Alcohol Consumption In Group Research Articles

Analysis of the relationship between sleep-related disorders and cadmium in the US population.

Cadmium is a heavy metal that accumulates in the body due to environmental and occupational exposure. The neurotoxicity of cadmium received increasingly attention in recent years. Sleeping is regulated and coordinated by nervous system, however, little is known about the relationship between cadmium and sleep. This study aimed to examine the relationship between blood cadmium concentrations and sleep-related disorders in US adults. This cross-sectional study used data on blood cadmium and sleep from the 2005-2008 and 2015-2020 National Health and Nutrition Examination Survey (NHANES). Weighted multiple regression, generalized weighted modeling, and weighted restricted cubic splines (RCS) were utilized to investigate the association between blood cadmium and sleep outcomes (sleep duration, trouble sleeping, symptoms of obstructive sleep apnea (OSA) and daytime sleepiness). Furthermore, subgroup analyses were conducted to investigate any differences in the associations between age, gender, ethnicity, education level, marital status, smoking status, alcohol consumption, diabetes mellitus (DM), cardiovascular disease (CVD) and hypertension groups. In 19,152 participants, the median blood cadmium concentration was 0.48 (IQR: 0.28, 0.82)μg/L. Compared with the lowest reference quartile, participants in the higher quartile had a significantly higher risk of insufficient sleeping (<7 h/night) in crude model (OR 1.53, 95% CI 1.33-1.74), Model 1 (OR 1.57, 95% CI 1.38-1.80) and Model 2 (OR 1.45, 95% CI 1.27-1.65). In the unadjusted model, individuals in the highest quartile of cadmium level had a significantly increased risk of OSA symptoms of 53% (OR = 1.53, 95% CI: 1.42, 1.65) compared with participants in the bottom quartile, and this risk increased by 35% (OR = 1.35, 95% CI: 1.23, 1.48) after adjusting for all covariates. Individuals in the highest quartile of cadmium level were 76% more likely to have a trouble sleeping than individuals in the lowest quartile in the unadjusted model (OR = 1.76, 95% CI: 1.31, 1.93), whereas in the fully adjusted model, this likelihood was 86% higher (OR = 1.86, 95% CI: 1.51, 1.96). A similar positive correlation was also observed for cadmium level and daytime sleepiness. However, no relationship was noted between cadmium and excessive sleep duration (≥9 h). A linear dose-response relationship was found between cadmium concentration and the risk of insufficient sleeping (P non-linearity = 0.321), OSA symptoms (P non-linearity = 0.176), trouble sleeping (P non-linearity = 0.682) and daytime sleepiness (P non-linearity = 0.565). Additionally, no significant interactions between cadmium concentrations and subgroup variables were identified (P for interaction>0.05). Insufficient sleep, symptoms of OSA, trouble sleeping and daytime sleepiness were found to have a positive association with the blood cadmium concentration in US adults. However, further prospective studies are necessary to establish whether there is a causal relationship between these factors.

Increased levels of urine volatile organic compounds are associated with hypertension risk.

Individuals are exposed to various volatile organic compounds (VOCs) in their surroundings. VOCs were associated with some cardiovascular and metabolic diseases, but the effects on blood pressure (BP) have not yet been clarified. This study aimed to ascertain the relationship between the urine levels of VOCs and the prevalence of hypertension (HTN) in the general population. This analysis utilized data from 4156 participants aged from 20 to 79 years in 2013-2018 National Health and Nutrition Examination Survey (NHANES). Exposure to VOCs was assessed through measurements of urinary VOC metabolites, with 16 VOCs selected for analysis. The relationships between VOCs and the risk of HTN in patients were examined through the weighted logistic regression and the weighted linear regression models. Generalized additive models were employed to analyze potential nonlinear associations between VOCs and the risk of HTN. Additionally, subgroup analyses and intergroup interaction tests were conducted. A total of 4156 participants with 16 VOCs were finally included for analysis. Multivariable logistic regression showed that ln-transformed urine levels of N-acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA) [odds ratio (OR) 1.54; 95% confidence interval (CI) 1.18-2.02], N-acetyl-S-(3-hydroxypropyl)-L-cysteine (3HPMA; OR 1.33; 95% CI 1.03-1.74), N-acetyl-S-(4-hydroxy-2-butenyl)-L-cysteine (MHBMA3; OR 1.68; 95% CI 1.29-2.20), and N-acetyl-S-(1-phenyl-2-hydroxyethyl)-L-cysteine + N-acetyl-S-(2-phenyl-2-hydroxyethyl)-L-cysteine (PHEMA; OR 1.55; 95% CI 1.19-2.00) were significantly associated with an increased risk of HTN in US general population. A nonlinear relationship and a threshold effect were only observed between ln (N-acetyl-S-(2-hydroxypropyl)-L-cysteine or 2HPMA) and HTN. There was a significantly positive correlation between ln(2HPMA) and HTN when ln(2HPMA) at least 5.29. Sub-analysis revealed that there was a more pronounced association in the elderly group (age ≥60 years), the overweight group (BMI ≥25), and the alcohol consumption group. Our work presents novel epidemiological evidence supporting the establishment of the relationship between environmental pollutants and HTN, highlighting hitherto ignored positive correlations between nonoccupational VOC exposure and the entire population's risk of HTN.

Socioeconomic disparities in alcohol-related depression: a national cohort study of low-income medical aid beneficiaries and national health insurance beneficiaries in Korea

ObjectiveTo examine the association between patterns of alcohol consumption in the past and the risk of depression among medical aid beneficiaries and National Health Insurance beneficiaries in Korea.MethodsWe used data from the National Health Information Database (NHID) of 1,292,618 participants who underwent health checkups in 2015–16 and 2017–18. We categorized alcohol consumption into four groups: continuous high, increased, decreased, and non-consumers. We followed the participants from 2019 to 2021 and identified new episodes of depression. We calculated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for depression by alcohol consumption groups and socioeconomic status.ResultsMedical aid beneficiaries had higher risks of depression than National Health Insurance beneficiaries across all alcohol consumption groups. The highest risk was observed among continuous high consumers (aOR, 2.31; 95% CI, 1.36–3.93), followed by increased (aOR, 1.51; 95% CI, 1.17–1.94), decreased (aOR, 1.48; 95% CI, 1.18–1.84), and non-consumers (aOR, 1.37; 95% CI, 1.22–1.54).ConclusionsSocioeconomic status and patterns of alcohol consumption in the past are associated with the risk of depression. Public health interventions should consider both factors to reduce alcohol-related depression and health inequalities.

Abstract MP07: Body Weight Change Mediates the Relationship Between Alcohol Intake and Incidence of Hypertension in Japanese Men

Background: Heavy drinking is a risk factor for hypertension. Alcohol consumption is also associated with weight changes. Therefore, the purpose of this study is to examine the mediating effect of weight change on the incidence of hypertension depending on the level of alcohol consumption in a cohort study of Japanese men. Methods: The participants were 2,137 non-hypertensive male employees (18-61 years old, mean age 38.3) of a metal products factory in Japan. BMI and blood pressure (BP) were measured during a health examination in 2009. BP was measured twice after resting, and the means of BP values were analyzed. Types of alcohol, amount and frequency of drinking were evaluated using a self-administered questionnaire. Follow-up body weight and BP were measured during a health examination in 2014. The incidence of hypertension was defined as systolic BP 130 or higher, diastolic BP 80 or higher, or oral antihypertensive medication. We investigated the mediating effect of BMI on the relationship between alcohol consumption and blood pressure. Associations were adjusted for baseline age, BMI, and systolic BP. Results: The mean values (standard deviations, SD) of baseline BMI (kg/m 2 ), systolic and diastolic BP (mmHg) were 22.6 (2.7), 111.6 (9.2), 67.0 (7.3), respectively. During the 5-year follow-up, 429 incident case of hypertension were identified. The mean body weight change (kg) over 5 years for each alcohol consumption category (non-drinker, &lt;20g ethanol/day, 20-39 g/day, and ≥40 g/day) was 0.8 (4.4), 0.7 (4.0), 0.0 (3.8), and -0.4 (4.4), and the incidence rates (%) of hypertension were 16.0, 17.7, 28.0, and 32.1, respectively. The multivariate-adjusted odds ratios (95% confidence intervals) for incident hypertension were 1.00 (reference), 1.22 (0.90-1.64), 1.71 (1.19-2.47), and 2.06 (1.37-3.09); ORs were significantly higher for those with 20-39g/day and ≥40g/day groups compared to non-drinkers. In the mediation analysis, the odds ratios for the direct effect of each alcohol consumption group on the development of hypertension were 1.00 (reference), 1.27 (0.94-1.73), 1.91 (1.39-3.44), 2.36 (1.56-3.58), and those for indirect effect mediated by body weight change were 1.00 (reference), 0.99 (0.95-1.04), 0.96 (0.90-1.01), and 0.93 (0.85-0.99), respectively. Conclusion: Alcohol consumption was inversely associated with body weight change and positively associated with the incidence of hypertension. Among heavy drinkers, there was a significant indirect effect mediated by body weight, and weight loss due to heavy drinking lowered the risk of developing hypertension. When evaluating the relationship between alcohol consumption and the risk of hypertension for heavy drinkers, the risk due to alcohol drinking may be underestimated through changes in body weight.

Метод определения экспозиции латентного чрезмерного потребления алкоголя в коллективах операторских профессий, влияние этого фактора на сердечно-сосудистую заболеваемость и смертность

Introduction. The problem of latent alcohol consumption in groups of certain professions, in particular among railway engine crews, still exists, despite the fact that admission to train operation is carried out by a medical expert commission and railway engine crews undergo mandatory breath alcohol testing. An association between an excessive alcohol consumption, in the doses exceeding safe limit, and cardiovascular diseases and mortality of this professional group has been established, that is directly related to the safety of train operation. However, the dose of latent excessive alcohol consumption that can cause specific cardiovascular diseases and a fatal outcome remains unknown. Aim. To find out the effect of latent excessive alcohol consumption on cardiovascular morbidity and mortality among railway engine crews, determine the exposure to this factor in the observation group. Materials and methods. Based on the material of the 2008-2013 study of a natural group of initially healthy 7,959 male railway engine crew members of the Trans-Baikal Railway aged 18-66 years, predictors of acute coronary syndrome, cerebral stroke, of coronary heart disease and sudden cardiac death were established using multivariate statistical analysis. Cardiovascular diseases had a common predictor – latent excessive alcohol consumption, the characteristics of which as a screening tool were assessed using the quality control method of a verifiable diagnostic test with binary outcomes. By determining the sensitivity value of latent excessive alcohol consumption, the exposure of the predictor in the observed group was determined with this method. Results. The latent excessive alcohol consumption determined the occurrence of acute coronary syndrome, of coronary heart disease, cerebral stroke and sudden cardiac death in the 7,959 railway engine crew members, in the exposure of 0.13; 0.03; 0.10 and more than 0.24 respectively of the total population studied. Cardiocerebral morbidity in the railway engine crew members involved in latent excessive alcohol consumption and mortality from all causes constituted 1.6% and 1.2%. Acute cardiovascular diseases – 0.7% Conclusion. It is necessary to monitor latent excessive alcohol consumption determined in railway engine crews. The data obtained can be used in planning the range of preventive measures and medical care among the railway engine crews or in other socially significant groups of the population, as well as in scientific studies aimed to determine the effect of the exposure of excessive alcohol consumption on the formation and development of cardiovascular events.

Chronic pain-mental health comorbidity and excess prevalence of health risk behaviours: a cross-sectional study.

Chronic musculoskeletal pain and anxiety/depression are significant public health problems. We hypothesised that adults with both conditions constitute a group at especially high risk of future cardiovascular health outcomes. To determine whether having comorbid chronic musculoskeletal pain and anxiety/depression is associated with the excess prevalence of selected known cardiovascular health risk behaviours. A cross-sectional survey of adults aged 35+ years randomly sampled from 26 GP practice registers in West Midlands, England. Respondents were classified into four groups based on self-reported presence/absence of chronic musculoskeletal pain (pain present on most days for six months) and anxiety or depression (Hospital Anxiety and Depression Score 11+). Standardised binomial models were used to estimate standardised prevalence ratios and prevalence differences between the four groups in self-reported obesity, tobacco smoking, physical inactivity, and unhealthy alcohol consumption after controlling for age, sex, ethnicity, deprivation, employment status and educational attainment. The excess prevalence of each risk factor in the group with chronic musculoskeletal pain-anxiety/depression comorbidity was estimated. Totally, 14519 respondents were included, of whom 1329 (9%) reported comorbid chronic musculoskeletal pain-anxiety/depression, 3612 (25%) chronic musculoskeletal pain only, 964 (7%) anxiety or depression only, and 8614 (59%) neither. Those with comorbid chronic musculoskeletal pain-anxiety/depression had the highest crude prevalence of obesity (41%), smoking (16%) and physical inactivity (83%) but the lowest for unhealthy alcohol consumption (18%). After controlling for covariates, the standardised prevalence ratios and differences for the comorbid group compared with those with neither chronic musculoskeletal pain nor anxiety/depression were as follows: current smoking [1.86 (95% CI 1.58, 2.18); 6.8%], obesity [1.93 (1.76, 2.10); 18.9%], physical inactivity [1.21 (1.17, 1.24); 14.3%] and unhealthy alcohol consumption [0.81 (0.71, 0.92); -5.0%]. The standardised prevalences of smoking and obesity in the comorbid group exceeded those expected from simple additive interaction.

Centre of pressure changes during stance but not during gait in young women after alcohol intoxication.

Women are underrepresented in research focused on alcohol (e.g., Brighton, Moxham & Traynor, 2016; DOI 10.1097/JAN.0000000000000136) despite the changing patterns of alcohol consumption, which has been increasing in women in recent decades. The purpose of this study was to analyse the relationship between habitual alcohol consumption and centre of pressure (CoP) parameters during stance and gait while intoxicated by alcohol. Thirty women (24.39 ±2.93 years) participated in this study. All participants were asked to answer the AUDIT questionnaire. Stance and gait analysis were repeated under two conditions on a Zebris platform (FDM GmbH; Munich, Germany): when the participants were sober (0.00% breath alcohol concentration, BrAC) and when they were in an intoxicated state (0.11% BrAC). Participants were divided by their AUDIT score into a low-risk alcohol consumption group (n=15; AUDIT score: 3 to 6) and a hazardous alcohol consumption group (n=15; AUDIT score: 7 to 13). No statistical difference was observed in stance and gait parameters when comparing the low-risk and hazardous groups under 0.00% BrAC and 0.11% BrAC conditions. A statistically significant difference was observed when comparing 0.00% BrAC and 0.11% BrAC conditions within each group. This significant difference was found in CoP path length and CoP average velocity during quiet stance. However, no statistically significant differences were observed in CoP parameters during gait. An alcohol intoxication of 0.11% BrAC was not sufficient to cause statistically significant impairments in butterfly parameters of gait.

Alcohol Consumption and Measures of Sarcopenic Muscle Risk: Cross-Sectional and Prospective Associations Within the UK Biobank Study

Alcohol intake is a major modifiable risk factor for many diseases. Alcohol can also damage skeletal muscle health during ageing which in turn increases risk of sarcopenia, frailty and falls but this relationship is understudied. The aim of this study was to model the relationship between a full range of alcohol consumption and components of sarcopenic risk, skeletal muscle mass and function, in middle-aged and younger older-aged men and women. A cross-sectional analyses was undertaken of 196,561 white participants from the UK Biobank with longitudinal analysis also in 12,298 of these participants, with outcome measures for the latter repeated after around four years. For the cross-sectional analysis fractional polynomial curves were fitted in models of measures of skeletal muscle mass, appendicular lean mass/body mass index (ALM/BMI), fat-free mass as a percentage of body weight (FFM%) and grip strength, all predicted from alcohol consumption with models fitted for men and women separately. Alcohol consumption at baseline was based on the mean of up to five dietary recalls, typically over 16 months. Linear regression was used for longitudinal analyses to model the effects of alcohol consumption groups on these measures. All models were adjusted for covariates. In the cross-sectional analysis, modelled values of the muscle mass measures all showed a peak at medium levels of alcohol consumption and a steep decline with increasing alcohol consumption. Modelled differences in muscle mass from zero consumption of alcohol to 160 g/d ranged from 3.6 to 4.9% for ALM/BMI for men and women, respectively, and 3.6 to 6.1% for FFM%. Grip strength consistently increased with alcohol consumption. No association between alcohol consumption and muscle measures were seen in the longitudinal results. Our results suggest that higher levels of alcohol consumption could have detrimental effects on muscle mass in middle- and older-aged men and women.

Association between alcohol consumption and incidence of type 2 diabetes mellitus in Japanese men: a secondary analysis of a Retrospective Cohort Study

BackgroundAlcohol consumption is known to be associated with an increased risk of type 2 diabetes (T2DM). However, the effect of alcohol intake on the incidence of T2DM remains controversial due to inconsistent results across studies. This study aimed to bridge the gap among available literature in order to better define the association between alcohol consumption and incidence of T2DM.MethodsWe performed a secondary analysis using open-access data from a retrospective Japanese cohort of 15,464 participants who underwent regular medical examinations at Murakami Memorial Hospital. All participants underwent an initial exam including a questionnaire survey, physical examination, and blood biochemical testing to establish a at baseline. The primary outcome was new-onset T2DM during the follow-up exam. Statistical analysis was conducted using Cox regression and Kaplan–Meier methods to assess the risk of alcohol consumption on T2DM.ResultsDuring a median follow-up time of 5.39 years, 373 new-onset T2DM events were observed. The cumulative risk of T2DM incidence was higher in the heavy alcohol consumption group vs. the other three groups: none/minimal, light, and moderate consumption (log-rank test, P = 0.0002). Multivariate Cox regression analysis indicated incidental T2DM was independently associated with alcohol consumption. The adjusted hazard ratio relative to the none/minimal consumption group was as follows: 1.02 (95% confidence interval: 0.71, 1.48) for light consumption, 1.06 (0.71, 1.57) for moderate consumption, and 2.06 (1.30, 3.24) for heavy consumption (P value = 0.024). Subsequent subgroup analysis confirmed the association between alcohol consumption and T2DM incidence in men, but not in women.ConclusionHeavy alcohol consumption was independently associated with an increased risk of new-onset T2DM in Japanese men.

Alcohol consumption and cardiovascular risk: a descriptive study in a psychiatric short stay unit

IntroductionPatients with mental disorders have a decreased life expectancy, being the main reason the cardiovascular disease. An important proportion of patients present a comorbid drug consumption. Amongst drugs, alcohol is the most frequent, and it is associated with a higher cardiovascular risk. The metabolic syndrome is one of the most employed tools to assess cardiovascular risk.Objectives- To describe the demographic characteristics of the patients with an active alcohol consumption that were admitted to the hospital during the period of study. -To describe the prevalence of metabolic syndrome in the sample, according to the Adult Treatment Panel III (ATP-III) criteria.MethodsRetrospective observational study of three months duration. Data was collected from all patients admitted to the hospital during the period of study, with no specific exclusion criteria. Descriptive statistics were performed.ResultsDuring the period of study 172 patients were admitted to the hospital (56.4% women and 43.6% men). A 44.8% presented alcohol consumption (25% sporadically, 6.4% weekly and 13.4% daily). Amongst women, 1% presented daily and 1% weekly consumption. Amongst men, 21.3% presented daily and 5.3% weekly consumption.The prevalence of metabolic syndrome in the study sample was 29.11%. In the alcohol consumption group, the prevalence was 24.7% and differed according to the pattern of consumption: 43.5% in the daily consumption group, 27.3% in the weekly and 14% in the sporadically consumption group.ConclusionsOn the one hand, in the sample of study a higher percentage of men present an active alcohol consumption, compared to women. It is remarkable the high percentage of daily alcohol consumption amongst men in our sample.On the other hand, the prevalence of metabolic syndrome in our sample is similar to the one found in scientific literature regarding patients with mental disorders. It is noteworthy in our sample the increased prevalence of metabolic syndrome found in patients with a daily alcohol consumption, and a decreased prevalence in those with a sporadic pattern.Disclosure of InterestNone Declared

트레드밀 운동이 알코올 섭취로 유도된 쥐의 간 손상에 미치는 영향

Purpose: The purpose of this study is to investigate the liver function improvement effect of treadmill exercise on liver damage in rats induced by alcohol consumption.&#x0D; Method: Fifteen male Sprague Dawley (SD) rats were randomly assigned to CO (control group, n=5), AC (alcohol consumption, n=5) ACE (alcohol consumption + exercise, n=5). The treadmill exercise consisted of five times a week for five days and lasted 60 minutes (5 min for warm-up, 50 min for the main exercise, and 5 min for cool-down). Blood samples were taken after 5 weeks of exercise, and serum alanine transaminase (ALT) and aspartate transaminase (AST) were measured using an ELISA kit. The data were analyzed using one-way ANOVA to verify between-group differences in weight and liver damage index. If there was a statistically significant difference, Tukey's post-hoc was performed.&#x0D; Results: There was no weight change after five weeks of exercise intervention. However, ALT and AST were statistically significantly higher in the AC group than in the CO group and the ACE group(p&lt;0.001).&#x0D; Conclusion: In conclusion, treadmill exercise for 5 weeks improves liver function and reduces ALT and AST against alcohol-induced liver damage.

Alcohol consumption: context and association with mortality in Switzerland

PurposeNon-communicable diseases generate the largest number of avoidable deaths often caused by risk factors such as alcohol, smoking, and unhealthy diets. Our study investigates the association between amount and context of alcohol consumption and mortality from major non-communicable diseases in Switzerland.MethodsGeneralized linear regression models were fitted on data of the cross-sectional population-based National Nutrition Survey menuCH (2014–2015, n = 2057). Mortality rates based on the Swiss mortality data (2015–2018) were modeled by the alcohol consumption group considering the amount and context (i.e., during or outside mealtime) of alcohol consumption and potential confounders. The models were checked for spatial autocorrelation using Moran’s I statistic. Integrated nested Laplace approximation (INLA) models were fitted when evidence for missing spatial information was found.ResultsHigher mortality rates were detected among drinkers compared to non-drinkers for all-cancer (rate ratio (RR) ranging from 1.01 to 1.07) and upper aero-digestive tract cancer (RR ranging from 1.15 to 1.20) mortality. Global Moran’s I statistic revealed spatial autocorrelation at the Swiss district level for all-cancer mortality. An INLA model led to the identification of three districts with a significant decrease and four districts with a significant increase in all-cancer mortality.ConclusionSignificant associations of alcohol consumption with all-cancer and upper aero-digestive tract cancer mortality were detected. Our study results indicate the need for further studies to improve the next alcohol-prevention scheme and to lower the number of avoidable deaths in Switzerland.

Association between the metabolic score for insulin resistance (METS-IR) and estimated glomerular filtration rate (eGFR) among health check-up population in Japan: A retrospective cross-sectional study.

This study aimed to investigate the relationship between a new metric-metabolic score for insulin resistance (METS-IR)-and estimated glomerular filtration rate (eGFR) among Japanese participants who underwent health check-ups. We conducted a cross-sectional study that involved participants in a medical health screening program, which was conducted at the Medical Health Check-up Center in Japan. This retrospective study examined the relationship between METS-IR and eGFR among 881 individuals that joined the program between March 1, 2004, and December 31, 2012. Covariates consisted of serum laboratory tests and lifestyle questionnaires. Multivariate linear regression analysis was used to explore the association between METS-IR and eGFR. In addition, subgroup and interaction analyses were done based on age, sex, body mass index (BMI), alcohol use, smoking status, and hyperuricemia. A total of 881 individuals participated in this study. High METS-IR was highly linked with reduced eGFR (adjusted β = -5.04, 95% confidence interval (CI): -7.65 to -2.43), while METS-IR was utilized as a categorical variable inside the multiple regression analysis. A decrease in eGFR of 2.54 units was reported for every 10-unit rise in METS-IR (adjusted β = -2.54, 95% CI: -4.04 to -1.05, P-value = 0.001). Stratified analysis suggested no marked interaction between METS-IR and eGFR across age, sex, BMI, and alcohol consumption groups. However, there was an indication of interaction between METS-IR level, smoking status (P-value = 0.001), and uric level (P-value = 0.011) on eGFR decrease. METS-IR is remarkably associated with eGFR among the participants who underwent health check-ups in Gifu, Japan. Although more studies are required to prove it, METS-IR could be applied as a monitoring index for early screening, primary prevention, and diagnostic and treatment management strategies for chronic kidney disease.

Chronic pancreatitis: analysis of disease progression factors

Alcohol and tobacco are important risk factors for chronic pancreatitis (CP). To analyze the effect of etiological factors such as tobacco and alcohol and pancreatic enzyme replacement therapy (PERT) in the progression of CP. Patients with a diagnosis of CP were recruited and grouped according to variables such as tobacco, alcohol and PERT. They were followed for 18 months. Subsequently, different variables and analytical parameters involved in the progression of the disease were analyzed. A total of 50 patients diagnosed with CP were included. Of these, 28 patients underwent PERT, 39 were smokers and 33 were alcohol users. Compared with patients without PERT, those with PERT had a higher proportion of diabetes (64 and 32%, respectively), had a higher need for endoscopic treatment (25 and 0%, respectively) and a normal body mass index (71 and 27.3%, respectively. The smokers had higher calcium levels and increased lymphocytosis and leukocytosis. The alcohol consumption group had a higher mean age (p = 0.04) Conclusions: PERT may improve the nutritional status but does not reduce the need for endoscopic or surgical treatment. Smoking and alcohol consumption favored the progression of CP. Also, smoking induced a pro-inflammatory state.

S122 Endoscopic Ultrasound Evaluation of Primary Pancreatic Lymphoma Compared to Adenocarcinoma: A Case-Control Study

Introduction: Primary pancreatic lymphoma (PPL) is a rare extranodal lymphoma representing 0.5% of all pancreatic neoplasms. Prognosis and treatment strategies of PPL vastly differ from pancreatic ductal adenocarcinoma (PDAC), therefore making an accurate diagnosis is vital. Our aim is to describe the presentation, endoscopic ultrasound (EUS) features, and the role of fine needle aspiration (FNA) in the diagnosis of PPL compared with PDAC. Methods: Out of 1,946 patients who underwent EUS-FNA of solid pancreatic lesions, 11 were diagnosed with PPL. Patients who had peripancreatic lesions, lymph nodes, or bile duct masses were excluded. Age and gender- matched controls with a diagnosis of PDAC were identified in a 1:3 ratio. Presenting symptoms, demographics, and EUS characteristics were evaluated. Results: There were 11 patients with PPL and 33 age and gender-matched controls with PDAC. The median age was 65 years (60-76) and 63.6% were males. There was no difference between two groups in smoking, alcohol consumption, or history of a second malignancy. PPL patients were more likely to present with abdominal pain (81.8% vs 26.4%, p=0.01). Pancreatic head location was most common in both groups. Both PPL and PDAC tended to be hypoechoic and poorly defined on EUS, while PPL were more commonly described as heterogeneous (36.4% vs 6.1%, p=0.01). PPL were significantly larger on EUS (45.8 mm vs 31 mm, p< 0.01) and less likely associated with pancreatic duct dilation. A higher number of FNA passes was required for the diagnosis of PPL compared to PDAC (5 vs 3, p< 0.01). Conclusion: While PPL remains rare, making an accurate distinction with PDAC is critical as treatment and prognosis radically differ. On presentation, PPL is more likely to cause abdominal pain. Certain EUS features were found to be beneficial in differentiating PPL from PDAC in our study, as PPL tend to be larger, more likely heterogeneous, and are less likely associated with pancreatic duct dilation compared to PDAC. Tissue diagnosis is more challenging in PPL as reflected by a significantly higher number of passes obtained on EUS- FNA. Table 1. - Adenocarcinoma (n=33) Primary Pancreatic Lymphoma (n=11) P value Ethnicity, white n (%) 21 (63.6) 8 (72.7) 0.58 Smoking history ( >15 pack-years), n (%) 9 (27.3) 5 (45.5) 0.26 Alcohol history ( >1 drink/day), n (%) 7 (21.2) 2 (18.2) 0.83 History of cancer diagnosis, n (%) 10 (30.3) 3 (27.3) 0.85 Multiple pancreatic lesions, n (%) 1 (3) 0 0.56 Presenting symptoms Abdominal pain, n (%) 12 (36.4) 9 (81.8) 0.01 Jaundice, n (%) 11 (33.3) 6 (54.5) 0.21 Weight loss, n (%) 8 (24.2) 3 (27.3) 0.84 Incidental, n (%) 5 (15.2) 1 (9.1) 0.61 Located in the head of the pancreas, n (%) 23 (69.7) 9 (81.8) 0.43 Regional lymphadenopathy on imaging, n (%) 20 (60.6) 10 (90.9) 0.06 EUS features Hypoechoic, n (%) 31 (93.9) 9 (81.8) 0.23 Heterogeneous, n (%) 2 (6.1) 4 (36.4) 0.01 Poorly defined, n (%) 23 (69.7) 8 (72.7) 0.85 Common bile duct dilation, n (%) 14 (42.4) 5 (45.5) 0.86 Pancreatic duct dilation, n (%) 23 (69.7) 3 (27.3) 0.01 Number of passes on FNA, mean (IQR) 3 (1-3) 5 (2-7) 0.008 Largest diameter on EUS (mm), median (IQR) 31 (25-38.8) 45.8 (35.5-56) 0.001 Treatment Chemotherapy, n (%) 29 (87.9) 10 (90.9) 0.78 Radiation therapy, n (%) 17 (51.5) 2 (18.2) 0.053 Surgery, n (%) 7 (21.2) 1 (9.1) 0.37

Fatty Liver Change in Korean Adults in a Systematic Social Distancing System Amid the COVID-19 Pandemic: A Multicenter Analysis.

In response to the COVID-19 pandemic, the Korean government implemented policies including the systematic social distancing (SSD) system which started on 28 June 2020. The present study investigated the development and aggravation of fatty liver measured using ultrasonography during the transition period (from pre-SSD to SSD) compared to the fatty liver changes during the pre-SSD period. Changes in fatty liver and liver enzymes were assessed in different groups stratified by alcohol consumption. Our retrospective cohort analysis included 5668 participants who underwent health checkups at 13 university hospitals during the SSD period and two or more checkups before the SSD period. Fatty liver developed and aggravated more in the transition period (13.6% development and 12.0% aggravation) than in the pre-SSD period (10.8% development and 10.1% aggravation) in the alcohol consumption group. This finding was more prominent in women than in men. Abnormal alanine transaminase levels were more often developed in the transition period than in the pre-SSD period, especially in men (11.1% vs. 8.6% in each period). In conclusion, the SSD system may contribute to fatty liver changes in individuals who regularly consume alcohol. Further research of the post-pandemic period is needed to assess long-term changes in fatty liver disease.

Clinical and epidemiological features of healthcare workers after a coronavirus disease 2019 cluster infection in Japan and the effects of Kampo formulas-Hochuekkito and Kakkonto: A retrospective cohort study.

It is expected that a low-toxicity natural compound like Kampo formulas would exhibit a preventive effect on COVID-19, in a global outbreak of coronavirus disease 2019 (COVID-19). Although the biological properties and safety of the representative Kampo, Hochuekkito (HET), and Kakkonto (KKT) have been confirmed in various animal model experiments and clinical studies, and in a few human studies to induce biological effects on various infectious diseases without significant toxicity, it is unclear whether HET and KKT are safe and effective for COVID-19 prevention. We summarized the clinical characteristics of HCWs and the preventive effects of HET and KKT. We performed a retrospective, single-center, cohort study that included 175 HCWs (aged 21-77 years) from a total number of 217 in a hospital with a history of COVID-19 cluster infection. In total, 175 HCWs were tested for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies. We identified 27 patients (median age: 49 ± 10.7 years) who were diagnosed with COVID-19. The patients in the group that had a body mass index ≥ 25 had a high COVID-19 infection risk, while those in the group with a Kampo formula adherence rate ≥ 40% had a low COVID-19 risk. Patients in the group with an adherence rate ≥ 40%, as well as those in the current alcohol consumption group, were at a low risk of developing severe COVID-19. In conclusion, HET and KKT may have prevented the onset or worsening of COVID-19, which could be clinically used. Obesity might have increased the patients' susceptibility to COVID-19 and the disease severity.

Quantitative analysis of spatial distribution of lymphocytes in hepatocellular carcinoma: A biomarker correlated with survival and gene expression in cancer immune system.

4119 Background: Tumor microenvironment (TME) is known to impact prognosis in hepatocellular carcinoma (HCC). Although digital pathology and artificial intelligence have been adopted in modern medicine and oncology, few quantitative biomarkers have been identified to predict the prognosis and guide treatment for HCC via an automated analysis of TME at the cellular level. Methods: Histopathological images and clinical data of 365 cases with HCC were obtained from TCGA (The Cancer Genome Atlas), and 60 of HCC pathology images and cancer lesion annotations were collected from PAIP2019 [1]. DenseNet-based HCC segmentation model (F1-score, 0.904) and Hover-Net-based cell detection model (F1-score, 0.914) were developed using PAIP2019 and MoNuSac datasets, respectively [2,3,4]. Each histopathology image of TME was segmented via the segmentation model into two areas: 1) non-tumoral regions that include the stroma; 2) tumoral regions where HCC cells are concentrated. The cell detection model recognized individual cells on images, specified lymphocytes, and calculated ratios of lymphocyte to total cell count (RLTCC) in segmented regions. RLTCC was then correlated with clinical survival outcomes, HCC primary risk factors, and RNA expression profiles. Results: RLTCC in tumoral regions was not significantly associated with prognosis. Patient groups with higher RLTCC in non-tumoral regions (RLTCC in NT) showed better overall survival (OS) than those with lower RLTCC in NT regardless of HCC risk factors (median OS 45.7 vs 18.6 months; log hazard ratio of -1.6 ± 1.1, p=0.006). These patients had significantly enriched expression of genes (p&lt;0.05) related to cancer antigen presentation (higher gene expression by +33.7%), recognition of cancer cells by T-cell (+32.0%), T-cell priming and activation (+32.2%), immune cell localization to tumors (+31.9%), and killing of cancer cells (+24.7%). Those with HCC etiology of hepatitis B and C had more patients in the higher RLTCC in NT (17/21 patients, 81.0%; 23/29, 79.3%, respectively). In comparison, those with alcohol consumption showed equal distribution (26/53, 49.1%). The RLTCC in NT in hepatitis B/C groups was statistically higher than alcohol consumption group (p&lt;0.05). Conclusions: A digital prognostic biomarker, RLTCC in NT of TME was identified as a significant prognostic indicator, and it was shown to correlate with RNA gene expression related to T-cell mediated cancer immunity. A retrospective analysis of clinical response from systemic therapy in relation to digital biomarkers is underway and will be reported.

Relationship Between Preoperative Alcohol Consumption and Postoperative Nausea and Vomiting in Liver Resection: A Propensity Score Matched Analysis in a Single Institute.

Patients with alcohol drinking habits have less nausea and vomiting during chemotherapy because of cytochrome P450 enzyme induction. However, few studies have examined the effect of alcohol consumption on postoperative nausea and vomiting (PONV). We conducted a study to clarify the relationship between alcohol drinking habits and PONV. Data of patients undergoing hepatectomy under general anesthesia between 2016 and 2020 were retrospectively collected. Since alcohol drinking habits vary by gender, age, and comorbidities, propensity score matching was performed to adjust patient background before multivariate logistic regression analysis. Seventy-eight patients in the alcohol consumption and non-consumption groups were matched by propensity matching. Univariate analysis showed that alcohol consumption (P = 0.04) and male (P ＜ 0.001) were the factors that significantly reduced PONV. Multiple logistic regression analysis including intraoperative factors showed that alcohol consumption (odds ratio, 0.36; 95% confidence interval [CI], 0.15-0.90) and female (odds ratio, 5.34; 95% CI, 2.0-14.2) were associated with PONV as factors affecting PONV. Patients with no alcohol drinking habits may be at higher risk of PONV.

Relationship Between Preoperative Alcohol Consumption and Postoperative Nausea and Vomiting in Liver Resection: A Propensity Score Matched Analysis in a Single Institute.

Patients with alcohol drinking habits have less nausea and vomiting during chemotherapy because of cytochrome P450 enzyme induction. However, few studies have examined the effect of alcohol consumption on postoperative nausea and vomiting (PONV). We conducted a study to clarify the relationship between alcohol drinking habits and PONV.Data of patients undergoing hepatectomy under general anesthesia between 2016 and 2020 were retrospectively collected. Since alcohol drinking habits vary by gender, age, and comorbidities, propensity score matching was performed to adjust patient background before multivariate logistic regression analysis.Seventy-eight patients in the alcohol consumption and non-consumption groups were matched by propensity matching. Univariate analysis showed that alcohol consumption (P = 0.04) and male (P ＜ 0.001) were the factors that significantly reduced PONV. Multiple logistic regression analysis including intraoperative factors showed that alcohol consumption (odds ratio, 0.36; 95% confidence interval [CI], 0.15-0.90) and female (odds ratio, 5.34; 95% CI, 2.0-14.2) were associated with PONV as factors affecting PONV.Patients with no alcohol drinking habits may be at higher risk of PONV.