Unraveling the roles of excessive alcohol use and liver disease in mortality.
Unraveling the roles of excessive alcohol use and liver disease in mortality.
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揭示过量饮酒和肝病在死亡率中的作用。
DOI：
10.1111/acer.15007
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Cotter,ThomasG
中科院分区：
文献类型：
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作者：
Mitchell,MackC;Cotter,ThomasG
长期以来，过量饮用酒精饮料一直被认为是导致肝脏疾病死亡的主要原因。在COVID-19大流行的高峰期，过度饮酒对健康的影响变得更加明显，从2019年到2020年，美国酒精相关死亡人数增加了25%，酒精相关肝病（ALD）增加了22% （White et al., 2022）。Whitfield、Seth、Morgan等人的文章在英国生物银行（UK Biobank）的大型人群队列中证实了过量饮酒对健康的影响（Whitfield et al., 2022）。他们的研究清楚地表明，过度饮酒者的全因死亡率和肝脏相关死亡率都有所增加，过度饮酒者的定义是男性每天饮酒超过80克，女性每天饮酒超过50克，至少持续10年。除了用大量的统计数据证实过量饮酒的危害之外，他们的研究还呼吁人们关注一些值得进一步研究的问题，以及为干预提供机会的临床情况。在讨论这项重要研究的结果时，我们必须指出，重点是与其他人群相比，过度饮酒者的所有死亡原因的风险因素，而不是所有范围的酒精消费对所有原因死亡率的影响。虽然重要，但酒精消费与全因死亡率之间的关系已被广泛研究，但关于适度饮酒对死亡率的影响的结果相互矛盾（合作者，2018,Dawson, 2000， Di Castelnuovo等人，2006，Xi等人，2017）。大多数先前的人口研究发现，过度饮酒者的全因死亡率增加。然而，其中许多研究在研究人群中缺乏足够的过量饮酒者，无法确定影响肝病、癌症、心脏病和其他健康问题死亡率的因素。
Excessive consumption of alcoholic beverages has long been recognized as the major cause of death from liver disease. During the height of the COVID-19 pandemic, the health consequences of excessive drinking became even more obvious as demonstrated by a 25% increase in alcohol-related deaths and a 22% increase in alcohol-associated liver disease (ALD) in the United States from 2019 to 2020 (White et al., 2022). The article by Whitfield, Seth, Morgan and others provides confirmation of the health-related consequences of excessive drinking in a large population-based cohort, the UK Biobank (Whitfield et al., 2022). Their study clearly indicates an increase in both all-cause and liver-related mortality in excessive drinkers defined as men drinking more than 80 g and women drinking more than 50 g of ethanol daily for at least 10 years. Beyond confirming, with substantial statistical power, the harm associated with excessive consumption, their study calls attention to issues that deserve further research and clinical situations that provide an opportunity for intervention.In discussing the findings from this important study, we must point out that the focus was on risk factors for all causes of mortality only in excessive drinkers compared to the rest of the population, not the impact of all ranges of alcohol consumption on all-cause mortality. While important, the relationship between alcohol consumption and all-cause mortality has been studied extensively with conflicting results regarding the effects of moderate drinking on mortality (Collaborators, 2018, Dawson, 2000, Di Castelnuovo et al., 2006, Xi et al., 2017). Most previous population studies found an increase in all-cause mortality in excessive drinkers. However, many of those studies lacked enough excessive drinkers within the study population to determine factors that influence the mortality from liver diseases, cancer, heart disease and other health problems.