January 30, 2018

Late Teen Drinking Can Lead to Liver Problems

Alcohol is the leading cause of liver cirrhosis and liver-related deaths. Results of a large long-term study in Sweden have confirmed that drinking during late adolescence could be the first step towards liver problems in adulthood and that guidelines for safe alcohol intake in men might have to be revised downwards, reports the Journal of Hepatology.

Current recommended cut-off levels in some countries suggest that safe alcohol consumption for men to avoid alcoholic liver disease is 30 grams per day, roughly equivalent to three drinks.

A Safe Cut-Off Level?

"Our study showed that how much you drink in your late teens can predict the risk of developing cirrhosis later in life," explains lead investigator Hannes Hagström, MD, PhD, of the Centre for Digestive Diseases, Division of Hepatology, Karolinska University Hospital, Stockholm, Sweden. "However, what can be considered a safe cut-off in men is less clear."

Investigators conducted a retrospective study to assess the association between alcohol consumed early in life with later development of severe liver disease. They used data from a nationwide population-based study conducted during 1969-1970 of all Swedish men conscripted into military service.

During that period, conscription was mandatory in Sweden, and only 2-3 % of men were exempted from conscription, mostly due to severe disabilities or disease. This study was based on more than 49,000 Swedish men, aged 18-20, who were conscripted at that time.

Researchers matched personal identity numbers from the conscription data with records in the National Patient Register and the Causes of Death Register to establish whether participants had developed severe liver disease up to the end of 2009. Results were adjusted for body mass index, smoking, use of narcotics, cognitive ability, and cardiovascular capacity.

Follow-Up After 39 Years

Data indicated that alcohol consumption early in life was associated with an increased risk of developing severe liver disease. After 39 years of follow-up, 383 men had developed severe liver disease, which was defined as a diagnosis of liver cirrhosis, decompensated liver disease (hepatocellular carcinoma, ascites, esophageal varices, hepatorenal syndrome, or hepatic encephalopathy), liver failure, or death from liver disease.

The risk was dose-dependent, with no sign of a threshold effect and was more pronounced in men consuming two drinks per day, about 20 grams, or more.

Before adjustment for body mass index, tobacco consumption, the use of narcotics, cardiovascular fitness, and cognitive ability, the risk was significant for daily alcohol consumption as low as six grams per day. These results are only valid for men and need to be validated in women.

Lowering the Level

"If these results lead to lowering the cut-off levels for a 'safe' consumption of alcohol in men, and if men adhere to recommendations, we may see a reduced incidence of alcoholic liver disease in the future," says Dr. Hagström.

Alexandre Louvet, MD, PhD, Service des maladies de l'appareil digestif, Hôpital Huriez, Lille, France, observes in an accompanying editorial that despite the huge disease burden, there are no approved treatments for alcoholic liver disease.

"The present study adds to our knowledge about the risks of chronic alcohol consumption at a younger age," comments Dr. Louvet. "Safe levels of alcohol consumption must be revised for the general population and public health policies must be adapted accordingly. General recommendations by physicians must be accompanied by alcohol-control policies, especially access to alcohol, prices, and advertising.

Individual Interventions Useful

"Education and information are not sufficient on their own to reduce alcohol consumption in the general population. On the other hand, targeted interventions aimed at identifying and advising excessive drinkers are useful on an individual level."

According to the World Health Organization's 2014 global status report on alcohol and health, alcohol-related cirrhosis is responsible for 493,300 deaths each year.

Although there is no approved treatment, alcohol-related disease is theoretically 100% preventable, which makes the role of preventive measures central in decreasing the impact of excessive alcohol consumption on society.

Posted by Webmaster at 08:07 AM


January 18, 2018

Alcohol-Related E.R. Visits Surge

Heavy and chronic alcohol consumption is blamed for a significant increase in emergency department visits over an eight-year period, according to a study by the Research Society on Alcoholism.

While moderate drinking – up to one drink per day for women, two for men – can be part of a healthy lifestyle, excessive and chronic drinking can contribute to injury and disease.

Study of 945 Hospitals

Each year, U.S. patients utilize emergency department (ED) services more than 130 million times, averaging nearly four visits per every 10 people. Alcohol-related injury and disease are commonly the cause of these visits. This study examined trends in ED visits that involved heavy and chronic drinking by age and gender between 2006 to 2014.

Researchers accessed data from the Nationwide Emergency Department Sample (NEDS), a U.S. database representing 945 hospitals in 33 states and Washington, D.C. They assessed changes in the prevalence and rates of ED visits involving persons 12 years of age and older.

Larger Increase for Females

Findings of the study included:

  • Drinking contributed to an increasing number of ED visits in the U.S. between 2006 to 2014, especially among females (5.3% vs 4.0% in males)

  • The number of alcohol-related ED visits increased 61.6%, from 3,080,214 to 4,976,136

  • The he total cost of such visits increased 272% from $4.1 billion to $15.3 billion

Given the greater burden of alcohol-related ED use and its associated costs – particularly within the age group of 45–54 years for both males and females – the authors called for a greater use of evidence-based interventions for patients who are in emergency situations.

Source: White AM, et al "Trends in Alcohol-Related Emergency Department Visits in the United States: Results from the Nationwide Emergency Department Sample, 2006 to 2014." Alcoholism: Clinical & Experimental Research January 2018.

Posted by Webmaster at 11:08 AM