Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 14.087
Filtrar
1.
BMC Public Health ; 21(1): 1644, 2021 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-34496822

RESUMO

BACKGROUND: The study aimed to characterize the prevalence of alcohol consumption and further investigate the relationship between alcohol consumption and type 2 diabetes mellitus (T2DM). METHODS: We studied 39,259 participants aged 18 to 79 years of the Henan Rural Cohort study. The associations between alcohol consumption and T2DM were examined using the logistic regression models and restricted cubic spline. RESULTS: For men, alcohol abstinence was associated with an increased risk of T2DM (1.491(1.265, 1.758)), whereas current drinkers were not associated with T2DM (1.03(0.91, 1.15)). Further analysis of alcohol drinkers revealed that only high-risk drinkers of WHO drinking risk levels increased the risk of T2DM (1.289(1.061,1.566)) compared to never drinkers. The risk of T2DM increased as the age of starting to consume alcohol decreased and as the number of years of consuming alcohol and the alcohol intake increased only in men. We further found that the risk of T2DM decreased as the number of years of abstinence increases and no association between alcohol abstinence and T2DM was found after more than 10 years of abstinence among men. CONCLUSIONS: Our results suggested that reducing the amount of alcohol consumed and adhering to abstinence from alcohol consumption are beneficial in reducing the risk of T2DM. TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06. http://www.chictr.org.cn/showproj.aspx?proj=11375.


Assuntos
Diabetes Mellitus Tipo 2 , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , China/epidemiologia , Estudos de Coortes , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Humanos , Masculino , Prevalência , Fatores de Risco , População Rural
2.
Nutrients ; 13(8)2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34445006

RESUMO

Evidence for effective government policies to reduce exposure to alcohol's carcinogenic and hepatoxic effects has strengthened in recent decades. Policies with the strongest evidence involve reducing the affordability, availability and cultural acceptability of alcohol. However, policies that reduce population consumption compete with powerful commercial vested interests. This paper draws on the Canadian Alcohol Policy Evaluation (CAPE), a formal assessment of effective government action on alcohol across Canadian jurisdictions. It also draws on alcohol policy case studies elsewhere involving attempts to introduce minimum unit pricing and cancer warning labels on alcohol containers. Canadian governments collectively received a failing grade (F) for alcohol policy implementation during the most recent CAPE assessment in 2017. However, had the best practices observed in any one jurisdiction been implemented consistently, Canada would have received an A grade. Resistance to effective alcohol policies is due to (1) lack of public awareness of both need and effectiveness, (2) a lack of government regulatory mechanisms to implement effective policies, (3) alcohol industry lobbying, and (4) a failure from the public health community to promote specific and feasible actions as opposed to general principles, e.g., 'increased prices' or 'reduced affordability'. There is enormous untapped potential in most countries for the implementation of proven strategies to reduce alcohol-related harm. While alcohol policies have weakened in many countries during the COVID-19 pandemic, societies may now also be more accepting of public health-inspired policies with proven effectiveness and potential economic benefits.


Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Bebidas Alcoólicas/legislação & jurisprudência , Política de Saúde , Saúde Pública , Consumo de Bebidas Alcoólicas/efeitos adversos , Bebidas Alcoólicas/economia , COVID-19/epidemiologia , Canadá , Comércio/economia , Comércio/normas , Custos e Análise de Custo , Programas Governamentais , Regulamentação Governamental , Humanos , Pandemias , Rotulagem de Produtos/legislação & jurisprudência , Política Pública , SARS-CoV-2/isolamento & purificação
3.
PLoS One ; 16(8): e0255594, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34352012

RESUMO

INTRODUCTION: Implementation of evidence-based care for heavy drinking and depression remains low in global health systems. We tested the impact of providing community support, training, and clinical packages of varied intensity on depression screening and management for heavy drinking patients in Latin American primary healthcare. MATERIALS AND METHODS: Quasi-experimental study involving 58 primary healthcare units in Colombia, Mexico and Peru randomized to receive: (1) usual care (control); (2) training using a brief clinical package; (3) community support plus training using a brief clinical package; (4) community support plus training using a standard clinical package. Outcomes were proportion of: (1) heavy drinking patients screened for depression; (2) screen-positive patients receiving appropriate support; (3) all consulting patients screened for depression, irrespective of drinking status. RESULTS: 550/615 identified heavy drinkers were screened for depression (89.4%). 147/230 patients screening positive for depression received appropriate support (64%). Amongst identified heavy drinkers, adjusting for country, sex, age and provider profession, provision of community support and training had no impact on depression activity rates. Intensity of clinical package also did not affect delivery rates, with comparable performance for brief and standard versions. However, amongst all consulting patients, training providers resulted in significantly higher rates of alcohol measurement and in turn higher depression screening rates; 2.7 times higher compared to those not trained. CONCLUSIONS: Training using a brief clinical package increased depression screening rates in Latin American primary healthcare. It is not possible to determine the effectiveness of community support on depression activity rates due to the impact of COVID-19.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Alcoólicos/psicologia , Depressão/terapia , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/prevenção & controle , Intoxicação Alcoólica/psicologia , Alcoolismo/diagnóstico , Colômbia/epidemiologia , Comorbidade , Atenção à Saúde , Depressão/psicologia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , México/epidemiologia , Pessoa de Meia-Idade , Peru/epidemiologia , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Encaminhamento e Consulta , Detecção do Abuso de Substâncias/métodos
4.
Nutrients ; 13(7)2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34371928

RESUMO

The "drunken monkey" hypothesis posits that attraction to ethanol derives from an evolutionary linkage among the sugars of ripe fruit, associated alcoholic fermentation by yeast, and ensuing consumption by human ancestors. First proposed in 2000, this concept has received increasing attention from the fields of animal sensory biology, primate foraging behavior, and molecular evolution. We undertook a review of English language citations subsequent to publication of the original paper and assessed research trends and future directions relative to natural dietary ethanol exposure in primates and other animals. Two major empirical themes emerge: attraction to and consumption of fermenting fruits (and nectar) by numerous vertebrates and invertebrates (e.g., Drosophila flies), and genomic evidence for natural selection consistent with sustained exposure to dietary ethanol in diverse taxa (including hominids and the genus Homo) over tens of millions of years. We also describe our current field studies in Uganda of ethanol content within fruits consumed by free-ranging chimpanzees, which suggest chronic low-level exposure to this psychoactive molecule in our closest living relatives.


Assuntos
Consumo de Bebidas Alcoólicas , Evolução Biológica , Exposição Dietética , Etanol/metabolismo , Fermentação , Frutas/microbiologia , Leveduras/metabolismo , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/metabolismo , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/metabolismo , Alcoolismo/psicologia , Animais , Exposição Dietética/efeitos adversos , Etanol/efeitos adversos , Comportamento Alimentar , Frutas/metabolismo , Humanos , Pan troglodytes
6.
Medicine (Baltimore) ; 100(33): e26982, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34414976

RESUMO

OBJECTIVE: : To study the correlation between alcohol consumption and the risks of liver, esophageal squamous cell carcinoma (ESCC), and gastric cancers in China mainland by meta-analysis. METHODS: : We systematically searched electronic databases to identify the case-control studies that reported the association between alcohol consumption and the risks of liver, ESCC, and gastric cancers from January 1, 2010 to April 1, 2020. The Newcastle-Ottawa Scale (NOS) was used to evaluate literature quality, and I2 analyzes were used to evaluate the heterogeneity. RESULTS: : A total of 2855-related studies were retrieved. After conditional screening, we included 26 case-control studies for meta-analysis. Meta-analysis showed that alcohol consumption was associated with increased risks of liver, ESCC, and gastric cancers (total pooled odds ratio [OR], 1.83; 95% confidence interval [CI], 1.58-2.11; liver cancer OR, 1.83; 95% CI, 1.39-2.40; ESCC OR, 2.00; 95% CI, 1.66-2.40; gastric-cancer OR, 1.54; 95% CI, 1.10-2.15). Subgroup analysis results showed that the pooled ORs of volume of alcohol consumed, years of drinking, age of starting drinking, and drinking status were 1.71 (95% CI, 1.36-2.15), 1.65 (95% CI, 1.33-2.06), 1.38 (95% CI, 0.98-1.94), and 2.00 (95% CI, 1.42-2.81), respectively. Regression analysis showed that geographical region was a source of heterogeneity. CONCLUSION: : Alcohol consumption increased the risks of liver cancer, ESCC, and gastric cancers in China. Volume of alcohol consumed, years of drinking, age of starting drinking, and drinking status were all significant factors for these risks.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Neoplasias Esofágicas/diagnóstico , Neoplasias Hepáticas/diagnóstico , Neoplasias Gástricas/diagnóstico , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , China/epidemiologia , Correlação de Dados , Neoplasias Esofágicas/epidemiologia , Humanos , Neoplasias Hepáticas/epidemiologia , Razão de Chances , Neoplasias Gástricas/epidemiologia
7.
J Neuroophthalmol ; 41(3): 316-320, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34415266

RESUMO

BACKGROUND: Leber's hereditary optic neuropathy (LHON) is a disorder affecting oxidative phosphorylation in mitochondria. A majority of affected patients are men of 15 to 35 years of age. Phenotypic penetrance of this condition is only 50% in man and 10% in women and increases if the cellular energy demands go up, with the most common risk factors being smoking and alcohol use. METHODS: Review of clinical features of 3 patients who were diagnosed with LHON in their sixth decade of life after doubling their alcohol intake during the recent COVID-19 pandemic. RESULTS: All 3 patients were older than the age of 50 when they developed severe sequential visual loss. All have at least doubled their alcohol intake for at least 4 weeks preceding visual loss, and 2 who were smokers increased the number of cigarettes consumed daily because of the stress and boredom during the lockdowns triggered by the pandemic. CONCLUSIONS: Significant increase in substance abuse in the general population during the recent lockdowns to combat the COVID-19 pandemic is well documented. We report 3 patients older than the age of 50, one of them a woman, who developed severe bilateral visual loss due to LHON after doubling their alcohol consumption and increasing number of cigarettes smoked daily during the pandemic. Clinicians are reminded to consider LHON in the differential diagnosis when encountering older patients with bilateral sequential visual loss and to specifically inquire about alcohol use and cigarette smoking in these patients.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , COVID-19/complicações , Atrofia Óptica Hereditária de Leber/etiologia , Pandemias , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2
8.
Artigo em Inglês | MEDLINE | ID: mdl-34360212

RESUMO

(1) This longitudinal study aimed to investigate the link between prenatal alcohol exposure and prenatal maternal depression with the offspring's low-grade inflammatory status. (2) Prenatal alcohol exposure was determined via maternal self-report during the 3rd trimester of pregnancy (self-report+: n = 29) and the meconium alcohol metabolite Ethyl Glucuronide (EtG), collected at birth (≥30 ng/g: n = 23). The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for prenatal maternal depressive symptoms during the 3rd trimester (≥10: n = 35). Fifteen years later, 122 adolescents (M = 13.32 years; 48.4% female) provided blood samples for the analysis of high sensitivity C-reactive protein (hsCRP; M = 0.91; SD = 1.28). (3) Higher hsCRP levels were found in EtG positive adolescents (p = 0.036, ηp2 = 0.04) and an inverse non-significant dose-response relation with hsCRP (r = -0.35, p = 0.113). For maternal self-reported prenatal alcohol consumption (p = 0.780, ηp2 = 0.00) and prenatal depressive symptoms (p = 0.360, ηp2 = 0.01) no differences for hsCRP levels between the affected and unaffected groups were found. (4) Adolescents with prenatal alcohol exposure are at risk for low-grade systemic inflammation. The EtG biomarker may be more accurate compared to self-reports. The findings suggest that prenatal maternal depression does not evoke low-grade systemic inflammation.


Assuntos
Depressão , Efeitos Tardios da Exposição Pré-Natal , Adolescente , Consumo de Bebidas Alcoólicas/efeitos adversos , Depressão/epidemiologia , Feminino , Humanos , Recém-Nascido , Inflamação , Estudos Longitudinais , Masculino , Exposição Materna/efeitos adversos , Mecônio , Gravidez
9.
Am J Gastroenterol ; 116(9): 1844-1852, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34240714

RESUMO

INTRODUCTION: To help target preventive strategies, we estimated US population attributable risks (PARs) of demographic and potentially modifiable risk factors for esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), gastric cardia adenocarcinoma (GCA), and gastric noncardia adenocarcinoma (GNCA). METHODS: We prospectively examined the associations for risk factors and these cancers in 490,605 people in the National Institutes of Health-the American Association of Retired Persons Diet and Health cohort Diet and Health Study cohort from 1995 to 2011. Exposures were obtained from the baseline questionnaire. Diagnoses of gastroesophageal reflux disease were extracted for a subset of eligible National Institutes of Health-the American Association of Retired Persons Diet and Health cohort subjects through linkage to Medicare and then multiply imputed for non-Medicare-eligible subjects. Hazard ratios were calculated using multivariable-adjusted Cox proportional hazards regression. Adjusted population attributable risks were calculated for the US population aged 50-71 years by combining the hazard ratios with the estimated joint distribution of risk factor prevalence from the 2015 National Health Interview Survey. RESULTS: Smoking remained the most important risk factor for ESCC and was estimated to cause more than 1/3 of EAC and GCA and 1/10 of GNCA. Obesity and gastroesophageal reflux disease were associated with more than 1/2 of EAC and 1/3 of GCA. Compared with each lowest-risk level category, common risk factors were estimated to be associated with 73.7% of ESCC (95% confidence interval [CI]: 62.1%-85.4%), 70.3% of EAC (95% CI: 64.4%-76.2%), 69.3% of GCA (95% CI: 61.0%-77.7%), and 33.6% of GNCA (95% CI: 21.7%-45.5%). DISCUSSION: These factors accounted for a large proportion of esophageal and gastric cancers in the United States, highlighting opportunities for education and intervention to reduce the burden of these highly fatal cancers.


Assuntos
Adenocarcinoma/epidemiologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Fumar/efeitos adversos , Neoplasias Gástricas/epidemiologia , Adenocarcinoma/etiologia , Idoso , Dieta/efeitos adversos , Neoplasias Esofágicas/etiologia , Carcinoma de Células Escamosas do Esôfago/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco , Fatores de Risco , Neoplasias Gástricas/etiologia , Estados Unidos/epidemiologia
10.
Bull World Health Organ ; 99(7): 496-505, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34248222

RESUMO

Objective: To validate a Russian-language version of the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT). Methods: We invited 2173 patients from 21 rural and urban primary health-care centres in nine Russian regions to participate in the study (143 declined and eight were excluded). In a standardized interview, patients who had consumed alcohol in the past 12 months provided information on their sociodemographic characteristics and completed the Russian AUDIT, the Kessler Psychological Distress Scale and the Composite International Diagnostic Interview to identify problem drinking and alcohol use disorders. We assessed the feasibility of administering the test, its internal consistency and its ability to predict hazardous drinking and alcohol use disorders in primary health care in the Russian Federation. Findings: Of the 2022 patients included in the study, 1497 were current drinkers with Russian AUDIT scores. The test was internally consistent with good psychometric properties (Cronbach's α : 0.842) and accurately predicted alcohol use disorders and other outcomes (area under the curve > 75%). A three-item short form of the test correlated well with the full instrument and had similar predictive power (area under the curve > 80%). We determined sex-specific thresholds for all outcomes, as non-specific thresholds resulted in few women being identified. Conclusion: With the validated Russian AUDIT, there is no longer a barrier to introducing screening and brief interventions into primary health care in the Russian Federation to supplement successful alcohol control policies.


Assuntos
Alcoolismo/diagnóstico , Programas de Rastreamento/métodos , Inquéritos e Questionários/normas , Consumo de Bebidas Alcoólicas/efeitos adversos , Alcoolismo/epidemiologia , Feminino , Humanos , Masculino , Atenção Primária à Saúde , Psicometria , Reprodutibilidade dos Testes , População Rural , Federação Russa/epidemiologia , População Urbana
11.
Int J Mol Sci ; 22(14)2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34299105

RESUMO

The human gut is the largest organ with immune function in our body, responsible for regulating the homeostasis of the intestinal barrier. A diverse, complex and dynamic population of microorganisms, called microbiota, which exert a significant impact on the host during homeostasis and disease, supports this role. In fact, intestinal bacteria maintain immune and metabolic homeostasis, protecting our organism against pathogens. The development of numerous inflammatory disorders and infections has been linked to altered gut bacterial composition or dysbiosis. Multiple factors contribute to the establishment of the human gut microbiota. For instance, diet is considered as one of the many drivers in shaping the gut microbiota across the lifetime. By contrast, alcohol is one of the many factors that disrupt the proper functioning of the gut, leading to a disruption of the intestinal barrier integrity that increases the permeability of the mucosa, with the final result of a disrupted mucosal immunity. This damage to the permeability of the intestinal membrane allows bacteria and their components to enter the blood tissue, reaching other organs such as the liver or the brain. Although chronic heavy drinking has harmful effects on the immune system cells at the systemic level, this review focuses on the effect produced on gut, brain and liver, because of their significance in the link between alcohol consumption, gut microbiota and the immune system.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Disbiose/complicações , Microbioma Gastrointestinal , Sistema Imunitário/imunologia , Inflamação/patologia , Animais , Humanos , Inflamação/etiologia
12.
Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34209676

RESUMO

Alcohol consumption may be associated with the risk of rheumatoid arthritis (RA), but potential sex-related differences in this association have not been explored. Thus, we utilized 87,118 participants in the Kailuan Study, a prospective cohort initiated in 2006 to study the risk factors of cardiovascular disease in a Chinese population. We included those that did not have RA at baseline (2006), and performed cox proportional hazard modeling to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) of RA according to the levels of alcohol consumption (never or past, light or moderate (<1 serving/day for women, <2 servings/day for men), and heavy (>1 serving/day for women, >2 servings/day for men), adjusting for age, sex, body mass index, and smoking. Diagnoses of RA were confirmed via medical record review by rheumatologists. From 2006 to 2018, we identified 87 incident RA cases. After adjusting for potential confounders, the HR of RA was 1.26 (95% CI: 0.62, 2.56) for participants with light or moderate alcohol consumption and 1.98 (95% CI: 0.93, 4.22) for participants with heavy alcohol consumption) versus non-drinkers. The HR of each 10 g increase in alcohol consumption was 1.11 (95% CI: 0.98, 1.26) (p-trend = 0.09). A significant association between alcohol consumption and RA risk was observed in women, but not in men (p for interaction = 0.06). Among women, each 10 g increase in alcohol consumption was significantly associated with a high risk of RA (HR: 1.56; 95% CI: 1.06, 2.29). In contrast, each 10 g increase in alcohol consumption was not significantly associated with the risk of RA in men (HR: 1.10; 95% CI: 0.97, 1.25). Excluding past drinkers generated similar results. In this prospective Chinese cohort, increasing alcohol consumption was associated with an elevated risk of RA among women, but not in men. These findings highlight the importance of incorporating analysis of sex differences into future studies of alcohol consumption and RA risk.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Artrite Reumatoide/epidemiologia , Fatores Sexuais , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Artrite Reumatoide/etiologia , Índice de Massa Corporal , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
13.
Lancet Oncol ; 22(8): 1071-1080, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34270924

RESUMO

BACKGROUND: Alcohol use is causally linked to multiple cancers. We present global, regional, and national estimates of alcohol-attributable cancer burden in 2020 to inform alcohol policy and cancer control across different settings globally. METHODS: In this population-based study, population attributable fractions (PAFs) calculated using a theoretical minimum-risk exposure of lifetime abstention and 2010 alcohol consumption estimates from the Global Information System on Alcohol and Health (assuming a 10-year latency period between alcohol consumption and cancer diagnosis), combined with corresponding relative risk estimates from systematic literature reviews as part of the WCRF Continuous Update Project, were applied to cancer incidence data from GLOBOCAN 2020 to estimate new cancer cases attributable to alcohol. We also calculated the contribution of moderate (<20 g per day), risky (20-60 g per day), and heavy (>60 g per day) drinking to the total alcohol-attributable cancer burden, as well as the contribution by 10 g per day increment (up to a maximum of 150 g). 95% uncertainty intervals (UIs) were estimated using a Monte Carlo-like approach. FINDINGS: Globally, an estimated 741 300 (95% UI 558 500-951 200), or 4·1% (3·1-5·3), of all new cases of cancer in 2020 were attributable to alcohol consumption. Males accounted for 568 700 (76·7%; 95% UI 422 500-731 100) of total alcohol-attributable cancer cases, and cancers of the oesophagus (189 700 cases [110 900-274 600]), liver (154 700 cases [43 700-281 500]), and breast (98 300 cases [68 200-130 500]) contributed the most cases. PAFs were lowest in northern Africa (0·3% [95% UI 0·1-3·3]) and western Asia (0·7% [0·5-1·2]), and highest in eastern Asia (5·7% [3·6-7·9]) and central and eastern Europe (5·6% [4·6-6·6]). The largest burden of alcohol-attributable cancers was represented by heavy drinking (346 400 [46·7%; 95% UI 227 900-489 400] cases) and risky drinking (291 800 [39·4%; 227 700-333 100] cases), whereas moderate drinking contributed 103 100 (13·9%; 82 600-207 200) cases, and drinking up to 10 g per day contributed 41 300 (35 400-145 800) cases. INTERPRETATION: Our findings highlight the need for effective policy and interventions to increase awareness of cancer risks associated with alcohol use and decrease overall alcohol consumption to prevent the burden of alcohol-attributable cancers. FUNDING: None.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Carga Global da Doença , Neoplasias/induzido quimicamente , Neoplasias/epidemiologia , Humanos
15.
Liver Int ; 41(9): 2020-2023, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34297882

RESUMO

Despite being widely recognized as a common cause of fatty liver, the exact impact of alcohol consumption on hepatic steatosis in the general population is elusive. The recent National Health and Nutrition Examination Survey (NHANES) allowed us to examine this relationship among US adults. Herein, we extracted data on detailed alcohol consumption and controlled attenuation parameter (CAP) by FibroScan from 4509 participants in NHANES 2017-2018. Compared to metabolic risk factors such as diabetes and obesity, the association between alcohol consumption and CAP was less significant. In multivariable analysis, only those drinking 5-7 times per week showed significant increases in CAP scores. Although both frequency and quantity of drinking were positively associated with CAP score, only frequency remained significant after adjustment for quantity and binge drinking. These epidemiological observations suggested that the impact of alcohol on hepatic steatosis was much smaller than metabolic factors and dependent upon the frequency of drinking.


Assuntos
Técnicas de Imagem por Elasticidade , Fígado Gorduroso , Hepatopatia Gordurosa não Alcoólica , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Fígado Gorduroso/diagnóstico por imagem , Fígado Gorduroso/epidemiologia , Fígado Gorduroso/etiologia , Humanos , Inquéritos Nutricionais , Obesidade/complicações , Obesidade/epidemiologia , Estados Unidos/epidemiologia
16.
Behav Neurol ; 2021: 6696806, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34257742

RESUMO

Aldehyde dehydrogenase 2 (ALDH2) polymorphisms are related to both stroke risk and alcohol consumption. However, the influence of ALDH2 polymorphisms and alcohol consumption on cognitive impairment after ischemic stroke remains unknown, as do the possible mechanisms. We enrolled 180 Han Chinese ischemic stroke patients from four community health centers in Bengbu, China. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and two different MoCA cutoff scores were used to define cognitive impairment in ischemic stroke patients. The ALDH2 genotypes were determined using polymerase chain reaction and direct sequencing. To assess the associations of ALDH2 polymorphisms and alcohol consumption with cognitive impairment after ischemic stroke, we performed binary logistic regression analysis with odds ratios. We revealed that individuals with the ALDH2 wild-type genotype were more likely to have high MoCA scores than those with the mutant and heterozygous types (p = 0.034). In addition, using two MoCA cutoff scores, the percentage of moderate to excessive alcohol consumption in the cognitive impairment group was higher than that in the nonimpairment group (p = 0.001). The levels of 4-hydroxy-2-nonenal (p = 0.001) and swallowing function (p = 0.001) were also higher in the cognitive impairment group than in the nonimpairment group. Moreover, after adjusting for other potential risk factors, ALDH2 polymorphisms and alcohol consumption had a significant synergistic effect on cognitive impairment (p = 0.022). Specifically, the ALDH2∗2 mutant allele and higher alcohol consumption were associated with cognitive impairment and swallowing ability after ischemic stroke. Targeting ALDH2 may be a useful biomarker for cognitive rehabilitation following ischemic stroke.


Assuntos
Isquemia Encefálica , Disfunção Cognitiva , AVC Isquêmico , Acidente Vascular Cerebral , Álcool Desidrogenase/genética , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/genética , Aldeído Desidrogenase/genética , Aldeído-Desidrogenase Mitocondrial/genética , Isquemia Encefálica/complicações , Isquemia Encefálica/genética , China , Disfunção Cognitiva/complicações , Disfunção Cognitiva/genética , Genótipo , Humanos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/genética
19.
Mayo Clin Proc ; 96(7): 1758-1769, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34218856

RESUMO

OBJECTIVE: To investigate the joint associations of amounts of alcohol consumed and drinking habits with the risks of all-cause mortality and cause-specific mortality. PATIENTS AND METHODS: A total of 316,627 healthy current drinkers, with baseline measurements between March 13, 2006, and October 1, 2010, were included in this study. We newly created a drinking habit score (DHS) according to regular drinking (frequency of alcohol intake ≥3 times/wk) and whether consuming alcohol with meals (yes). RESULTS: During a median follow-up of 8.9 years, we documented 8652 incident cases of all-cause death, including 1702 cases of cardiovascular disease death, 4960 cases of cancer death, and 1990 cases of other-cause death. After adjustment confounders and amount of alcohol consumed, higher DHS was significantly associated with a lower risk of all-cause mortality, cardiovascular disease mortality, cancer mortality, or other-cause mortality (Ptrend<.001, Ptrend=.03, Ptrend<.001, and Ptrend<.001, respectively). We observed that the amount of alcohol consumed have different relationships with the risks of all-cause mortality and cause-specific mortality among participants with distinct drinking habits, grouped by DHS. For example, in the joint analyses, a J-shaped association between the amount of alcohol consumed and all-cause mortality was observed in participants with unfavorable DHS (Pquadratictrend=.02) while the association appeared to be U-shaped in participants with favorable DHS (Pquadratictrend=.003), with lower risks in those consuming greater than or equal to 50 g/wk and less than 300 g/wk. CONCLUSION: Our results indicate that alcohol consumption levels have different relationships with the risk of mortality among current drinkers, depending on their drinking habits.


Assuntos
Consumo de Bebidas Alcoólicas , Doenças Cardiovasculares/mortalidade , Etanol , Neoplasias/mortalidade , Medição de Risco , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/fisiopatologia , Causas de Morte , Depressores do Sistema Nervoso Central/metabolismo , Depressores do Sistema Nervoso Central/farmacologia , Correlação de Dados , Etanol/metabolismo , Etanol/farmacologia , Feminino , Seguimentos , Hormese , Humanos , Masculino , Refeições , Pessoa de Meia-Idade , Mortalidade , Fatores de Proteção , Fatores de Risco , Estados Unidos/epidemiologia
20.
JAMA ; 326(2): 165-176, 2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34255003

RESUMO

Importance: Alcohol-associated liver disease results in cirrhosis in approximately 10% to 20% of patients. In 2017, more than 2 million people had alcohol-associated cirrhosis in the US. Alcohol-associated liver disease is the primary cause of liver-related mortality and the leading indication for liver transplant, representing 40% to 50% of all liver transplant in high-income countries. Observations: Steatosis, alcoholic hepatitis, and fibrosis are the 3 pathologic findings that are associated with progression to cirrhosis, with highest risk in patients with alcoholic hepatitis. The amount and duration of alcohol consumption, female sex, obesity, and specific genetic polymorphisms such as patatin-like phospholipase domain protein 3, membrane bound O-acyltransferase, and transmembrane 6 superfamily member 2 genes are risk factors for alcohol-associated liver disease progression. Ten-year survival of patients with alcohol-associated liver disease is 88% among those who are abstinent and 73% for those who relapse to alcohol consumption. Symptomatic alcoholic hepatitis is characterized by rapid onset of jaundice and a 30% risk of mortality 1 year after diagnosis. Severe alcoholic hepatitis, defined as a modified discriminant function score greater than or equal to 32 or Model for End-Stage Liver Disease score (starts at 6 and capped at 40; worst = 40) greater than 20, is associated with the development of acute-on-chronic liver failure and multiorgan failure. Corticosteroid therapy is associated with improved 1-month survival from 65% in untreated patients to 80% in treated patients. Early liver transplant may be appropriate in highly select patients with severe alcoholic hepatitis who do not respond to medical therapy. In patients with decompensated cirrhosis, liver transplant should be considered if the Model for End-Stage Liver Disease score remains greater than 17 after 3 months of alcohol abstinence. Between 2014 and 2019, the proportion of patients waiting for liver transplantation who had alcohol-associated liver disease increased from 22% to 40%. Alcohol-associated cirrhosis accounted for approximately 27% of 1.32 million deaths worldwide related to cirrhosis in 2017. Conclusions and Relevance: Alcohol-associated liver disease is among the most common liver diseases and more than 2 million people in the US in 2017 had alcohol-associated cirrhosis. Corticosteroid therapy improves survival in select patients with severe alcoholic hepatitis. Liver transplantation is the most effective therapy in patients with decompensated liver disease.


Assuntos
Corticosteroides/uso terapêutico , Hepatopatias Alcoólicas , Transplante de Fígado , Fígado/patologia , Abstinência de Álcool , Consumo de Bebidas Alcoólicas/efeitos adversos , Feminino , Humanos , Fígado/metabolismo , Hepatopatias Alcoólicas/diagnóstico , Hepatopatias Alcoólicas/genética , Hepatopatias Alcoólicas/terapia , Masculino , Fatores de Risco , Índice de Gravidade de Doença
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...