Amount Of Alcohol Consumption Research Articles

Multiple imputation of semi-continuous exposure variables that are categorized for analysis.

Semi-continuous variables are characterized by a point mass at one value and a continuous range of values for remaining observations. An example is alcohol consumption quantity, with a spike of zeros representing non-drinkers and positive values for drinkers. If multiple imputation is used to handle missing values for semi-continuous variables, it is unclear how this should be implemented within the standard approaches of fully conditional specification (FCS) and multivariate normal imputation (MVNI). This question is brought into focus by the use of categorized versions of semi-continuous exposure variables in analyses (eg, no drinking, drinking below binge level, binge drinking, heavy binge drinking), raising the question of how best to achieve congeniality between imputation and analysis models. We performed a simulation study comparing nine approaches for imputing semi-continuous exposures requiring categorization for analysis. Three methods imputed the categories directly: ordinal logistic regression, and imputation of binary indicator variables representing the categories using MVNI (with two variants). Six methods (predictive mean matching, zero-inflated binomial imputation, and two-part imputation methods with variants in FCS and MVNI) imputed the semi-continuous variable, with categories derived after imputation. The ordinal and zero-inflated binomial methods had good performance across most scenarios, while MVNI methods requiring rounding after imputation did not perform well. There were mixed results for predictive mean matching and the two-part methods, depending on whether the estimands were proportions or regression coefficients. The results highlight the need to consider the parameter of interest when selecting an imputation procedure.

An integrated dual process simulation model of alcohol use behaviours in individuals, with application to US population-level consumption, 1984–2012

IntroductionThe Theory of Planned Behaviour (TPB) describes how attitudes, norms and perceived behavioural control guide health behaviour, including alcohol consumption. Dual Process Theories (DPT) suggest that alongside these reasoned pathways, behaviour is influenced by automatic processes that are determined by the frequency of engagement in the health behaviour in the past. We present a computational model integrating TPB and DPT to determine drinking decisions for simulated individuals. We explore whether this model can reproduce historical patterns in US population alcohol use and simulate a hypothetical scenario, “Dry January”, to demonstrate the utility of the model for appraising the impact of policy interventions on population alcohol use. MethodConstructs from the TPB pathway were computed using equations from an existing individual-level dynamic simulation model of alcohol use. The DPT pathway was initialised by simulating individuals’ past drinking using data from a large US survey. Individuals in the model were from a US population microsimulation that accounts for births, deaths and migration (1984–2015). On each modelled day, for each individual, we calculated standard drinks consumed using the TPB or DPT pathway. In each year we computed total population alcohol use prevalence, frequency and quantity. The model was calibrated to alcohol use data from the Behavioral Risk Factor Surveillance System (1984–2004). ResultsThe model was a good fit to prevalence and frequency but a poorer fit to quantity of alcohol consumption, particularly in males. Simulating Dry January in each year led to a small to moderate reduction in annual population drinking. ConclusionThis study provides further evidence, at the whole population level, that a combination of reasoned and implicit processes are important for alcohol use. Alcohol misuse interventions should target both processes. The integrated TPB-DPT simulation model is a useful tool for estimating changes in alcohol consumption following hypothetical population interventions.

Association of the Frequency and Quantity of Alcohol Consumption With Gastrointestinal Cancer

Although total alcohol consumption is a known risk factor for gastrointestinal (GI) cancers, few studies have attempted to assess the pattern of alcohol drinking in association with GI cancers. To evaluate the relative association of the frequency of drinking vs the amount of alcohol consumed per occasion with the development of GI cancers. A population-based retrospective cohort study used data from the Korean National Health Insurance System database on 11 737 467 participants without cancer who underwent a national health screening program from January 1, 2009, to December 31, 2010. Participants were followed up from the year after their health screening date until they received a diagnosis of GI cancer, death, or December 31, 2017. The median follow-up duration was 6.4 years (interquartile range, 6.4-7.4 years). Statistical analysis was performed from January 1, 2019, to March 31, 2020. Weekly alcohol consumption (nondrinker [0 g/week], mild drinker [0-104 g/week], moderate drinker [105-209 g/week], and heavy drinker [≥210 g/week]), drinking frequency, and amount per occasion. Incident GI cancers at 6 specific sites (esophagus, stomach, colorectal, liver, biliary, and pancreas). Among 11 737 467 participants (6 124 776 women [52.2%]; mean [SD] age, 54.6 [10.4] years), 319 202 (2.7%) developed GI cancer. Compared with nondrinkers, the risk of GI cancer was higher for mild drinkers (adjusted hazard ratio [aHR], 1.04; 95% CI, 1.03-1.05), moderate drinkers (aHR, 1.14; 95% CI, 1.12-1.15), and heavy drinkers (aHR, 1.28; 95% CI, 1.26-1.29). The risk of GI cancer increased linearly with the frequency of drinking in a dose-dependent manner (aHR, 1.39; 95% CI, 1.36-1.41 for individuals who drink every day). In contrast, the risk of GI cancer appeared to increase with consumption up to 5 to 7 units per occasion (aHR, 1.15; 95% CI, 1.14-1.16), and then the HRs were no higher for those with a higher intake per session than 5 to 7 units (8-14 units per occasion: aHR, 1.11; 95% CI, 1.09-1.12; >14 units per occasion: aHR, 1.11; 95% CI, 1.08-1.14). Given similar weekly alcohol consumption levels, the risk of GI cancer increased with a higher frequency of drinking and decreased with a higher amount per occasion. Risk patterns for 6 specific cancers were generally similar to that of all GI cancers. In this cohort study, frequent drinking was a more important risk factor for incident GI cancers than the amount of alcohol consumed per occasion. Individuals should be cautioned about regular consumption of small amounts of alcohol in addition to the total amount of alcohol consumption or amount per occasion.

Alcohol Consumption Patterns during COVID-19 Lockdown and Their Relationship with Perceived Immune Fitness and Reported COVID-19 Symptoms.

Since the outbreak of the 2019 coronavirus (COVID-19) pandemic, lockdown periods have been installed to counteract the spread of the virus. These lockdowns, characterized by social isolation, have been associated with mood changes and increased stress. Individuals have used various strategies to cope with the negative effects of being in lockdown, including increasing the frequency and quantity of alcohol consumption. The aim of this study was to investigate mood before and during lockdown of individuals who reported consuming more, less, or the same amount of alcohol during lockdown, and examine how this impacts and perceived immune fitness and the presence and severity of COVID-19 symptoms. Analysis included a sub-sample from the ‘Corona Lockdown: how fit are you?’ (CLOFIT) study, comprising N = 761 participants who reported consuming alcohol in 2020. The results of the online survey showed that half of the participants did not alter their weekly alcohol consumption during lockdown (50.4%), whereas 25.9% of drinkers reported a reduction and 23.8% reported an increase in weekly alcohol consumption. Compared to individuals that did not alter their drinking behaviour, both increased and reduced alcohol consumption during lockdown was associated with poorer mood and higher stress levels. Increased alcohol consumption was associated with significantly reduced perceived immune fitness and a high presence and severity of COVID-19 symptoms. This effect was not significant among individuals with reduced or unaltered alcohol consumption.

Strategies for measuring peer alcohol use within egocentric network analysis

Objective Compare different strategies for measuring perceived peer alcohol use within network research. Participants College students (N = 309). Methods Collected demographic, personal alcohol use, and egocentric network data. Hierarchical linear regression analyses predicted egos’ drinking behavior (AUDIT-C scores). Results Egos’ perceptions of nominated peers’ binge-drinking frequency explained a significant portion of variance in egos’ AUDIT-C scores, over and above perceptions of nominated peers’ frequency/typical quantity of alcohol consumption and important demographic covariates. Using more than three items to assess perceived peer alcohol use did not offer statistically significant improvements and may add unnecessary response burden. Conclusions Utilizing the three-item approach (i.e., frequency, quantity, binge-drinking frequency) to assess perceived peer drinking explained more variance in egos’ AUDIT-C scores, as opposed to one- and two-item assessments. Implementing this three-item assessment in egocentric network research can enhance programming efforts targeting reductions in binge drinking among college students within social contexts.

Association between alcohol consumption in midlife and cognitive function in old age: Findings from the China health and Nutrition Survey

Background and aimsAlcohol consumption has been reported to impair the physical and mental health of the elderly. This study aimed to explore the association between alcohol consumption patterns in midlife and cognition in the elderly among the Chinese population. Methods and resultsStudy subjects were individuals aged ≥45 years in the shared database of the China Health and Nutrition Survey in 1997, who were followed up in 2006. A questionnaire was used to collect information about alcohol consumption (frequency, amount and type). Alcohol consumption (grams/week) was classified into none, light (≤84), light-to-moderate (84.01–168), moderate-to-heavy (168.01–336) and heavy (≥336.01) categories in men, and none, light (<42) and moderate (≥42) categories in women. Cognitive function was measured in 2006 using a subset of items from the modified Telephone Interview for Cognitive Status. The lowest quintile was used as the cut-off point for cognitive impairment. A multivariate logistic regression model was applied. The study involved 1926 participants with a mean age of 56.91 years, and men accounted for 51.66% of the total participants. Drinking behaviours and cognitive scores had significant sexual difference (P < 0.001). Cognitive impairment was identified in 135 men and 237 women. Compared with light drinking, heavy drinking and non-drinking were associated with cognitive impairment in men [adjusted odds ratio (aOR) and 95% CI were 2.19 (1.59–3.00), 1.54 (1.21–1.96), respectively; P < 0.001]. Compared with light drinkers, female non-drinkers and moderate drinkers were associated with cognitive impairment [aOR and 95% CI were 1.54 (1.16–2.03) and 1.75 (1.08–2.85), respectively; P < 0.001]. ConclusionsScientific evidence on the adverse effects of heavy drinking on elderly cognition and the possibly protective effects of light drinking could influence policy decisions on alcohol consumption in China.

Exploring the influence of smoking and alcohol consumption on clinical severity in patients with facioscapulohumeral muscular dystrophy

Despite the growing knowledge on the (epi)genetic background of facioscapulohumeral muscular dystrophy (FSHD), the substantial variability in disease severity that exists between FSHD patients is not fully understood. We hypothesized that smoking and alcohol consumption are disease modifiers in FSHD and contribute to the variability in disease severity, because they are both associated with higher levels of oxidative stress in muscle tissue. Oxidative stress is known to influence FSHD muscle tissue. One hundred and ninety-eight genetically confirmed FSHD patients completed a questionnaire from which the number of packyears of smoking and the lifetime cumulative alcohol units consumed were calculated. Disease severity was determined by the FSDH evaluation score. Multiple linear regression analyses showed that both the number of packyears and the amount of alcohol consumption did not influence disease severity (respectively B = 0.025, ΔR2=0.006, p = 0.231; and B = 0.000, ΔR2=0.004, p = 0.406). Although smoking and excessive alcohol consumption are unhealthy habits which should be discouraged, these results show that smoking and alcohol consumption have no clinically meaningful modifying effect on disease severity in FSHD patients. However, prospective data should show whether alcohol consumption and smoking influence disease progression rate.

Relationship between alcohol consumption and insulin resistance measured using the homeostatic model assessment for insulin resistance: A retrospective cohort study of 280,194 people

Background and aimAlcohol consumption causes metabolic disorders and is a known risk factor for cardiovascular disease. However, some studies suggested that low level alcohol consumption improves insulin resistance. We evaluated the effects of alcohol consumption on insulin resistance using the homeostatic model assessment for insulin resistance (HOMA-IR). Methods and resultsThis study included 280,194 people without diabetes who underwent comprehensive health examinations more than twice between 2011 and 2018. The levels of alcohol intake were obtained through a self-questionnaire. All subjects were divided into two groups based on the Korean standard cut-off value of HOMA-IR, 2.2. Cox proportional hazard analysis was used to assess the risk of insulin resistance according to alcohol consumption. The mean age of the study subjects was 38.2 years and 55.7% were men. During the follow-up period (median 4.13 years), HOMA-IR progressed from <2.2 to ≥2.2 in 64,443 subjects (23.0%) and improved from ≥2.2 to <2.2 in 21,673 subjects (7.7%). In the parametric survival analysis, alcohol consumption was associated with improvement of HOMA-IR (HR [95% CI], 1.09[1.03–1.14], 1.11[1.06–1.17] and 1.20[1.13–1.26], respectively). In the analysis classified according to changes in alcohol consumption amounts, increased alcohol consumption tended to prevent the progression of HOMA-IR (0.97[0.96–0.99]; p = 0.004). However, the association between the changes in alcohol consumption amounts and improvement of HOMA-IR was not statistically significant. ConclusionThis retrospective observational study has shown that alcohol consumption can improve insulin resistance and increased alcohol consumption amounts may have preventive effects on the progression of HOMA-IR compared to the baseline level.

PECULIARITIES OF ETHANOL INTOXICATION OF ANIMALS AT APPLICATION OF INTERMITTENT HYPOXIC TRAINING AT THE BEGINNING OF ALCOHOL CONSUMPTION

Relevance. It was shown a wide therapeutic effects of intermittent hypoxic training (IHT) on the human organism which can increase the organism's resistance to damaging factors by inducing mechanisms of the safety use of energy resources.&#x0D; The objective: to investigate the protective effect of IHT applied at the beginning of the 30-day alcohol intoxication of rats on the redox processes and the state of the antioxidant system of blood and liver tissues.&#x0D; Materials and methods. The study was performed on white male rats, which were divided into four groups: the first - intact (control); animals of the second group received a 15% ethanol solution for 30 days as the only source of drink; third - animals under IHT; fourth - rats that IHT was applied at the beginning of 30 days alcohol intoxication. The amount of the consumed ethanol was monitored during the experiment. Intermittent hypoxic training was performed in the altitude chamber in the following mode: five 10-min “elevations” to a height of 6 km at a rate of 20 m/sec, intervals between the elevations being 30 min. The activity of antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase), total antioxidant activity (IAOA), as well as the content of lactic and pyruvic acids, malone dialdehyde and diene conjugates were determined. The research materials were homogenates of liver tissues and blood. The process is two-phase, which obviously reflects the stages of alcoholism.&#x0D; Results. It was found that alcohol intoxication of animals adapted to IHT is accompanied by an increase in the activity of superoxide dismutase and glutathione peroxidase in the blood and liver tissue against rats that consumed ethanol as the only source of drink. A tendency to increase IAOA and catalase activity against rats that received ethanol for a long time under these conditions was revealed. Analyzing the process of consumption of ethanol solution by animals, we can conclude that animals have a pronounced craving for alcohol in this model of alcoholization. The application of IHT at the beginning of alcohol intoxication as a protective agent delays the phase of formation of a pronounced craving for ethanol and reduces the amount of daily alcohol consumption.&#x0D; Conclusions. Thus, sessions of short-term hypoxic effects at the beginning of chronic ethanol consumption, provide an increase in the antioxidant defence of these animals relative to rats with alcohol intoxication.

Alcohol use among young Australian adults in May-June 2020 during the COVID-19 pandemic: a prospective cohort study.

AimsTo estimate change in young people's alcohol consumption during COVID‐19 restrictions in Australia in early‐mid 2020, and test whether those changes were consistent by gender and level of consumption prior to the pandemic.DesignProspective longitudinal cohort.SettingSecondary schools in New South Wales, Tasmania and Western Australia.ParticipantsSubsample of a cohort (n = 443) recruited in the first year of secondary school in 2010–11. Analysis data included three waves collected in September 2017–July 2018, September 2018–May 2019 and August 2019–January 2020), and in May–June 2020.MeasurementsThe primary predictors were time, gender and level of consumption prior to the pandemic. Outcome variables, analysed by mixed‐effects models, included frequency and typical quantity of alcohol consumption, binge drinking, peak consumption, alcohol‐related harm and drinking contexts.FindingsOverall consumption (frequency × quantity) during the restrictions declined by 17% [incidence rate ratio (IRR) = 0.83; 95% confidence interval (CI) = 0.73, 0.95] compared to February 2020, and there was a 35% decline in the rate of alcohol‐related harms in the same period (IRR = 0.66; 95% CI = 0.54, 0.79). Changes in alcohol consumption were largely consistent by gender.ConclusionsFrom a survey of secondary school students in Australia, there is evidence for a reduction in overall consumption and related harms during the COVID‐19 restrictions.

426 PREVALENCE OF, AND RISK FACTORS FOR, DEMENTIA IN ADULT OUTPATIENT REFERRALS TO A REGIONAL REFERRAL HOSPITAL IN ARUSHA, TANZANIA

Abstract Introduction The global burden of dementia is increasing, with the greatest increase predicted to occur in sub-Saharan Africa (SSA). Despite this there are limited previous data on the prevalence of, and risk factors for, dementia in SSA. This study aimed to estimate the prevalence of dementia, and investigate its associations, in those aged 60 years and older attending the outpatient department of Mount Meru Hospital in northern Tanzania. This is the first hospital-based outpatient dementia prevalence and risk factors study to be conducted in an east African population. Methods This was a one-phase cross-sectional study. Adults aged 60 years and over attending medical outpatients were screened for dementia using The Identification and Intervention for Dementia in Elderly Africans cognitive screening tool. Those who scored ≤9 were clinically assessed using the DSM-IV criteria. Demographic, medical comorbidity and lifestyle information were collected during a clinical assessment. Results Prevalence of dementia was 5.0% (95% confidence interval: 3.7–6.3). Binary logistic regression found female sex (odds ratio (OR) = 2.778), having no formal education (OR = 6.088), quantity of alcohol consumption (units/week) (OR = 1.080), uncorrected visual impairment (OR = 4.260), body mass index &amp;lt;18.5 kg/m2 (OR = 6.588) and stroke (OR = 15.790 with wide 95% confidence interval (3.48–74.475)) to be significantly, independently associated with dementia. Conclusions The prevalence of dementia in this population is lower than previously reported community-based rates in Tanzania, and similar to those in high-income countries. This is the first time the association between uncorrected visual impairment and dementia has been reported in SSA. Other associations identified are in keeping with previous literature. Further research on the management of dementia and its risk factors, and the support and education of carers and patients in east African populations is required.

Oxytocin blood concentrations in alcohol use disorder: A cross-sectional, longitudinal, and sex-separated study

Alcohol use disorder (AUD) is a severe illness, for which we lack sufficient mechanistic understanding. Preliminary evidence associates AUD with the oxytocin (OXT) system. Here we investigated alterations in endogenous OXT blood concentrations in patients with AUD and their association with alcohol drinking and prospective course. In sex-separated analyses, OXT serum concentrations of 200 in-patients with AUD (56.5% male; baseline, 24–72 h of abstinence) were compared with those of 240 age-matched healthy controls (55.4% male), investigated longitudinally (follow-up, 5 days later), and tested for associations with alcohol drinking behavior and prospective 24-month alcohol-related hospital readmissions. At baseline, the patients showed increased OXT concentrations relative to controls (men, 156%, P < 0.001; women, 124%, P = 0.002). The elevations normalized at follow-up. In male patients, baseline OXT concentrations correlated positively with alcohol concentration at admission, the amount of alcohol consumption per drinking year, and the number of previous withdrawal treatments (Rho > 0.195, P < 0.044). In beverage type-specific analysis, baseline OXT concentrations correlated with liquor consumption positively in male and negatively in female patients (|Rho| > 0.277, P < 0.017). Higher baseline OXT concentrations predicted more readmissions and fewer days to the first readmission (|Rho| > 0.185, P < 0.050) in male patients. This study provides novel and sex-separated insights into the role of the OXT system in AUD. We identified a mechanism that might underlie the sex-separated choice of beverage type and established that increased OXT concentrations during early abstinence predict a worse outcome in male patients with AUD.

MO509DOSE-RESPONSE RELATIONSHIP BETWEEN ALCOHOL CONSUMPTION AND THE RISK OF DEVELOPING CKD: RETROSPECTIVE COHORT STUDY

Abstract Background and Aims Drinking habits are one of the most important modifiable lifestyle factors to prevent the development of chronic kidney disease (CKD). Previous studies showed that it was inversely associated with the risk of developing CKD, but the dose-response relationship between alcohol consumption and the development of CKD is still controversial. In the present study, we aimed to examine whether the amount of alcohol consumed at one time is associated with new onset of CKD in general population. Method Study subjects were 11,162 Japanese aged 45 to 74 years, with an estimated glomerular filtration rate ≥60 mL/min/1.73m2, no proteinuria, no past history of cardiovascular disease, COPD or liver disease. The drinking status was obtained by self-administered questionnaires. We categorized the study subjects into four groups based on the amount of alcohol consumption: &amp;lt;20g/time of ethanol equivalent (lowest); 20-40g/time (low intermediate); 40-60g/time (high intermediate); &amp;gt;60g/time (highest). We set non-drinkers as a reference category. The primary outcome was the incidence of CKD, defined as 25% reduction of eGFR and to less than 60 mL/min/1.73 m2 and/or a dipstick urinalysis score of 1+ or greater (equivalent to ≥30 mg/dL) during the follow up period. We employed Cox proportional hazards regression models to examine the dose-response relationship between baseline alcohol consumption and the risk of CKD. Trend tests were performed using Cox proportional hazards regression models that treated alcohol consumption as a continuous linear term. Results Lowest and low intermediate groups were significantly associated with a decreased risk of CKD (hazard ratio [HR] 0.84; 95% confidence interval [CI], and 0.71–0.99; HR 0.79; 95% CI, 0.66–0.96, respectively) compared to non-drinkers. High intermediate group was associated with a decreased risk of CKD (HR 0.92; 95% CI, 0.70–1.21), and highest group was associated with an increased risk of CKD (HR 1.28; 95% CI, 0.84–1.95), but these associations did not reach statistical significance. There was no dose-response relationship between baseline alcohol consumption and risk of CKD (P-trend = 0.30). Conclusion A J-shape association was observed between self-reported alcohol intake and the incidence of CKD. Moderate alcohol consumption at one time may help reduce the risk of CKD.

Association between alcohol consumption status and obesity-related comorbidities in men: data from the 2016 Korean community health survey

BackgroundThis study was performed to investigate the association between the amount of alcohol consumption or binge drinking and obesity-related comorbidities in Korean men.MethodsA total of 103,048 men aged 19 years or older were investigated in the 2016 Korean Community Health Survey. The participants were divided into five groups according to the standard number of alcoholic drinks consumed per week.ResultsOf the total participants, 20.7% were in the high alcohol consumption group, consuming more than 28 drinks per week. After adjustment for clinical factors, high alcohol consumption was significantly associated with higher odds ratios (ORs) of obesity (OR, 1.449; 95% confidence interval [CI], 1.412 to 1.591; P < 0.0001), hypertension (OR, 1.76; 95% CI, 1.636 to 1.894; P < 0.0001), and dyslipidemia (OR, 1.356; 95% CI, 1.247 to 1.474; P < 0.0001). In contrast, mild to moderate alcohol consumption was associated with a lower risk of diabetes (OR, 0.799; 95% CI, 0.726 to 0.88; P = 0.0015) and high alcohol consumption was not associated with a higher risk of diabetes (OR, 0.945; 95% CI, 0.86 to 1.039; P = 0.0662). Among drinkers, except for social drinkers, binge drinking was significantly associated with higher risks of obesity, hypertension, diabetes, and dyslipidemia.ConclusionsHigh alcohol consumption was associated with higher risks of obesity, hypertension, and dyslipidemia in Korean men. In contrast, high consumption was not associated with a higher risk of diabetes. In particular, binge drinkers were associated with higher risks of obesity, hypertension, diabetes, and dyslipidemia compared to non-binge drinkers.

Longitudinal predictors of problematic alcohol use in adolescence: A 2-year follow-up study

Alcohol consumption in adolescence is widespread. Several studies have investigated alcohol use in minors and its consequences in adulthood, but prospective findings on psychosocial predictors for problematic alcohol use (PAU) already in youth are still limited. Next to genetic aspects, psychosocial predictors appear to be particularly relevant. The objective of the present longitudinal survey was to explore psychosocial influences on PAU in adolescence. At baseline, 1,444 adolescents (52.1% girls, average age: 14.65 years) were surveyed. Two years later (at follow-up), we were able to re-assess 515 adolescents (mean age: 16.60 years). Both times, a standardized questionnaire was applied to explore PAU and various psychosocial aspects. We conducted multiple imputation, created 100 datasets with a Markov Chain Monte Carlo algorithm and calculated regression analyses to identify predictors for PAU. In a multivariable analysis, we found that female gender (protective factor), school-type ‘Gymnasium’ (highest level of school education, protective factor), PAU, more conduct problems and lower psychological well-being (all at baseline) predicted adolescent PAU at follow-up. In supplementary analyses for frequent alcohol use (regardless of quantity) and high alcohol consumption quantity (regardless of frequency), these predictors could only partially be found again. According to the findings of the present study, psychosocial aspects are relevant for PAU in adolescence, and particularly psychological well-being should be given more attention in primary prevention measures and treatment approaches.

A RANDOMIZED CONTROLLED TRIAL OF LIFE-MODIFICATION INTERVENTION FOCUSED ON REDUCING ALCOHOL INTAKE TO CONTROL THE HYPERTENSION IN MALE PATIENTS DURING OUTPATIENT VISIT: OSAKE STUDY

Objective: To verify the effectiveness of the nurse-led life-modification intervention focused on reducing alcohol in male patients with hypertension during outpatient visit. Design and method: We enrolled 53 male patients (20–74years old) with morning home blood pressure (HBP) of 135/85 mmHg or more with excessive drinking (alcohol &gt; = 210 g/week or &gt; = 60 g/day habitually) from outpatient visit (at University hospital, General hospital, and Clinic setting) in a randomized controlled trial. Patients were assigned to a nurse-led intervention (in which patients were encouraged to modifying the alcohol consumption to optimal level in addition to the usual treatment every 2 month) or to the control (in which patients were followed see by their doctor as usual). The primary outcome were mean morning HBP of 5 consecutive days at 6 months and the amount of alcohol consumption. The HBP was measured by OMRON EM7251G and recorded on the Medical link Website. Results: The number of patients randomized to intervention were 28 and control were 25 (mean age; 62.7 ± 8.8years old, 64.5 ± 5.9 respectively), and 1 patient drooped-out in each group. At baseline, the mean HBP was 143/90 mmHg in the intervention group and 144/88 mmHg in the control (n.s.). At 6 months, the mean HBP was 131/82 mmHg in the intervention group and 145/87 mm Hg in the control (SBP &lt; 0.001, DBP = 0.09). HBP level of less than 135/85 mmHg was achieved among 55.6% of the participants in the intervention group versus 16.7% in the control (P = 0.004). At baseline, the weekly alcohol consumption was 479 ± 353 g in the intervention group and 360 ± 182 g in the control (n.s.). At 6 months, it was 256 ± 206 g in the intervention group and 413 ± 260 g in the control (p = 0.020). Conclusions: We confirmed the effectiveness of the nurse-led life-modification intervention focused on reducing alcohol intake to control the morning HBP in male patients with hypertension as a method of non-pharmacological treatment during outpatient visit.

Effects of Smoking, and Drinking on Serum Gamma-Glutamyl Transferase Levels Using Physical Examination Data: A Cross-Sectional Study in Northwest China.

PurposeAlthough drinking and smoking have been associated with gamma-glutamyl transferase (GGT) levels, studies on the effects of smoking and drinking on GGT levels are scarce. The objective of this study was to assess the individual and combined effects of smoking, drinking on GGT levels in the Shaanxi province of Northwest China.Participants and MethodsA questionnaire survey was conducted in a population that underwent health examination at the First Affiliated Hospital of Xi’an Jiaotong University and included employees of enterprises or public institutions. The survey was used to collect the baseline characteristics, smoking status, and drinking status of the participants. This information was collected from January 2019 to December 2019. Data related to the physical examinations were exported using the hospital information system (HIS). A linear regression model was employed to explore the effects of smoking and drinking on GGT levels. The restricted cubic spline model was applied to assess the dose–response relationship between amount of smoking, alcohol consumption and GGT levels.ResultsA total of 10,177 participants were included in the study. Linear regression indicated that smoking (β=3.37, 95% CI: 2.57–4.17) and drinking (β=5.55 L, 95% CI: 4.40–6.71) individually, and collectively (β=9.30, 95% CI: 7.83–10.76) had a positive effect on GGT levels. The restricted cubic spline presented a linear dose–response relationship between the amount of daily smoking and GGT levels (P for non-linearity=0.148, P for overall association <0.001, OR=2.49, 95% CI: 1.27–4.90), and that between weekly alcohol consumption and GGT levels (P for non-linearity=0.231, P for overall association <0.001, OR=4.79, 95% CI: 1.72–13.32). In case of females, stratified analysis showed that in comparison to the reference group, only current drinkers had a significant effect on GGT levels (OR=3.37, 95% CI: 0.19–6.55).ConclusionSmoking and drinking have a dose-dependent and a synergistic effect on GGT levels. They should be controlled concurrently, especially among males.

An Experimental Test of the Relationship between Electronic Nicotine Delivery System Use and Alcohol Consumption.

Increasing research shows that the use of electronic nicotine delivery systems (ENDS) is associated with a higher rate and quantity of alcohol consumption. The present study used a 2-session, within-subjects design to experimentally examine the relationship between ENDS use and laboratory ad libitum alcohol consumption. A total of N=31 (mean age=28.71, SD=11.17; 45.2% women; 54.8% White/Caucasian) healthy adults from the community who use ENDS and endorsed liking beer completed the study, which included a beer consumption taste-test task that assessed the volume of beer consumed by the participants across 2 counterbalanced sessions: 1 in which concurrent ENDS use was allowed and 1 in which it was not. All analyses controlled for age, race, and gender. The effect of ENDS condition on the volume of beer consumed was not statistically significant, F(1, 30)=0.03, p=0.86). Results of linear mixed modeling showed that ENDS puffs were significantly related to alcohol sips (estimate=0.23, SE=0.07, p=0.002) across the ad libitum session. Overall, ENDS use did not increase alcohol consumption; however, the data suggest that ENDS puffs might act as a prime for beer sips or that these 2 behaviors are linked through habit. Future studies should more fully measure and compare global and event-level data on ENDS and alcohol use as they might show disparate patterns of relationships.

The Effect of Retirement on Older Adults’ Substance use, an Update and Expansion to the Literature

<h3>Introduction</h3> Transitions through life stages can be a vulnerable time for mental health, and this may lead to a change in the way people use substances. Extensive research has explored retirement, the most common life transition for older adults, and its effect on wellbeing and physical health. However, less research exists concerning the role retirement may play in the use of substances among older adults. This topic has been previously examined in two review articles with broad inclusion criteria and inconsistent results. This review attempts to update and expand on previous literature by only including studies that report on "old-age" retirement (excluding those who retired due to disability), and report on clear measures of substance use quantity or a validated screening tool for substance use disorder both before and after retirement for the same population. <h3>Methods</h3> A literature search for peer-reviewed publications identified 14 studies published between 2000 and 2019 which met inclusion criteria. A meta-analysis was not carried out given heterogeneity across studies, instead a narrative synthesis was employed. <h3>Results</h3> Of 1,246 studies identified for review, 14 were included, all of which assessed alcohol use. No studies meeting diagnostic criteria were identified that assessed the use of opiates or benzodiazepines prior to and after non-disability retirement. Of the 14 studies analyzed, 4 indicated an increase in alcohol use, risky drinking, or problems related to alcohol use, 1 study indicated a decrease in problems related to alcohol use, and 3 studies indicated no change in alcohol use. 6 studies showed mixed results, indicating different trends for different cohorts, such as men vs. women. The majority of these findings were not reported to be statistically significant. Various risk-factors were identified for increased alcohol use after retirement, including high levels of stress in job prior to retirement (2 studies), involuntary retirement (1 study), poor sleep (1 study), and positive belief about the effect of alcohol (1 study). Increased quantity of alcohol consumption on drinking occasions was a concerning pattern that emerged for recent retirees (3 studies). <h3>Conclusions</h3> Although findings from the identified studies are inconsistent and contradictory, several risk factors were identified, including increased stress at job before retirement, involuntary retirement, and sleep problems after retirement. The analysis also calls attention to a trend of increased quantity of alcohol consumption on drinking occasions. These findings have implications for providers as they counsel adults on the transition to retirement and screen for substance use disorders during this time. The lack of studies about benzodiazepine and opiate use during transition to retirement is notable, and given the increase in use of these substances among older adults, further research in this area would be beneficial.

Electrophysiological Detection of Asymptomatic Neuropathy in Alcohol Dependence Syndrome Patients- A Cross Sectional Observational Study

Aim: To detect the prevalence of asymptomatic neuropathy using nerve conduction study among alcohol dependence syndrome patients and to investigate the existence or not of correlation between duration, quantity of alcohol consumption and neuropathy.&#x0D; Study Design: Observational cross-sectional study.&#x0D; Place and Duration of Study: Department of General Medicine and Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Pondicherry, affiliated to Sri Balaji Vidyapeeth (Deemed to be) University, India between February 2019 and August 2020.&#x0D; Methods: Alcohol dependence syndrome patients, asymptomatic for neuropathy were prospectively included and, patients who were symptomatic and had other comorbid conditions that can cause neuropathy were excluded. Patients were then submitted to nerve conduction studies. In patients who had neuropathy, duration and quantity of alcohol consumption were compared for correlation.&#x0D; Results: This study included 65 male patients who were mostly middle aged heavy drinkers of alcohol. 73.8% (n=48) had neuropathy. Our research showed longer the duration, larger the quantity of alcohol consumption, and higher the Cut-Annoyed-Guilty-Eye (CAGE score), more were the prevalence of neuropathy. This research also used Severity Of Alcohol Dependence Questionnaire (SAD-Q) scoring for screening alcohol dependence which showed patients with neuropathy were moderate drinkers. We did not find correlation with age of patients and neuropathy.&#x0D; Conclusion: This research results like correlation of prevalence of neuropathy and duration of alcohol consumption and quantity of alcohol consumption were in contrast with previous studies on alcoholic neuropathy. This research used SAD-Q scoring for dependence, future researches can throw light on usage of SAD-Q score in asymptomatic neuropathy and the correlation of neuropathy with alcohol consumption.