Risk of somatic disease and mortality in individuals of parents with alcohol use disorder: a register-based cohort study.

AIMS: To estimate the risks of 12 types of somatic disease-alcohol-related, blood, cancer, circulatory, digestive, endocrine and metabolic, genitourinary, infectious, musculoskeletal, nervous, respiratory and skin-in individuals with parental alcohol use disorder (AUD) versus a reference population, and to estimate the risks of all-cause mortality and of death from an alcohol-related cause. DESIGN: Matched cohort study followed-up through nation-wide health registries. Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). SETTING: Denmark. PARTICIPANTS: A total of 14 008 individuals born 1962-2003 of parents with AUD and 139 087 reference offspring randomly selected from the Danish Civil Registration System were followed from their 15th birthday and onward during 1970-2018. Follow-up time ranged between 2 423 955 and 3 208 366 person-years for somatic diseases and was 3 214 411 person-years for all-cause and alcohol-related mortality. MEASUREMENTS: Information on somatic disease was obtained from the Danish National Patient Registry. Causes of death were obtained from the Danish Cause of Death Registry. FINDINGS: Individuals of parents with AUD had a higher risk of alcohol-related diseases (HR = 2.70, 95% CI = 2.24-3.24) compared with the reference individuals. Higher HRs among individuals with parental AUD compared with reference individuals were also observed in all other somatic diseases except for cancer. All-cause mortality (HR = 1.80, 95% CI = 1.63-2.00) and alcohol-related mortality (HR = 3.28, 95% CI = 2.11-5.08) were higher among individuals of parents with AUD compared with the reference individuals. No significant differences were found in relation to the gender of either parents or offspring. CONCLUSIONS: In Denmark, parental alcohol use disorder appears to predict alcohol-related and non-alcohol-related somatic morbidity and mortality in offspring.

Family structure and alcohol use disorder: a register-based cohort study among offspring with and without parental alcohol use disorder.

AIMS: To assess whether parental alcohol use disorder (AUD) is associated with higher risks of living in a non-intact family and assess whether non-intact family structure is associated with higher risks of AUD in the offspring. DESIGN: Prospective cohort study. SETTING: Danish nation-wide registries. PARTICIPANTS: A total of 9948 parental AUD offspring and 98 136 reference offspring from the Danish population. MEASUREMENTS: Family structure assessed at birth and at each birthday until age 15 as intact or non-intact (with mother only, father only or neither parent); years lived in an intact family defined as total number of years lived with both parents from birth until the 15th birthday; AUD defined as registration in medical, treatment and cause of death registries. Data were analyzed by Cox regression. FINDINGS: At birth, 30.9% [95% confidence interval (CI) = 29.1-32.6] of parental AUD offspring and 10.7% (95% CI = 10.3-11.0) of reference offspring lived in a non-intact family. At age 15, the numbers were 84.6% (95% CI = 83.9-85.3) and 38.4% (95% CI = 38.1-38.7). Parental AUD was associated with a higher risk of offspring AUD [hazard ratio (HR) = 1.88, 95% CI = 1.74-2.02]. Offspring were at lower risk of AUD if they lived 15 years in an intact family compared with offspring who never lived in an intact family (HR = 0.67, 95% CI = 0.52-0.87 for those with parental AUD, and HR = 0.53, 95% CI = 0.48-0.59 for those whose parents did not have AUD). Findings were inconclusive as to whether or not an association was present between family structure and AUD among offspring with parental AUD and reference offspring. CONCLUSIONS: The prevalence of non-intact family structure appears to be higher in offspring of parents with alcohol use disorder (AUD) than among offspring from the general population. Parental AUD appears to be associated with increased risk of offspring AUD, and non-intact family structure appears to be associated with increased risk of offspring AUD regardless of parental AUD.

Validation and calibration of self-reported height and weight in the Danish Health Examination Survey.

BACKGROUND: Body mass index (BMI) derived from self-reported information is widely used and the validity is therefore crucial. We aim at testing the validity of self-reported height and weight, and to test if the accuracy of self-reported information can be improved by calibration by testing if calibration improved the ability to predict diabetes. METHODS: Data from Danish Health Examination Survey (DANHES) was used. 15 692 participants who had both filled out questionnaire and participated in health examination, and 54 725 participants with questionnaire alone, were included. Data was analyzed using Pearson's R, Cohens Kappa, linear regression and Cox-regression. Self-reported values of height and weight were calibrated using coefficients obtained from linear regression analysis. To evaluate if the calibration improved the ability to predict diabetes, Akaike's information criterion was used. RESULTS: Self-reported height, weight and BMI were highly correlated with measured values (R ≥ 0.92). BMI was under-reported by 0.32 kg m-2 and 0.38 kg m-2 in women and men. The hazard ratio (HR) (95% confidence interval) for diabetes according to measured BMI was 2.09 (1.89-2.27) and for self-reported BMI was 1.60 (1.50-1.70) per 5 kg m-2. Calibrated values of self-reported BMI improved the predictive value of BMI for the risk of diabetes. CONCLUSIONS: Self-reported height and weight correlated highly with physical measurement of height and weight. Measured values of BMI were more strongly associated with diabetes risk as compared to self-reported values. Calibration of the self-reported values improved the accuracy of self-reported height and weight.

Alcohol drinking patterns and risk of diabetes: a cohort study of 70,551 men and women from the general Danish population.

AIMS/HYPOTHESIS: Alcohol consumption is inversely associated with diabetes, but little is known about the role of drinking patterns. We examined the association between alcohol drinking patterns and diabetes risk in men and women from the general Danish population. METHODS: This cohort study was based on data from the Danish Health Examination Survey 2007-2008. Of the 76,484 survey participants, 28,704 men and 41,847 women were eligible for this study. Participants were followed for a median of 4.9 years. Self-reported questionnaires were used to obtain information on alcohol drinking patterns, i.e. frequency of alcohol drinking, frequency of binge drinking, and consumption of wine, beer and spirits, from which we calculated beverage-specific and overall average weekly alcohol intake. Information on incident cases of diabetes was obtained from the Danish National Diabetes Register. Cox proportional hazards model was applied to estimate HRs and 95% CIs. RESULTS: During follow-up, 859 men and 887 women developed diabetes. The lowest risk of diabetes was observed at 14 drinks/week in men (HR 0.57 [95% CI 0.47, 0.70]) and at 9 drinks/week in women (HR 0.42 [95% CI 0.35, 0.51]), relative to no alcohol intake. Compared with current alcohol consumers consuming <1 day/week, consumption of alcohol on 3-4 days weekly was associated with significantly lower risk for diabetes in men (HR 0.73 [95% CI 0.59, 0.94]) and women (HR 0.68 [95% CI 0.53, 0.88]) after adjusting for confounders and average weekly alcohol amount. CONCLUSIONS/INTERPRETATION: Our findings suggest that alcohol drinking frequency is associated with risk of diabetes and that consumption of alcohol over 3-4 days per week is associated with the lowest risk of diabetes, even after taking average weekly alcohol consumption into account.

Alcohol dependence and risk of somatic diseases and mortality: a cohort study in 19 002 men and women attending alcohol treatment.

AIMS: To (1) estimate sex-specific risks of a comprehensive spectrum of somatic diseases in alcohol-dependent individuals versus a control population, and in the same population to (2) estimate sex-specific risks of dying from the examined somatic diseases. DESIGN: Register-based matched cohort study. Alcohol-dependent individuals were identified from the Copenhagen Alcohol Cohort. Controls were selected randomly from the Danish Civil Registration System. Information on somatic diseases was obtained from the Danish National Patient Registry and causes of death obtained from the Cause of Death Registry. Cox proportional hazards model was applied to estimate hazard ratios (HRs). SETTING: Denmark. PARTICIPANTS: A total of 19 002 alcohol-dependent individuals and 186 767 controls. MEASUREMENTS: Outcome variables included 11 disease groups and 29 subgroups, defined according to the International Classification of Diseases (ICD). The main predictor variable was diagnosis of alcohol dependence according to ICD. FINDINGS: Alcohol-dependent men and women compared with controls had statistically significantly higher risks of all disease groups and the majority of subgroups when analysed as disease events. HRs were elevated for well-established alcohol-related diseases but also for diseases such as dementia [men, HR = 2.0, 95% confidence interval (CI) = 1.6-2.3; women, HR = 2.4, 95% CI = 1.8-3.2], psoriasis (men, HR = 4.3, 95% CI = 3.5-5.2; women, HR = 5.4, 95% CI = 3.7-7.8) and breast cancer in men (HR = 3.3, 95% CI = 1.6-7.0). Similar results were found when disease groups and subgroups were analysed as causes of death. CONCLUSIONS: Alcohol-dependent men and women have significantly higher risks of a comprehensive spectrum of somatic diseases, both as disease events and as causes of death, relative to individuals from the general population.

Perceived parental alcohol problems and drinking patterns in youth: A cross-sectional study of 69,030 secondary education students in Denmark.

The aim of the study was to examine whether young people with parental alcohol problems have different drinking patterns than those without parental alcohol problems. Further, we examined whether the association between parental alcohol problems and young people's drinking patterns differed depending on the gender of the child and the parent, and whether more severe parental alcohol problems and cohabitation with the parent with alcohol problems was associated with earlier and heavier drinking patterns. Data came from the Danish National Youth Study 2014, a web-based national survey. 75,025 high school and vocational school students (15-25years) participated. Drinking patterns were investigated by the following outcomes: non-drinking, weekly alcohol consumption, frequent binge drinking, and early intoxication debut age. The main predictor variables were perceived parental alcohol problems, gender of the parent with alcohol problems, cohabitation with a parent with alcohol problems and severity of the parents' alcohol problems. Young people with parental alcohol problems had a higher weekly alcohol consumption (boys: 15.2 vs. 13.9 drinks per week; girls: 11.6 vs. 10.2 drinks per week), higher odds of early intoxication debut age (boys: OR=1.68 [95% CI 1.50-1.89]; girls: OR 1.95 [95% CI 1.79-2.14]), and more frequent binge drinking (boys, OR=1.16 [95% CI 1.04-1.29]; girls, OR=1.21 [95% CI 1.11-1.32]) compared to young people without parental alcohol problems. In conclusion, this study shows that young people with perceived parental alcohol problems have an earlier intoxication debut age, binge drink more frequently, and drink larger quantities per week than young people without perceived parental alcohol problems.

High risk of neonatal complications in children of mothers with gestational diabetes mellitus in their first pregnancy.

INTRODUCTION: THE study presents the neonatal outcome from a cohort of women with gestational diabetes mellitus (GDM) in their first pregnancy. METHODS: During a five-year period (2009-2013), a prospective follow-up study was performed at the Department of Gynaecology and Obstetrics, Lillebaelt Hospital - Kolding. The study included 535 pregnant women diagnosed with GDM. A study population of nulliparous GDM patients was sampled, and during the period from 1 January 2010 to 1 March 2013, a total of 137 women delivered for the first time. The present study population considers the 131 offspring, excluding six pairs of twins. RESULTS: The overwhelming majority of the offspring had a birth weight within the normal range and only six (4.6%) were large for gestational age. There were 95 (72.5%) vaginal deliveries, whereas 36 (27.5%) were born by caesarean section (CS). Nearly half of the 25 nulliparous GDM patients with a body mass index ≥ 35 kg/m² delivered by CS - six by emergency CS and three by planned CS. A total of 20 neonates (15.3%) developed neonatal hypoglycaemia and four (3.1%) had an Apgar score < 7 after 5 min. A total of 25 (19.1%) among the offspring were admitted to the neonatal intensive care unit. CONCLUSION: The present study supports the notion of high-risk pregnancy among GDM patients. Compared with nulliparous in general, the offspring were more likely to be delivered by emergency CS. Despite the prophylactic procedures, one in six had neonatal hypoglycaemia.

Fever during pregnancy and motor development in children: a study within the Danish National Birth Cohort.

AIM: The aim of this study was to examine how fever during pregnancy is associated with motor development in the child. METHOD: This cohort study was based on data from females and their children, from the Danish National Birth Cohort, who took part in an 18-month and/or 7-year follow-up study. Information regarding fever (number of episodes, temperature, duration, and pregnancy week) was obtained around gestation week 12 and at the end of pregnancy. Assessments of motor development in early childhood were based on the ages at which the motor milestones 'sitting unsupported' (n=44,256) and 'walking unassisted' (n=53,959) were attained. The Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07) was used to identify children with indication of developmental coordination disorder (DCD) at age 7 years (n=29,401). Any associations between the exposure to fever during pregnancy and motor development were estimated using Cox regression and logistic regression analyses. RESULTS: Fever during pregnancy was reported by 15,234 (28.0%) participants in the 18-month follow-up and by 7965 (26.9%) participants in the 7-year follow-up. Adjusted analyses showed no association between prenatal exposure to fever and either 'sitting unsupported' or 'walking unassisted'. The proportion of children with indication of DCD was 3.1%. The odds ratio of indication of DCD if children were exposed to fever in utero was 1.29 (95% CI 1.12-1.49). However, no dose-response association was found. INTERPRETATION: We found a significant association between maternal fever during pregnancy and DCD in children at age 7 years. The lack of a dose-response association might suggest that this association is explained by the underlying causes of the fever.