Degree Of Alcohol Consumption Research Articles

Association between alcohol consumption and risk of hyperuricaemia among adults: a large cross-sectional study in Chongqing, China

ObjectiveTo investigate the relationship between alcohol consumption and hyperuricaemia (HUA), we conducted a study based on a large population.SettingCross-sectional study.ParticipantsA total of 20 833 participants aged 30–79 years were enrolled...

Hepatocellular carcinoma in patients with metabolic dysfunction-associated fatty liver disease: Can we stratify at-risk populations?

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new nomenclature recently proposed by a panel of international experts so that the entity is defined based on positive criteria and linked to pathogenesis, replacing the traditional non-alcoholic fatty liver disease (NAFLD), a definition based on exclusion criteria. NAFLD/MAFLD is currently the most common form of chronic liver disease worldwide and is a growing risk factor for development of hepatocellular carcinoma (HCC). It is estimated than 25% of the global population have NAFLD and is projected to increase in the next years. Major Scientific Societies agree that surveillance for HCC should be indicated in patients with NAFLD/ MAFLD and cirrhosis but differ in non-cirrhotic patients (including those with advanced fibrosis). Several studies have shown that the annual incidence rate of HCC in NAFLD-cirrhosis is greater than 1%, thus surveillance for HCC is cost-effective. Risk factors that increase HCC incidence in these patients are male gender, older age, presence of diabetes and any degree of alcohol consumption. In non-cirrhotic patients, the incidence of HCC is much lower and variable, being a great challenge to stratify the risk of HCC in this group. Furthermore, large epidemiological studies based on the general population have shown that diabetes and obesity significantly increase risk of HCC. Some genetic variants may also play a role modifying the HCC occurrence among patients with NAFLD. The purpose of this review is to discuss the epidemiology, clinical and genetic risk factors that may influence the risk of HCC in NAFLD/MAFLD patients and propose screening strategy to translate into better patient care.

Alcohol use and cardiometabolic risk in the UK Biobank: A Mendelian randomization study.

Observational studies suggest alcohol use promotes the development of some adverse cardiometabolic traits but protects against others including outcomes related to coronary artery disease. We used Mendelian randomization (MR) to explore causal relationships between the degree of alcohol consumption and several cardiometabolic traits in the UK Biobank. Using the well-established ADH1B Arg47His variant (rs1229984) and up to 24 additional SNPs recently found to be associated with alcohol consumption in an independent dataset as instruments, we conducted two-stage least squares and inverse weighted variance MR analyses, both as one-sample analyses in the UK Biobank and as two-sample analyses in external consortia. In the UK Biobank inverse variance weighted analyses, we found that one additional drink of alcohol per day was positively associated with systolic blood pressure (beta = 2.65 mmHg [1.40, 3.89]), hemorrhagic stroke (OR = 2.25 [1.41, 3.60]), and atrial fibrillation (OR = 1.26 [1.07, 1.48]), which were replicated in multivariable analyses. Alcohol was also associated with all cardiovascular disease and all-cause death. A positive association with myocardial infarction did not replicate in multivariable analysis, with suggestive mediation through blood pressure; similarly, a positive association between alcohol use with type 2 diabetes was mitigated by BMI in multivariable analysis. Findings were generally null in replication with two-sample analyses. Alcohol was not protective for any disease outcome with any analysis method, dataset, or strata. Stratifications by sex and smoking in the UK Biobank revealed higher point estimates of risk for several outcomes for men and mixed results for smoking strata, but no statistically significant heterogeneity. Our results are consistent with an overall harmful and/or null effect of alcohol on cardiometabolic health at all levels of use and suggest that even moderate alcohol use should not be promoted as a part of a healthy diet and lifestyle.

Insights into Nonalcoholic Fatty-Liver Disease Heterogeneity.

The acronym nonalcoholic fatty-liver disease (NAFLD) groups a heterogeneous patient population. Although in many patients the primary driver is metabolic dysfunction, a complex and dynamic interaction of different factors (i.e., sex, presence of one or more genetic variants, coexistence of different comorbidities, diverse microbiota composition, and various degrees of alcohol consumption among others) takes place to determine disease subphenotypes with distinct natural history and prognosis and, eventually, different response to therapy. This review aims to address this topic through the analysis of existing data on the differential contribution of known factors to the pathogenesis and clinical expression of NAFLD, thus determining the different clinical subphenotypes observed in practice. To improve our understanding of NAFLD heterogeneity and the dominant drivers of disease in patient subgroups would predictably impact on the development of more precision-targeted therapies for NAFLD.

Smoking, alcohol consumption, and the risk of thyroid cancer: a population-based Korean cohort study of 10 million people.

The association between smoking, alcohol consumption, and thyroid cancer has been evaluated in observational studies, yet the results remain controversial. In the present investigation, we analyzed a longitudinal cohort study with representative data to determine the association between smoking, alcohol consumption, and thyroid cancer risk, allowing for risk modification due to age and sex. From the Korean National Health Insurance database, .subjects aged ≥20 who participated in health screening program in 2009 were identified and followed-up till 2017. The adjusted hazard ratio (aHR) for the risk of thyroid cancer was estimated by Cox proportional hazard model Results: During a mean follow-up period of 8.33 ± 0.57 years, out of 9,699,104 participants, 89,527 (0.9%) were diagnosed with thyroid cancer. In comparison with those who never smoked, current smokers [aHR: 0.74, 95% confidence interval (CI): 0.72-0.76)] had a decreased risk of thyroid cancer even though ex-smokers (aHR: 0.98, 95% CI: 0.96-1.01) did not. There was no dose-response relationship when the participants were examined with regard to the daily amount of smoking, duration of smoking, and pack-years. A decrease in the risk of thyroid cancer was observed according to both the number of drinking episodes per week and the number of glasses per once drinking (HR: 0.81, 95% CI: 0.74-0.88 for drinks consumed 7 times/week and HR: 0.87, 95% CI: 0.82-0.92 for ≥ 15 glasses once drinking vs. nondrinkers). A certain degree of alcohol consumption seemed to provoke a decreased risk of thyroid cancer as compared to those who did not drink (HR: 0.85, 95% CI: 0.81-0.89 for ≥ 40 g/week). The interaction of smoking and alcohol consumption was found to be significant (p-interaction < 0.0001), and sub-multiplicative. We found that the risk of thyroid cancer incidence was inversely associated with smoking and alcohol consumption. A sub-multiplicative interaction between smoking and alcohol intake on the risk of thyroid cancer was found. Further studies are needed to elucidate exactly how smoking and alcohol are related to the pathogenesis and the modification their effects may have on thyroid cancer development.

Prevalence patterns of alcohol consumption and factors associated with problematic drinking on remote islands of Okinawa, Japan: a cross-sectional study.

Objective: This study aims to investigate the drinking behavior on the remote islands of Okinawa Prefecture.Patients/Materials and Method: This was a cross-sectional study conducted with residents of Okinawa Prefecture’s small, isolated islands. Between October 1 and December 3, 2014, island residents over 20 years of age who visited island clinics for an annual health checkup or influenza vaccination were recruited. An anonymous entry survey was administered to those who provided their consent. The survey included information on age, sex, presence or absence of drinking, age at drinking initiation, smoking status, comorbidities, and family and social background. The Alcohol Use Disorder Identification Test (AUDIT) was used to assess alcohol consumption. Participant characteristics were analyzed descriptively, and logistic regression analysis was conducted to assess relationships between the high-risk drinking group (AUDIT score ≥10 points) and other measured variables (age, sex, age at drinking initiation, smoking, residence, and employment status).Results: Compared to the results of a national survey in 2013, there was a significantly higher prevalence of male island residents who drank ≥40 g of alcohol per day and female island residents who drank ≥20 g/day, levels which are considered risk factors for lifestyle diseases. Among both male and female island residents, there were significantly higher proportions of those with AUDIT scores ≥8 points, referred to as high-risk drinkers, and those with AUDIT scores ≥20, individuals considered to have probable alcohol dependence, as compared to the results of the national survey. In a logistic regression analysis, factors related to high-risk drinking included younger age, male sex, smoking history, inoccupation, and underage drinking initiation.Conclusion: This is the first report on drinking behavior among inhabitants of Okinawa’s remote islands. The degree of alcohol consumption is serious and must be recognized as a regional health problem.

Population Risk of Ischemic Heart Disease Depending on the Volume of Alcohol Consumption by the Population (ЭССЕ-РФ Study in the Kemerovo Region)

to assess relationship between the prevalence of cardiovascular risk factors and associated population risk of ischemic heart disease (IHD) alcohol consumption in the Siberian region (Kemerovo Region). This work was carried out within the framework of a multicenter epidemiological study "Epidemiology of CardioVascular Diseases in the regions of the Russian Federation" (ЭССЕ-РФ in the Kemerovo region) in 2013. In the final form, the sample size was 1628 individuals aged 25-64 years. We analyzed data on frequency, volume, and type of consumed alcoholic beverages, as well as on the presence of a number of risk factors of cardiovascular diseases and IHD. Alcohol consumption was estimated by the original method, volume of alcohol consumed in a year was categorized as absent (non-drinkers), moderate, medium, and strong. The calculation of the population risk of IHD was carried out according to the author's methodology, taking into account the prevalence of risk factors and their contribution to the development of IHD. Prevalence of several risk factors among non-drinkers was significantly different (p&lt;0.05) compared with drinkers with varying degrees of alcohol consumption. In men, there were differences in low physical activity, hypertriglyceridemia, excess weight, education, in women - in anxiety, low physical activity, hypertriglyceridemia, educational qualifications, smoking. In nondrinking men, the additional risk of IHD associated with risk factors was slightly reduced (-1.1 %). In groups of moderate, moderate, and strong alcohol consumption, risk of IHD was higher than the population risk by 2.2 %, 0.7 % and 6.5 %, respectively. In non-drinking women high burden of risk factors accounted for additional risk of IHD (4.5 %). In women with moderate and medium alcohol consumption the risk of IHD was 2.5 and 1.9 %, respectively, lower compared with population risk. Abuse of alcohol in women caused significant increase in the burden of risk factors and, accordingly, was associated with high additional risk of IHD (18.7 %). Predominantly linear in men and J-shaped in women relationship between prevalence of risk factors and volume of alcohol consumption accounted for analogous tendencies in population IHD risk. Specific for men is close to linear dependence of additional IHD risk on population IHD risk with insignificant variability in non-drinkers, moderate and medial consumers, and with significant growth in alcohol abusers. Women have a J-shaped relationship: in extreme categories (non-drinkiers and alcohol abusers), the risk of IHD is higher than the population risk, while in the middle categories (moderate and medial consumers) it is lower than the population risk.

Moderate alcohol consumption is associated with atrial electrical and structural changes: Insights from high-density left atrial electroanatomic mapping

Regular alcohol intake is an important modifiable risk factor associated with atrial fibrillation (AF) and left atrial (LA) dilation. The purpose of this study was to determine the impact of different degrees of alcohol consumption on atrial remodeling using high-density electroanatomic mapping. We enrolled 75 patients before AF ablation to undergo high-density LA mapping (CARTO, Biosense Webster) using a multipolar catheter. The Confidense algorithm was used to create maps during distal coronary sinus pacing at 600 ms. Bipolar voltage and complex atrial activity were assessed, and isochronal activation maps were created to determine global conduction velocity (CV). Patients were classified as lifelong nondrinkers, mild drinkers (2-7 drinks/week), or moderate drinkers (8-21 drinks/week). High-density electroanatomic mapping (mean 1016 ± 445 points per patient) was performed on 25 lifelong nondrinkers, 25 mild drinkers (4.4 ± 2.3 drinks/week), and 25 moderate drinkers (14.0 ± 4.2 drinks/week). Moderate drinkers had significantly lower mean global bipolar voltages (1.53 ± 0.62 mV vs 1.89 ± 0.45 mV; P= .02), slower CV (33.5 ± 14.4 cm/s vs 41.7 ± 12.1 cm/s; P=.04), and a higher proportion of complex atrial potentials (7.8% ± 4.7% vs 4.5% ± 2.7%; P = .004) compared to nondrinkers. Global voltage and CV did not differ significantly in mild drinkers, but there was a significant increase in global complex potentials (6.6% ± 4.6%; P = .04) and regional low-voltage zones (<0.5 mV) in the septum and lateral wall (P <.05) compared with nondrinkers. Regular moderate alcohol consumption, but not mild consumption, is an important modifiable risk factor for AF associated with lower atrial voltage and conduction slowing. These electrical and structural changes may explain the propensity to AF in regular drinkers.

African American emerging adults' experiences with racial discrimination and drinking habits: The moderating roles of perceived stress.

Despite the abundance of research aimed at quantifying the impact of racism on the mental and physical health of African Americans, results remain inconclusive largely because of challenges with operationalization, as well as conflation with the concept of racial discrimination, which may be more readily assessed. The purpose of the current study was to: (a) determine whether racial discrimination had an impact on the degree of alcohol use and binge drinking among African American emerging adults, and if so, (b) determine whether perceived stress linked to racially discriminatory experiences moderated these associations. We used a series of hierarchical regressions to examine associations among racial discrimination, perceived stress, and degree of alcohol consumption in a sample of African American emerging adults in the southeast (n = 235). We found that the association between racial discrimination and degree of alcohol consumption (alcohol use and binge drinking) was strongest among individuals who reported greater levels of perceived stress linked to racial discrimination experiences. This association, however, was not significant for individuals who reported lower levels of perceived stress in response to racial discrimination. African Americans who experience a high degree of perceived stress in response to experiences with racial discrimination may be at greater risk for problem drinking than their peers with less perceived stress. These findings highlight the need for novel intervention efforts aimed at mitigating the effects of stress and racial discrimination on health outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Blunted autonomic responses to emotional stimuli in alcoholism: relevance of impulsivity.

Alcohol dependence is associated with abnormalities in the processing of emotional signals and impulsive alcohol-seeking behaviours, and these alterations compromise the effectiveness of treatment approaches. However, there is a lack of studies linking the experience of emotions to everyday motivationally relevant stimuli in alcohol-dependent individuals using both autonomic and self-report measures. We analysed heart rate (HR), skin conductance (SC) and subjective emotional reactivity to everyday affective stimuli in alcohol-dependent individuals, and their associations with impulsivity and degree of alcohol consumption. SC and HR were continuously monitored in 28 alcohol-dependent individuals and in 31 non-alcohol healthy controls during passive viewing of pleasant, unpleasant, and neutral emotional pictures. Participants assessed the pictures for valence, arousal, and dominance and completed the Barratt Impulsiveness Scale. Alcohol-dependent individuals showed reduced HR and SC reactivity to both positive and negative emotional stimuli. In the case of SC, this blunted response was associated with impulsivity. Furthermore, alcohol-dependents displayed decoupled physiological and subjective responses, with blunted autonomic responses and normal subjective reports regarding emotional stimuli. Our findings indicate that alcohol-dependent individuals failed to use emotional autonomic feedback in response to natural, emotionally relevant stimuli, and provide initial evidence of the contribution of impulsivity to emotional processing deficits in this population. These results are in keeping with the proposed key role played by emotional experience and impulsivity in substance abuse.

Clinical characteristics and prevalence of adrenal insufficiency in hemodynamically stable patients with cirrhosis

It is well known that adrenal insufficiency is common in septic shock or hemodynamically unstable patients. But, there is as yet no sufficient clinically significant data about the exact prevalence or differences in the cause of cirrhosis with adrenal insufficiency. To investigate adrenal insufficiency prevalence in hemodynamically stable patients with cirrhosis and determine differences based on cirrhosis severity or etiology.From July 2011 to December 2012, 69 hemodynamically stable patients with cirrhosis without infection admitted at Hallym University Medical Center were enrolled. Adrenal insufficiency was defined as a peak cortisol level < 18 μg/dL, 30 or 60 minutes after 250 μg Synacthen injection.The study included 55 male patients (79.7%), and the mean age was 57.9 ± 12.9 years. Cirrhosis etiology was alcohol consumption, HBV, HCV, both viral and alcohol related, and cryptogenic in 49, 15, 7, 11, 9 patients, respectively. Adrenal insufficiency occurred in 24 patients (34.8%). No differences were found in age, sex, mean arterial pressure, heart rate, HDL, cirrhosis etiology, degree of alcohol consumption, encephalopathy, variceal bleeding history, or hepatocellular carcinoma between patients with or without adrenal insufficiency. Serum albumin level was lower (P < .05), and INR was higher (P < .05) in patients with than in those without adrenal insufficiency. However, multivariate analysis revealed no independent adrenal insufficiency predictor. Significant negative correlations were found between Child–Pugh score and peak cortisol levels (γ=−0.365, P = .008).Adrenal insufficiency was frequent even in hemodynamically stable patients with cirrhosis and tended to be associated with only liver disease severity, being unrelated to cirrhosis etiology.

Relationship between alcohol consumption and new-onset cholelithiasis: a multicentre retrospective study (A report of 77 755 cases)

Objective To explore the relationship between alcohol consumption and new-onset cholelithiasis. Methods The retrospective cohort study was conducted. The data of 77 755 participants who participated health examination at the Kailuan General Hospital, Kailuan Linxi Hospital, Kailuan Zhaogezhuang Hospital, Kailuan Tangjiazhuang Hospital, Kailuan Fan′gezhuang Hospital, Kailuan Lyujiatuo Hospital, Kailuan Jinggezhuang Hospital, Kailuan Linnancang Hospital, Kailuan Qianjiaying Hospital, Kailuan Majiagou Hospital and Kailuan Branch Hospital from June 2006 to December 2015 were collected. According to definition of alcohol consumption from literature, all the 77 755 participants were allocated into the 5 groups, including 50 695 with never drinking in the never group, 3 154 with alcohol withdrawal time≥1 year in the past group, 12 410 with light drinking in the light group, 1 606 with moderate drinking in the moderate group and 9 890 with heavy drinking in the heavy group. All participants received the same-order health examinations by the fixed team of doctors in 2006, 2008, 2010, 2012 and 2014 at the same place. Epidemiological investigation, anthropometric parameters and biochemical indicators were collected. Observation indicators: (1) comparisons of clinical characteristics among the 5 groups; (2) incidence of cholelithiasis; (3) risk factors analysis affecting new-onset cholelithiasis; (4) comparisons of the fitting degree of alcohol consumption on new-onset cholelithiasis model. Measurement data with normal distribution were represented as ±s, and comparisons among groups were analyzed using the one-way ANOVA. The pairwise comparison and homogeneity of variance were done using the least significance difference (LSD) test. Heterogeneity of variance was analyzed by the Dunnett′s T3 test. Measurement data with skewed distribution were described as M (Q), and comparisons among groups were analyzed using the rank sum test. Comparisons of count data were analyzed using chi-square test. The cumulative incidence of new-onset cholelithiasis was calculated by the Kaplan-Meier method, and comparisons of incidences among groups were done by the Log-rank test. The hazard ratio (HR) and 95% confidence interval (CI) of different intakes of alcohol on new-onset cholelithiasis were estimated by the COX proportional hazards regression models. The fitting degree of alcohol consumption on new-onset cholelithiasis model was calculated by the likelihood ratio test and akaike information criterion (AIC). Results (1) Comparisons of clinical characteristics among the 5 groups: male, age, systolic pressure, diastolic pressure, body mass index (BMI), total cholesterol (TC), triglyceride (TG), fasting plasma glucose (FPG) and waistline and cases with diabetes, hypertension, smoking and physical exercise were respectively 33 406, (51±12)years, (130±21)mmHg (1mmHg=0.133 kPa), (83±12)mmHg, (25±4)kg/m2, (4.93±1.13)mmol/L, 1.26 mmol/L (0.90-1.88 mmol/L), (5.5±1.7)mmol/L, (86±10) cm, 4 538, 21 773, 5 873, 6 140 in the never group and 3 077, (56±12)years, (134±22)mmHg, (85±12)mmHg, (25±3)kg/m2, (4.93±1.21)mmol/L, 1.29 mmol/L (0.91-1.90 mmol/L), (5.6±1.8)mmol/L, (89±9)cm, 420, 1 652, 856, 856 in the past group and 11 859, (46±12)years, (127±19)mmHg, (82±11)mmHg, (25±3)kg/m2, (4.89±1.15)mmol/L, 1.30 mmol/L (0.89-2.01 mmol/L), (5.4±1.4)mmol/L, (87±9)cm, 891, 4 294, 2 186, 2 186 in the light group and 1 585, (58±11)years, (134±22)mmHg, (84±11)mmHg, (25±3)kg/m2, (5.06±1.21)mmol/L, 1.23 mmol/L (0.85-1.82 mmol/L), (5.5±1.7)mmol/L, (88±9)cm, 159, 762, 591, 591 in the moderate group and 9 868, (52±9)years, (135±21)mmHg, (86±12)mmHg, (25±3)kg/m2, (5.18±1.21)mmol/L, 1.36 mmol/L (0.92-2.19 mmol/L), (5.5±1.5)mmol/L, (88±9)cm, 819, 4 900, 2 183, 2 183 in the heavy group, showing statistically significant differences among groups [χ2=9 989.71, F=869.28, F=254.13, 195.97, 27.52, 112.63, H(χ2)=154.09, F=11.92, 63.37, χ2=128.17, 656.31, 23 561.80, 656.31, P 0.05). (3) Risk factors analysis affecting new-onset cholelithiasis: results of COX proportional hazards regression models showed that risks of new-onset cholelithiasis in the light, moderate and heavy groups were reduced compared with never group after adjustment of gender, age, TC, TG, BMI, hypertension, diabetes, smoking and physical exercise (HR=0.88, 0.82, 0.73, 95%CI: 0.79-0.98, 0.76-0.89, 0.64-0.83, P<0.05). (4) Comparisons of the fitting degree of alcohol consumption on new-onset cholelithiasis model: multivariate model was constructed after adding risk factors of gender, age, BMI, TG, TC, hypertension, diabetes mellitus, smoking and physical exercise, and -2Log L and AIC were 76 331.83 and 76 353.83 for the multivariate model. Then drinking variable was added into multivariate model, and the -2Log L and AIC of the multivariate model+ drinking model were 76 307.86 and 76 337.86, respectively, with statistically significant differences (χ2=23.97, P<0.05). Conclusion Alcohol consumption is an independent protective factor for new-onset cholelithiasis, and the risk of cholelithiasis is decreased with increasing alcohol intake. Key words: Cholelithiasis, new onset; Gall stone; Drinking; Incidence; Predictive power; Epidemiology method

Diagnosis of alcoholic liver disease.

Alcohol is a hepatotoxin that is commonly consumed worldwide and is associated with a spectrum of liver injury including simple steatosis or fatty liver, alcoholic hepatitis, fibrosis, and cirrhosis. Alcoholic liver disease (ALD) is a general term used to refer to this spectrum of alcohol-related liver injuries. Excessive or harmful alcohol use is ranked as one of the top five risk factors for death and disability globally and results in 2.5 million deaths and 69.4 million annual disability adjusted life years. All patients who present with clinical features of hepatitis or chronic liver disease or who have elevated serum elevated transaminase levels should be screened for an alcohol use disorder. The diagnosis of ALD can generally be made based on history, clinical and laboratory findings. However, the diagnosis of ALD can be clinically challenging as there is no single diagnostic test that confirms the diagnosis and patients may not be forthcoming about their degree of alcohol consumption. In addition, clinical findings may be absent or minimal in early ALD characterized by hepatic steatosis. Typical laboratory findings in ALD include transaminase levels with aspartate aminotransferase greater than alanine aminotransferase as well as increased mean corpuscular volume, gamma-glutamyltranspeptidase, and IgA to IgG ratio. In unclear cases, the diagnosis can be supported by imaging and liver biopsy. The histological features of ALD can ultimately define the diagnosis according to the typical presence and distribution of hepatic steatosis, inflammation, and Mallory-Denk bodies. Because of the potential reversible nature of ALD with sobriety, regular screening of the general population and early diagnosis are essential.

Alcohol consumption is associated with high concentrations of urinary hydroxytyrosol

BackgroundPreviously, we reported the presence of hydroxytyrosol in red wine and higher human urinary recovery of total hydroxytyrosol than that expected after a single red wine intake. We hypothesized that the alcohol present in wine could promote endogenous hydroxytyrosol generation. ObjectiveThe objective was to assess the relation between alcohol consumption and urinary hydroxytyrosol concentrations. DesignThis was a cross-sectional study with baseline data from a subsample of the PREvención con DIeta MEDiterránea (PREDIMED) trial, an intervention study directed at testing the efficacy of the Mediterranean diet on the primary prevention of cardiovascular disease. Participants included 1045 subjects, aged 55–80 y, who were at high cardiovascular risk. Alcohol consumption was estimated through a validated food-frequency questionnaire. Urinary hydroxytyrosol and ethyl glucuronide, a biomarker of alcohol consumption, were measured. ResultsUrinary ethyl glucuronide concentrations were directly related to alcohol and wine consumption (P < 0.001) as well as to urinary hydroxytyrosol in both sexes (P < 0.001). The degree of alcohol consumption was directly associated with urinary hydroxytyrosol in male alcohol consumers (P < 0.001). Multivariate logistic regression analyses showed a significant linear trend (P < 0.05) for elevated hydroxytyrosol concentrations with an increase in alcohol consumption. Intakes of >20 g (2 drinks)/d and >10 g (1 drink)/d alcohol in men and women, respectively, were associated (P < 0.05) with elevated concentrations of hydroxytyrosol. ConclusionsWe report for the first time a direct association between urinary hydroxytyrosol and alcohol consumption at a population level. These findings reinforce previous work in human and animal models that examines wine as a source of hydroxytyrosol and alcohol as an indirect promoter of endogenous hydroxytyrosol generation. This trial was registered at controlled-trials.com/isrctn/ as ISRCTN 35739639.

Brain serotonin 2A receptor binding: Relations to body mass index, tobacco and alcohol use

Manipulations of the serotonin levels in the brain can affect impulsive behavior and influence our reactivity to conditioned reinforcers. Eating, tobacco smoking, and alcohol consumption are reinforcers that are influenced by serotonergic neurotransmission; serotonergic hypofunction leads to increased food and alcohol intake, and conversely, stimulation of the serotonergic system induces weight reduction and decreased food/alcohol intake as well as tobacco smoking. To investigate whether body weight, alcohol intake and tobacco smoking were related to the regulation of the cerebral serotonin 2A receptor (5-HT 2A) in humans, we tested in 136 healthy human subjects if body mass index (BMI), degree of alcohol consumption and tobacco smoking was associated to the cerebral in vivo 5-HT 2A receptor binding as measured with 18F-altanserin PET. The subjects' BMI's ranged from 18.4 to 42.8 (25.2 ± 4.3) kg/m 2. Cerebral cortex 5-HT 2A binding was significantly positively correlated to BMI, whereas no association between cortical 5-HT 2A receptor binding and alcohol or tobacco use was detected. We suggest that our observation is driven by a lower central 5-HT level in overweight people, leading both to increased food intake and to a compensatory upregulation of cerebral 5-HT 2A receptor density.

Alcohol Consumption and HIV Disease Progression-Are Heavy Drinkers Always Drinking Heavily?

et al 3 presents a new approach to demonstrate that the relation exists; however, the evidence is not strong enough to completely support this point of view. Adherence to treatment was evaluated through questions on the consistent use of antiretrovirals in the 3 days before the interview. Thus it cannot be representative of the real behavior and adherence in the periods between the interviews, which can compromise the validity of this information. Moreover, it seems that the viral load was not used at any time to indicate adherence and the consequent response to the therapeutic regimen. Participants sampled from a cohort of people classified as heavy drinkers can represent a source of bias. Alcoholism is a chronic disease, and during progression of HIV infection, the great majority of patients alternate different degrees of alcohol consumption. The current status of consumption cannot be the preponderant one. The comparison between the identified groups in the study, in a short

W1050 Impact of Alcohol Abuse and Dependence On Liver Fibrosis in a Prospective Cohort of 6090 HIV+/Hiv- U.S. Veterans

BACKGROUND:Liver injury is common among HIV-infected individuals, and often caused by HBV/HCV or HAART. Although alcoholic liver injury is well-described,the impact of varying levels of alcohol consumption is poorly defined. METHODS:The Veterans Aging Cohort Study(VACS) is a longitudinal study of 6090 age/sex matched HIV+/HIVveterans at 8 U.S. sites, with detailed baseline and longitudinal data on HIV/HBV/HCV status, HAART use, and alcohol consumption(AUDIT,CIDI-SAM,ICD-9). Non-hazardous, hazardous and binge drinking were defined by NIAAA criteria. Liver injury was assessed by inflammatory and fibrosis markers(AST,ALT,FIB-4). Logistic regression was used to determine the proportion of liver injury due to alcohol after controlling for age,sex,body mass,HIV,and HBV/HCV. RESULTS:Complete data were available for 4678 veterans,of whom 425(9.1%) had advanced fibrosis/cirrhosis(FIB-4>3.25),including 12.5% of HIV+ and 4.4% of HIVsubjects. A trend towards increased liver injury was seen with hazardous or binge-drinking, but a statistically significant increase in advanced fibrosis/cirrhosis was seen only in those with a ICD-9 diagnosis of alcohol abuse and dependence(AAD),including thosewith HIV alone(9.5%),HCV alone(15.6%),and HCV/HIV(33.1%). In multivariate analysis, after controlling for HCV and HIV, alcohol was the strongest correlate of advanced fibrosis/cirrhosis(OR=2.19, p 50 years,black race,and HBV were also significant correlates. Of subjects with advanced fibrosis/cirrhosis, 38.7% had a diagnosis of AAD. CONCLUSIONS: Alcohol abuse and dependence is common among individuals with advanced fibrosis/cirrhosis. In a large prospective cohort of U.S. veterans, AAD significantly increased the risk of advanced fibrosis/ cirrhosis among those with HIV,HCV,and HCV/HIV coinfection; this effect was not seen in lesser degrees of alcohol consumption.

Association between alcohol consumption and serum dehydroepiandrosterone sulphate concentration in men with Type 2 diabetes: a link to decreased cardiovascular risk

Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in patients with Type 2 diabetes. Both light-to-moderate alcohol consumption and higher serum concentrations of dehydroepiandrosterone (DHEA) are associated with reduced CVD mortality, raising the possibility of DHEA as a causal intermediate in CVD and alcohol consumption. Relationships between alcohol consumption and serum DHEA sulphate (DHEA-S) concentration, carotid atherosclerosis as evaluated by carotid ultrasonography and major cardiovascular risk factors were investigated in 404 consecutive men with Type 2 diabetes. Patients were divided into three groups according to mean ethanol consumption per week: non-drinkers, light-to-moderate drinkers (< 210 g per week) or heavy drinkers (> or = 210 g per week). Plasma HDL-cholesterol was positively associated with the degree of alcohol consumption. Intima-media thickness (0.92 +/- 0.21 vs. 1.09 +/- 0.35 mm, P < 0.0001) and plaque score (3.0 +/- 3.3 vs. 5.2 +/- 4.9, P = 0.008) were lower in light-to-moderate drinkers than in non-drinkers. Serum DHEA-S concentrations were higher in light-to-moderate drinkers (1264.2 +/- 592.2 ng/ml, P < 0.0001) and heavy drinkers (1176.2 +/- 607.6 ng/ml, P = 0.0100) than in non-drinkers (956.8 +/- 538.6 ng/ml). In a subgroup aged 60-75-year-old patients (n = 277), serum DHEA-S concentrations were higher in light-to-moderate drinkers (1126.8 +/- 502.5 ng/ml, P = 0.0121) than in non-drinkers (937.9 +/- 505.1 ng/ml). Also, in a subgroup without CVD (n = 339), serum DHEA-S concentrations were higher in light-to-moderate drinkers (1328.5 +/- 593.7 ng/ml, P < 0.0001) than in non-drinkers (970.1 +/- 540.7 ng/ml). Higher serum DHEA-S concentrations in light-to-moderate drinkers may represent part of the link between light-to-moderate alcohol consumption and lower CVD mortality.

Consumption of Alcohol, Nicotine, and Caffeine Among Depressed Outpatients: Relationship With Response to Treatment

The authors present findings from the first investigation of the use of alcohol, nicotine, and caffeine in nonsubstance-abusing outpatients with major depressive disorder. The patients (N = 94) were assessed for their intake of alcohol, nicotine, and caffeine, and then treated openly for 8 weeks with 20 mg/day of fluoxetine. The degree of alcohol consumption at baseline was a significant predictor of poorer response to the antidepressant. This relationship remained significant even after adjusting for severity of depression at baseline. Even moderate levels of alcohol consumption appear to negatively affect pharmacologic treatment in depressed outpatients.

Immunohistochemical demonstration of acetaldehyde-modified epitopes in human liver after alcohol consumption.

Acetaldehyde, the toxic product of ethanol metabolism in the liver, covalently binds to a variety of proteins. Recent studies indicate that such binding can stimulate the production of antibodies against the acetaldehyde adducts. We raised rabbit antibodies which recognized various protein-acetaldehyde conjugates but not the corresponding control proteins. Such antibodies were used in immunohistochemical studies to find out whether acetaldehyde-generated epitopes can be detected from liver specimens of 13 human subjects with different degrees of alcohol consumption. While the specimens obtained from alcohol abusers (n = 4) and alcoholics (n = 3) exhibited marked positive staining for acetaldehyde adducts inside the hepatocytes in a granular uneven pattern, the control samples (n = 6) were almost devoid of immunoreactivity. In the alcohol abusers with an early stage of alcohol-induced liver damage, staining was detected exclusively around the central veins. The data indicate that intracellular acetaldehyde adducts occur in the centrilobular region of the liver of individuals consuming excessive amounts of alcohol. Immunohistochemical detection of such adducts may prove to be of value in the early identification of alcohol abuse and in elucidating the mechanisms of alcohol-induced organ damage.