21 April 2021 In Cardiovascular System

BACKGROUND AND AIMS: Most studies assess the relationship between alcohol and stroke at some point. Little is known about the effect on stroke of drinking status changes over time. This study aimed to examine the association of median 2.4-year drinking status changes with risk of stroke.

METHODS AND RESULTS: We examined 22,691 adults from rural China. Drinking status was assessed at 2004-2006 and in 2008. Participants were divided into four change patterns: consistent non-drinkers, abstainers, starters, and consistent drinkers. A Cox proportional hazards model were performed. We observed 1215 cases of stroke during a median follow-up period of 11.8 years. A faint J-shaped association between alcohol consumption and risk of stroke was found in this population. Based on the amount of alcohol consumption, only current drinkers with >/=721 g/week at baseline in both males and females had a higher risk of stroke [hazard ratio (HR): 1.342; 95% confidence interval (CI): 1.070-1.683 and HR: 2.130; CI: 1.041-4.357, respectively]. Based on change patterns, Compared with consistent non-drinkers, the HR (95% CI) for consistent drinkers, abstainers and starters was 1.298 (1.070-1.576), 1.093 (0.877-1.362) and 1.263 (1.034-1.543), respectively. The same trend was observed in male. The HR (95% CI) for consistent drinkers, abstainers and starters was 1.360 (1.098-1.685), 1.139 (0.883-1.470) and 1.364 (1.092-1.703), respectively. No difference was observed in females.

CONCLUSION: High alcohol consumption was associated with increased risk of stroke in both males and females. However, based on change patterns, consistent drinkers and starters were at higher risk of stroke only in males.

21 April 2021 In Cancer

Stomach cancer is one of the most common cancers in the world. The relationship between alcohol consumption and the risk of stomach cancer remains unclear. Epidemiology studies investigating this relationship have shown inconsistent findings.

A meta-analysis was performed to explore the association between alcohol consumption and increased stomach cancer risk. Eighty-one epidemiology studies, including 68 case-control studies and 13 cohort studies, were included in this study. A significant association was found between alcohol consumption and increased risk of stomach cancer (OR = 1.20, 95% CI 1.12-1.27).

To explore the source of the significant heterogeneity (p < 0.05, I(2) = 86%), analysis was stratified by study type (case-control study and cohort study), control type (hospital-based control and population-based control), gender (male, female, and mix), race (White and Asian), region (United States, Sweden, China, Japan), subsite of stomach cancer, and type of alcohol. The stratified analyses found that region and cancer subsite are major sources of the high heterogeneity.

The inconsistent results in different regions and different subsites might be related to smoking rates, Helicobacter pylori infection, obesity, and potential genetic susceptibility. The positive association between drinking and increased risk of stomach cancer is consistent in stratified analyses. The dose-response analysis showed a clear trend that a higher daily intake of alcohol is associated with a higher risk of stomach cancer.

24 March 2021 In Cardiovascular System
Several studies have reported a J-shaped relationship between alcohol consumption and coronary heart disease (CHD) risk. However, the mechanisms of this relationship remain unclear. This study aimed to evaluate the relationships of alcohol consumption with established CHD risk factors and with macro-/micro-nutrient intake among Japanese people. Participants were 1,090 Japanese men and women aged 40-59 y enrolled in the INTERLIPID study, excluding former drinkers. Based on two 7-d alcohol records, participants were classified as non-drinkers (0 g/wk), light-drinkers (/=300 g/wk). Detailed macro-/micro-nutrient intake was evaluated using four in-depth 24-h dietary recalls and adjusted for total energy intake excluding alcohol. We analyzed the associations of CHD risk factors and nutrient intake with alcohol consumption. Serum high-density lipoprotein cholesterol and blood pressure were higher and low-density lipoprotein cholesterol was lower among those with higher alcohol consumption. J-shaped relationships with alcohol consumption were observed for the proportion of current smokers, number of cigarettes smoked, and prevalence of hypertension; these risk factors were lowest among light-drinkers. Carbohydrate and total fiber intakes were lower and protein and dietary cholesterol intakes were higher among those with higher alcohol consumption. These associations were similar for men and women. Alcohol consumption was related to nutrient intake as well as established CHD risk factors. Non-drinkers were higher on some CHD risk factors than were light-drinkers. These findings may influence the J-shaped relationship between alcohol consumption and CHD risk.
23 February 2021 In Liver Disease

OBJECTIVE: To study the interaction of alcohol consumption with body mass index (BMI) in the development of hepatic steatosis and mortality.

PARTICIPANTS AND METHODS: We conducted a retrospective cohort study of 18,506 participants without fatty liver disease or cirrhosis at enrollment in the Mayo Clinic Biobank from April 9, 2009, through March 31, 2016. Participants were classified by self-reported alcohol consumption status (nondrinkers, moderate drinkers [0 to 2 drinks per day], and heavy drinkers [>2 drinks per day]). The primary outcome of interest was the incidence of hepatic steatosis, identified by International Classification of Diseases, Ninth Revision code and confirmed with imaging. The secondary outcome of interest was all-cause mortality. Multivariate Cox regression analysis determined the impact of alcohol consumption stratified by BMI on outcomes compared with nondrinkers.

RESULTS: The cohort (mean +/- SD age, 55.8+/-16.9 years; 63.8% female; mean +/- SD BMI, 28.8+/-6.1 kg/m(2)) of 18,506 participants included 3657 (19.8%) nondrinkers, 14,236 (76.9%) moderate drinkers, and 613 (3.3%) heavy drinkers at enrollment. After a median follow-up of 5.8 years (interquartile range, 3.8 to 7.2 years), 684 participants had development of hepatic steatosis and 968 died. In moderate drinkers, the risk of hepatic steatosis development was high in the obese group (adjusted hazard ratio [AHR], 1.31; 95% CI, 1.03 to 1.67), insignificant in the overweight group (AHR, 0.86; 95% CI, 0.58 to 1.26), and decreased in the normal-BMI group (AHR, 0.48; 95% CI, 0.26 to 0.90). Heavy drinkers had an increased risk of hepatic steatosis irrespective of BMI. Moderate alcohol use was associated with decreased mortality in the normal-weight (AHR, 0.44; 95% CI, 0.34 to 0.58) and overweight (AHR, 0.70; 95% CI, 0.56 to 0.88) groups but not in the obese group (AHR, 0.80; 95% CI, 0.64 to 1.00).

CONCLUSION: In obese individuals, even moderate alcohol use is associated with the development of hepatic steatosis. Moderate alcohol consumption is associated with lower mortality in normal-BMI and overweight individuals but not in those who are obese.

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