Alcohol dependence and risk of somatic diseases and mortality: a cohort study in 19002 men and women attending alcohol treatment
Alcohol dependence and risk of somatic diseases and mortality: a cohort study in 19002 men and women attending alcohol treatment
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DOI：
10.1111/add.13799
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发表时间：
2017-08-01
期刊：
影响因子：
6
通讯作者：
Becker, Ulrik
中科院分区：
文献类型：
--
作者：
Holst, Charlotte;Tolstrup, Janne Schurmann;Becker, Ulrik
目的：（1）估计酒精依赖个体与对照人群中全面的躯体疾病的性别特异性风险，并在同一人群中（2）估计性别特异性死于检查的躯体疾病的风险。酒精依赖者是从哥本哈根酒精队列中确定的。对照组从丹麦民事登记系统中随机抽取。躯体疾病的信息来自丹麦国家患者登记处，死亡原因来自死亡原因登记处。方法采用考克斯比例风险模型（proportional hazards model，Cox）对19002名酒精依赖者和186767名对照者进行危险比（hazardratios，HR）的估计。主要预测变量是酒精依赖的诊断，根据ICD.FindingsAlcohol-dependent男性和女性与对照组相比，所有疾病组和大多数亚组的疾病事件分析时，统计学显着较高的风险。已确定的酒精相关疾病的HR升高，但痴呆[男性，HR=2.0，95%置信区间（CI）=1.6-2.3;女性，HR=2.4，95% CI=1.8-3.2]、银屑病（男性，HR=4.3，95% CI=3.5-5.2;女性，HR=5.4，95% CI=3.7-7.8）和男性乳腺癌（HR=3.3，95% CI=1.6-7.0）。当疾病组和亚组被分析为causes of death.ConclusionsAlcohol-dependent男性和女性有显着更高的风险，一个全面的躯体疾病，无论是作为疾病事件和死亡原因，相对于个人从一般人群。
AimsTo (1) estimate sex-specific risks of a comprehensive spectrum of somatic diseases in alcohol-dependent individuals versus a control population, and in the same population to (2) estimate sex-specific risks of dying from the examined somatic diseases.DesignRegister-based matched cohort study. Alcohol-dependent individuals were identified from the Copenhagen Alcohol Cohort. Controls were selected randomly from the Danish Civil Registration System. Information on somatic diseases was obtained from the Danish National Patient Registry and causes of death obtained from the Cause of Death Registry. Cox proportional hazards model was applied to estimate hazard ratios (HRs).SettingDenmark.ParticipantsA total of 19002 alcohol-dependent individuals and 186767 controls.MeasurementsOutcome variables included 11 disease groups and 29 subgroups, defined according to the International Classification of Diseases (ICD). The main predictor variable was diagnosis of alcohol dependence according to ICD.FindingsAlcohol-dependent men and women compared with controls had statistically significantly higher risks of all disease groups and the majority of subgroups when analysed as disease events. HRs were elevated for well-established alcohol-related diseases but also for diseases such as dementia [men, HR=2.0, 95% confidence interval (CI)=1.6-2.3; women, HR=2.4, 95% CI=1.8-3.2], psoriasis (men, HR=4.3, 95% CI=3.5-5.2; women, HR=5.4, 95% CI=3.7-7.8) and breast cancer in men (HR=3.3, 95% CI=1.6-7.0). Similar results were found when disease groups and subgroups were analysed as causes of death.ConclusionsAlcohol-dependent men and women have significantly higher risks of a comprehensive spectrum of somatic diseases, both as disease events and as causes of death, relative to individuals from the general population.