25 August 2020 In Liver Disease

BACKGROUND: Favorable association between modest alcohol consumption and cardiovascular disease had been reported in general population, however, whether observed benefit extend to men with established fatty liver disease remains unknown.

METHODS: Cross-sectional study of 10,581 consecutive male participants aged 30 years or older undergoing abdominal ultrasonography and carotid artery ultrasonography were screened. Non-alcoholic fatty liver disease (NAFLD) was diagnosed with ultrasonography and exclusion of secondary causes for fat accumulation or other causes of chronic liver disease. Modest alcohol use was defined as consumption of less than 20 g of alcohol per day.

RESULTS: There were total 2280 men diagnosed with fatty liver, and the mean age was 51.8 years old. Among them, 1797 were modest alcohol drinkers. The prevalence of carotid plaques (55.3% vs. 43.4%, p < 0.001) and carotid artery stenosis (11.0% vs. 5.5%, p < 0.001) was higher in non-drinkers than modest drinkers. Modest alcohol consumption had the independent inverse association with carotid plaques [odd ratio (OR): 0.74, 95% confidence interval (CI): 0.60-0.92] and carotid artery stenosis (OR: 0.62, 95% CI: 0.43-0.90), adjusted for age, smoking and metabolic syndrome.

CONCLUSIONS: Modest alcohol consumption had a favorable association with carotid plaque or CAS in men with NAFLD

26 February 2019 In Cancer

PURPOSE: Breast cancer (BC) risk prediction allows systematic identification of individuals at highest and lowest risk. We extend the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) risk model to incorporate the effects of polygenic risk scores (PRS) and other risk factors (RFs).

METHODS: BOADICEA incorporates the effects of truncating variants in BRCA1, BRCA2, PALB2, CHEK2, and ATM; a PRS based on 313 single-nucleotide polymorphisms (SNPs) explaining 20% of BC polygenic variance; a residual polygenic component accounting for other genetic/familial effects; known lifestyle/hormonal/reproductive RFs; and mammographic density, while allowing for missing information.

RESULTS: Among all factors considered, the predicted UK BC risk distribution is widest for the PRS, followed by mammographic density. The highest BC risk stratification is achieved when all genetic and lifestyle/hormonal/reproductive/anthropomorphic factors are considered jointly. With all factors, the predicted lifetime risks for women in the UK population vary from 2.8% for the 1st percentile to 30.6% for the 99th percentile, with 14.7% of women predicted to have a lifetime risk of >/=17-<30% (moderate risk according to National Institute for Health and Care Excellence [NICE] guidelines) and 1.1% a lifetime risk of >/=30% (high risk).

CONCLUSION: This comprehensive model should enable high levels of BC risk stratification in the general population and women with family history, and facilitate individualized, informed decision-making on prevention therapies and screening.

22 February 2019 In Cancer

PURPOSE: Breast cancer (BC) risk prediction allows systematic identification of individuals at highest and lowest risk. We extend the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) risk model to incorporate the effects of polygenic risk scores (PRS) and other risk factors (RFs).

METHODS: BOADICEA incorporates the effects of truncating variants in BRCA1, BRCA2, PALB2, CHEK2, and ATM; a PRS based on 313 single-nucleotide polymorphisms (SNPs) explaining 20% of BC polygenic variance; a residual polygenic component accounting for other genetic/familial effects; known lifestyle/hormonal/reproductive RFs; and mammographic density, while allowing for missing information.

RESULTS: Among all factors considered, the predicted UK BC risk distribution is widest for the PRS, followed by mammographic density. The highest BC risk stratification is achieved when all genetic and lifestyle/hormonal/reproductive/anthropomorphic factors are considered jointly. With all factors, the predicted lifetime risks for women in the UK population vary from 2.8% for the 1st percentile to 30.6% for the 99th percentile, with 14.7% of women predicted to have a lifetime risk of >/=17-<30% (moderate risk according to National Institute for Health and Care Excellence [NICE] guidelines) and 1.1% a lifetime risk of >/=30% (high risk).

CONCLUSION: This comprehensive model should enable high levels of BC risk stratification in the general population and women with family history, and facilitate individualized, informed decision-making on prevention therapies and screening.

25 January 2019 In Cardiovascular System

BACKGROUND: Alcohol consumption is associated with cardiovascular disease (CVD), with moderate drinkers having decreased CVD risk compared to non- and heavy drinkers. However, whether alcohol consumption is associated with ideal cardiovascular health (CVH), assessed by the American Heart Association's (AHA) Life's Simple 7 (LS7) metrics, and whether associations differ by sex, is uncertain.

HYPOTHESIS: Heavy alcohol consumption is associated with worse CVH.

METHODS: We explored associations between alcohol consumption and CVH in a multi-ethnic population including 6506 participants free of CVD, aged 45 to 84 years. Each LS7 metric was scored 0 to 2 points. Total score was categorized as inadequate (0-8), average (9-10) and optimal (11-14). Participants were classified as never, former or current drinkers. Current drinkers were categorized as 2 (heavy) drinks/day. Multinomial logistic regression models assessed associations between alcohol and CVH, adjusted for age, sex, race/ethnicity, education, income, and health insurance.

RESULTS: Mean (SD) age was 62 (10) years, 53% were women. Compared to never drinkers, those with >2 drinks/day were less likely to have average [0.61 (0.43-0.87)] and optimal CVH [0.29 (0.17-0.49)]. Binge drinking was also associated with unfavorable CVH. Overall, there was no independent association for light or moderate drinking with CVH. However, women with 1 to 2 drinks/day were more likely to have optimal CVH [1.85 (1.19-2.88)] compared to non-drinking women, which was not seen in men.

CONCLUSION: Heavy alcohol consumption was associated with unfavorable CVH. Although light or moderate drinking may be associated with a more favorable CVH in women, overall, the association was not strong.

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