciencesCambridge Biomedical CampusCambridgeUK
| | - Annie Britton
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| |
Collapse
|
21
|
Britton A, O’Neill D, Kuh D, Bell S. Sustained heavy drinking over 25 years is associated with increased N-terminal-pro-B-type natriuretic peptides in early old age: Population-based cohort study. Drug Alcohol Depend 2020; 212:108048. [PMID: 32450480 PMCID: PMC7301434 DOI: 10.1016/j.drugalcdep.2020.108048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/01/2020] [Accepted: 04/21/2020] [Indexed: 10/29/2022]
Abstract
UNLABELLED Heavy alcohol consumption is associated with an increased risk of heart failure. We sought to investigate whether levels of NT-proBNP differ by alcohol consumption profiles, both current drinking as well as cumulative exposure to drinking over several decades in a general population sample. METHODS Data on 2054 participants (49% male) were taken from the UK Medical Research Council National Survey for Health and Development, a longitudinal cohort study based on a nationally representative sample of births in 1946. Categories of long-term alcohol consumption were created based on consumption over 25 years of observations and compared with levels of NT-proBNP measured at mean age 63. RESULTS We found that those who drank heavily (both currently and long-term) had higher levels of NT-proBNP than moderate drinkers, after adjusting for major confounders (age, sex, socio-economic position and smoking). As NT-proBNP has attracted attention as a biomarker for heart failure, this suggests a critical pathway through which heavy drinking may increase risk of this cardiovascular disease. When we looked at heavy drinkers who varied their intake over the decades, it was only the recently heavy group that had higher levels of NT-proBNP. Further work is needed to demonstrate whether effects are reversible upon cessation of heavy drinking, but this finding highlights the need to have repeated data to unpack dynamics over time. CONCLUSION Our findings suggest heavy drinkers could be screened for NT-proBNP levels in order to identify those at high risk earlier in the clinical stages of heart failure and targeted for risk reduction strategies.
Collapse
Affiliation(s)
- Annie Britton
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK.
| | - Dara O’Neill
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK,CLOSER, UCL Institute of Education, University College London, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at University College London, London, UK
| | - Steven Bell
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK,Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort’s Causeway, Cambridge, CB1 8RN, UK,Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| |
Collapse
|
22
|
Zheng Q, Lin W, Liu C, Zhou Y, Chen T, Zhang L, Zhang X, Yu S, Wu Q, Jin Z, Zhu Y. Prevalence and epidemiological determinants of metabolically obese but normal-weight in Chinese population. BMC Public Health 2020; 20:487. [PMID: 32293373 PMCID: PMC7161294 DOI: 10.1186/s12889-020-08630-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/01/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND There is metabolic heterogeneity in normal-weight individuals, however, there has been limited research in the Chinese population. This study aimed to investigate the prevalence, distribution and epidemiological determinants of metabolically obese but normal-weight (MONW) in a Chinese population. METHODS A total of 17,876 normal-weight individuals were recruited from 37,815 individuals in Zhejiang province in southeastern China. Normal-weight was defined as a body mass index (BMI) of 18.5-23.9 kg/m2. Metabolically abnormal traits were assessed by metabolic syndrome criteria from the International Diabetes Federation (IDF) in 2015. MONW was defined as individuals who had at least two metabolically abnormal trait but normal weight. Multiple logistic regression was used to investigate MONW risk factors, adjusting for potential confounders. RESULTS The prevalence of metabolic abnormality was 34.1% in normal-weight individuals, and the overall prevalence of MONW was 16.1% in the general population. Different MONW distributions were found between men and women depending on age. Compared with women, men had a significantly higher MONW prevalence among those aged < 45 years old, and there was a lower prevalence for those aged ≥50 years old. Higher BMI or waist circumference (WC), central obesity, menopause, and family histories of hypertension, diabetes, and cardiovascular diseases, increased MONW risk. Higher education levels, regular alcohol drinking, and balanced or vegetarian food preferences reduced MONW risk. CONCLUSIONS Normal-weight individuals have metabolic heterogeneity in China. The MONW distribution between men and women depends on age. BMI, WC, dietary factors, and family history of chronic diseases, are associated with metabolic status.
Collapse
Affiliation(s)
- Qianqian Zheng
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Weihua Lin
- Hangzhou MetaWell Technology Co., Hangzhou, China
| | - Chengguo Liu
- Putuo District People's Hospital, Zhoushan, 316100, Zhejiang, China
| | - Yaohan Zhou
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Tianhui Chen
- Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang Province, China
| | - Liqun Zhang
- Putuo District People's Hospital, Zhoushan, 316100, Zhejiang, China
| | - Xuhui Zhang
- Hangzhou Center for Disease Control and Preventio, Hangzhou, 310051, Zhejiang, China
| | - Senhai Yu
- Daicun Town Community Health Service Center, Xiaoshan District, Hangzhou, Zhejiang, China
| | - Qiong Wu
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Ziqi Jin
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Yimin Zhu
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
- Department of Respiratory Diseases, Sir Run Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University, Hangzhou, 310020, Zhejiang, China.
| |
Collapse
|
23
|
Butler T, Kerley CP, Altieri N, Alvarez J, Green J, Hinchliffe J, Stanford D, Paterson K. Optimum nutritional strategies for cardiovascular disease prevention and rehabilitation (BACPR). Heart 2020; 106:724-731. [PMID: 32098809 PMCID: PMC7229899 DOI: 10.1136/heartjnl-2019-315499] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/28/2019] [Accepted: 01/02/2020] [Indexed: 12/20/2022] Open
Abstract
Nutrition has a central role in both primary and secondary prevention of cardiovascular disease yet only relatively recently has food been regarded as a treatment, rather than as an adjunct to established medical and pharmacotherapy. As a field of research, nutrition science is constantly evolving making it difficult for patients and practitioners to ascertain best practice. This is compounded further by the inherent difficulties in performing double-blind randomised controlled trials. This paper covers dietary patterns that are associated with improved cardiovascular outcomes, including the Mediterranean Diet but also low-carbohydrate diets and the potential issues encountered with their implementation. We suggest there must be a refocus away from macronutrients and consideration of whole foods when advising individuals. This approach is fundamental to practice, as clinical guidelines have focused on macronutrients without necessarily considering their source, and ultimately people consume foods containing multiple nutrients. The inclusion of food-based recommendations aids the practitioner to help the patient make genuine and meaningful changes in their diet. We advocate that the cardioprotective diet constructed around the traditional Mediterranean eating pattern (based around vegetables and fruits, nuts, legumes, and unrefined cereals, with modest amounts of fish and shellfish, and fermented dairy products) is still important. However, there are other approaches that can be tried, including low-carbohydrate diets. We encourage practitioners to adopt a flexible dietary approach, being mindful of patient preferences and other comorbidities that may necessitate deviations away from established advice, and advocate for more dietitians in this field to guide the multi-professional team.
Collapse
Affiliation(s)
- Tom Butler
- Department of Clinical Sciences and Nutrition, University of Chester, Chester, UK .,BACPR Diet Working Group
| | - Conor P Kerley
- BACPR Diet Working Group.,Connolly Hospital Blanchardstown, Dublin, Ireland
| | - Nunzia Altieri
- BACPR Diet Working Group.,Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Joe Alvarez
- BACPR Diet Working Group.,Whittington Health NHS Trust, London, UK
| | - Jane Green
- BACPR Diet Working Group.,Doddington Hospital - Cambridgeshire and Peterborough NHS Foundation Trust, Doddington, UK
| | - Julie Hinchliffe
- BACPR Diet Working Group.,Salford Royal NHS Foundation Trust, Salford, UK
| | - Dell Stanford
- BACPR Diet Working Group.,Department of Community Cardiology, Central London Community NHS Trust, Berkhamstead, UK
| | - Katherine Paterson
- BACPR Diet Working Group.,Norfolk and Norwich University Hospital, Norwich, UK
| |
Collapse
|
24
|
Russell M, Fan AZ, Freudenheim JL, Dorn J, Trevisan M. Lifetime Drinking Trajectories and Nonfatal Acute Myocardial Infarction. Alcohol Clin Exp Res 2019; 43:2384-2394. [PMID: 31566766 DOI: 10.1111/acer.14190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/29/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The relation of lifetime drinking trajectories to coronary heart disease is not well understood. METHODS Cases hospitalized for a nonfatal acute myocardial infarction (AMI) and healthy population-based controls matched on age and sex completed a physical examination and an interview covering known AMI risk factors and a detailed lifetime drinking history. Distinct lifetime drinking trajectories based on ounces of ethanol consumed per decade between ages 10 and 59 years were derived and characterized according to lifetime drinking patterns associated with each. Sex-specific multiple logistic regression analyses were conducted to estimate AMI risk among participants who never drank regularly compared to lifetime drinking trajectories and risk associated with distinct trajectories among former and current drinkers. RESULTS Two lifetime drinking trajectories were derived, early peak and stable. Early peak trajectories were characterized by earlier onset of regular drinking, less frequent drinking, more drinks per drinking day, fewer total drinks, more frequent drunkenness per drinking year, and reduced alcohol intake or abstention by middle age. Never drinking regularly, reported by significantly more women than men, was associated with significantly higher AMI risk than stable lifetime drinking trajectories among men and in the sex-combined analysis of former drinkers only. Compared to stable lifetime drinking trajectories, early peak trajectories were associated with significantly higher AMI risk among male former drinkers, among sex-combined former drinkers, and among female current drinkers. CONCLUSIONS Epidemiological studies of alcohol and health in populations over age 35 may have underestimated the impact of heavy episodic drinking during adolescence and emerging adulthood on the cardiovascular system.
Collapse
Affiliation(s)
- Marcia Russell
- Prevention Research Center, Pacific Institute for Research and Evaluation (PIRE), Berkeley, California
| | - Amy Z Fan
- Prevention Research Center, Pacific Institute for Research and Evaluation (PIRE), Berkeley, California
| | - Jo L Freudenheim
- Department of Social and Preventive Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Joan Dorn
- Sophie Davis Biomedical Education Program, City University of New York School of Medicine, New York, New York
| | | |
Collapse
|
25
|
Gémes K, Moeller J, Engström K, Sidorchuk A. Alcohol consumption trajectories and self-rated health: findings from the Stockholm Public Health Cohort. BMJ Open 2019; 9:e028878. [PMID: 31427328 PMCID: PMC6701653 DOI: 10.1136/bmjopen-2018-028878] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/20/2019] [Accepted: 07/12/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To investigate whether poor self-rated health and psychological distress are differentially associated with drinking trajectories over time. METHODS From the Stockholm Public Health Cohort, two subcohorts surveyed in 2002-2010-2014 and 2006-2010-2014 (n=23 794 and n=34 667 at baseline, respectively) were used. Alcohol consumption, self-rated health, psychological distress (measured by General Health Questionnaire-12), lifestyle factors and longstanding illness were assessed by questionnaires. Demographic and socioeconomic variables were obtained by register linkage. Logistic regression was fitted to assess the associations with eight alcohol consumption trajectories, which were constructed among 30 228 individuals (13 898 and 16 330 from the 2002 and 2006 subcohorts, respectively) with measures of consumption at three time points. RESULTS Compared with stable moderate drinkers, all other trajectories were associated with poor self-rated health with multiadjusted OR for stable non-drinkers of 2.35 (95% CIs 1.86 to 2.97), unstable non-drinkers (OR=2.58, 95% CI 1.54 to 3.32), former drinkers (OR=2.81, 95% CI 2.31 to 3.41) and stable heavy drinkers (OR=2.16, 95% CI 1.47 to 3.20). The associations were not fully explained by sociodemographic and lifestyle factors and longstanding illness. Former drinking, but no other trajectories, was associated with psychological distress (OR=1.24; 95% CI 1.10 to 1.41). CONCLUSION We found a U-shape association between alcohol trajectories and self-rated health, but not with psychological distress. Compared with stable moderate drinking, former drinking was associated with the highest odds of both poor self-rated health and psychological distress. The study confirms the importance of a life-course approach to examining the effect of alcohol consumption on health and highlights the poorer general and mental health status of non-drinkers who were former drinkers.
Collapse
Affiliation(s)
- Katalin Gémes
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jette Moeller
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Karin Engström
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Anna Sidorchuk
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm & Healthcare Services, Stockholm County Council, CAP Research Center, Gävlegatan, Stockholm
| |
Collapse
|
26
|
Han T, Zhang S, Duan W, Ren X, Wei C, Sun C, Li Y. Eighteen-year alcohol consumption trajectories and their association with risk of type 2 diabetes and its related factors: the China Health and Nutrition Survey. Diabetologia 2019; 62:970-980. [PMID: 30923839 DOI: 10.1007/s00125-019-4851-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 02/18/2019] [Indexed: 01/09/2023]
Abstract
AIMS/HYPOTHESIS Alcohol consumption levels frequently fluctuate over the life course, but studies examining the association between alcohol consumption trajectories and type 2 diabetes are limited. This study aims to investigate the association of alcohol consumption trajectories with the risk of type 2 diabetes and its related factors. METHODS Weighted longitudinal data were obtained for 12,186 adults who completed a questionnaire about alcohol consumption and diabetes status as part of the China Health and Nutrition Survey (1993-2011). Participants were designated into subgroups based on alcohol consumption trajectory, and subgroup analyses included 5436 individuals who were tested for specified diabetes-related factors. Light alcohol consumption was defined as fewer than seven standard drinks per week; moderate as 7-21 drinks per week; and heavy as more than 21 drinks per week. Latent class trajectory modelling was used to identify different alcohol consumption trajectories by sex. Multivariate Cox regression models and general linear regression models were used to assess association of trajectories with type 2 diabetes and its related factors. RESULTS Compared with stable abstainers (individuals who never drank alcohol), two trajectories in men showing reduction to moderate or light levels after heavy alcohol consumption during early adulthood were significantly associated with increased risk of type 2 diabetes (HR 1.66 [95% CI 1.18, 2.33]; HR 1.93 [95% CI 1.01, 3.70]), while no significant association between trajectories and risk of type 2 diabetes was observed in women (p for trend = 0.404). Triacylglycerol, HDL-cholesterol (HDL-C), uric acid and high sensitivity C-reactive protein were significantly higher in these two trajectories than other trajectories in men (all p < 0.05), while only HDL-C showed significant increasing trends in women. Trajectories showing light-stable, or increase to moderate, levels were not associated with reduced risk of type 2 diabetes. CONCLUSIONS This study indicated that heavy alcohol consumption in early adulthood is significantly associated with increased risk of type 2 diabetes and higher levels of its biomarkers throughout adulthood in men. Gradually reducing alcohol consumption to moderate levels may not make a difference, which demonstrates the importance of alcohol intervention strategies in early adulthood. Although association between alcohol consumption and increased HDL-C levels has been observed, the results of this study did not support the hypothesis regarding the protective effect of moderate alcohol consumption on risk of type 2 diabetes in the Asian population. DATA AVAILABILITY Data from China Health and Nutrition Survey was used in this study, which can be downloaded at www.cpc.unc.edu/projects/china .
Collapse
Affiliation(s)
- Tianshu Han
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, People's Republic of China, 150081
| | - Shuang Zhang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, People's Republic of China, 150081
- Department of Endocrinology, The Second Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Wei Duan
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, People's Republic of China, 150081
| | - Xinhui Ren
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, People's Republic of China, 150081
| | - Chunbo Wei
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, People's Republic of China, 150081
| | - Changhao Sun
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, People's Republic of China, 150081.
| | - Ying Li
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, People's Republic of China, 150081.
| |
Collapse
|
27
|
Alcohol Pattern Consumption Differently Affects the Efficiency of Macrophage Reverse Cholesterol Transport in Vivo. Nutrients 2018; 10:nu10121885. [PMID: 30513887 PMCID: PMC6316025 DOI: 10.3390/nu10121885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 11/23/2018] [Accepted: 11/26/2018] [Indexed: 12/22/2022] Open
Abstract
It has been well established that moderate alcohol consumption inversely correlates with cardiovascular morbidity and mortality, whereas binge alcohol drinking increases cardiovascular disease risk. The aim of this study was to assess in vivo the impact of different drinking patterns on reverse cholesterol transport (RCT); the atheroprotective process leading to the removal of excess cholesterol from the body. RCT was measured with a standardized, radioisotope-based technique in three groups of atherosclerosis-prone apolipoprotein E knock out mice: Placebo group, receiving water, which would mimic the abstainers; moderate group, receiving 0.8 g/kg alcohol/day for 28 days, which would mimic a moderate intake; binge group, receiving 0.8 g/kg alcohol/day for 5 days/week, followed by the administration of 2.8 g/kg alcohol/day for 2 days/week, which would mimic a heavy intake in a short period. Mice in the binge drinking group displayed an increase in total cholesterol, high density lipoprotein cholesterol (HDL-c) and non-HDL-c (all p < 0.0001 vs. placebo), and a significantly reduced elimination of fecal cholesterol. The moderate consumption did not lead to any changes in circulating lipids, but slightly improved cholesterol mobilization along the RCT pathway. Overall, our data confirm the importance of considering not only the total amount, but also the different consumption patterns to define the impact of alcohol on cardiovascular risk.
Collapse
|