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Aldo Lorenzetti M.D, Internal Medicine & Hepatology, Milano - SIMEDET Delegate
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Population Impact Attributable to Modifiable Risk Factors for #Hyperuricemia

#BMI, #alcohol intake, adherence to a DASH‐style #diet, and diuretic use were all associated with serum urate levels and the presence of hyperuricemia in a dose‐response manner. The corresponding PARs of hyperuricemia cases for overweight/obesity (prevalence, 60%), non‐adherence to a DASH‐style diet (prevalence, 82%), alcohol use (prevalence, 48%), and diuretic use (prevalence, 8%) were 44% (95% CI, 41 to 48%), 9% (3% to 16%), 8% (5% to 11%), and 12% (11% to 14%), respectively, whereas the corresponding variances explained were 8.9%, 0.1%, 0.5%, and 5.0%. Our simulation study showed the variance nearing zero with exposure prevalence's nearing 100%.

Conclusion
In these nationally representative US adults, four modifiable risk factors (BMI, the DASH diet, alcohol use, and diuretic use) could individually account for a notable proportion of hyperuricemia cases. However, the corresponding serum urate variance explained by these risk factors was very small and paradoxically masked their high prevalences, providing real‐life empirical evidence for its limitations in assessing common risk factors.

https://onlinelibrary.wiley.com/doi/abs/10.1002/art.41067
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Convergent evidence for predispositional effects of #brain gray matter volume on #alcohol consumption

Smaller right dorsolateral prefrontal cortex (DLPFC; i.e., middle and superior frontal gyri) and insula GMVs were associated with increased alcohol use across samples. Family-based and prospective longitudinal data suggest these associations are genetically-conferred and that DLPFC GMV prospectively predicts future use and initiation. Genomic risk for alcohol use was enriched in gene-sets preferentially expressed in the DLPFC, and associated with replicable differential gene expression in the DLPFC.

Conclusions
These data suggest that smaller DLPFC and insula GMV plausibly represent genetically-conferred predispositional risk factors for, as opposed to consequences of, alcohol use. DLPFC and insula GMV represent promising biomarkers for alcohol consumption liability and related psychiatric and behavioral phenotypes.

https://www.biologicalpsychiatryjournal.com/article/S0006-3223(19)31678-6/fulltext
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#Alcohol Consumption and Risk of Liver #Cirrhosis
A Systematic Review and Meta-Analysis

..There was no increased risk for occasional drinkers. Consumption of one drink per day in comparison to long-term abstainers showed an increased risk for liver cirrhosis in women, but not in men. The risk for women was consistently higher compared to men. Drinking ≥5 drinks per day was associated with a substantially increased risk in both women (relative risk [RR] = 12.44, 95% confidence interval [CI]: 6.65–23.27 for 5–6 drinks, and RR = 24.58, 95% CI: 14.77–40.90 for ≥7 drinks) and men (RR = 3.80, 95% CI: 0.85–17.02, and RR = 6.93, 95% CI: 1.07–44.99, respectively). Heterogeneity across studies indicated an additional impact of other risk factors.

DISCUSSION: Alcohol is a major risk factor for liver cirrhosis with risk increasing exponentially. Women may be at higher risk compared to men even with little alcohol consumption. More high-quality research is necessary to elucidate the role of other risk factors, such as genetic vulnerability, body weight, metabolic risk factors, and drinking patterns over the life course. High alcohol consumption should be avoided, and people drinking at high levels should receive interventions to reduce their intake.

https://journals.lww.com/ajg/Fulltext/2019/10000/Alcohol_Consumption_and_Risk_of_Liver_Cirrhosis__A.8.aspx
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Evidence for a Direct Harmful Effect of #Alcohol on #Myocardial Health: A Large Cross‐Sectional Study of Consumption Patterns and Cardiovascular Disease Risk Biomarkers From Northwest Russia, 2015 to 2017

..Measurements were made of the following: (1) high‐sensitivity cardiac troponin T, (2) NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide), and (3) hsCRP (high‐sensitivity C‐reactive protein). The narcology clinic subsample had the most extreme drinking pattern and the highest levels of all 3 biomarkers relative to nonproblem drinkers in the general population: high‐sensitivity cardiac troponin T was elevated by 10.3% (95% CI, 3.7%–17.4%), NT‐proBNP by 46.7% (95% CI, 26.8%–69.8%), and hsCRP by 69.2% (95% CI, 43%–100%). In the general population sample, NT‐proBNP was 31.5% (95% CI, 3.4%–67.2%) higher among harmful drinkers compared with nonproblem drinkers. Overall, NT‐proBNP and hsCRP increased with increasing intensity of alcohol exposure (test of trend P<0.001).

Conclusions
These results support the hypothesis that heavy alcohol drinking has an adverse effect on cardiac structure and function that may not be driven by atherosclerosis.

https://bit.ly/2s263vV
#Alcoholics Anonymous and other 12‐step programs for #alcohol use disorder
https://2medical.news/2020/03/19/alcoholics-anonymous-and-other-12%E2%80%90step-programs-for-alcohol-use-disorder/

Alcohol use disorder (AUD) confers a prodigious burden of disease, disability, premature mortality, and high economic costs from lost productivity, accidents, violence, incarceration, and increased healthcare utilization. For over 80 years, Alcoholics Anonymous (AA) has been a widespread AUD recovery organization, with millions of members and treatment free at the point of access, but it is only recently that rigorous research on its effectiveness has …
#Alcohol Use Disorder and Risk of #Suicide in a Swedish Population-Based Cohort
https://2medical.news/2020/03/25/alcohol-use-disorder-and-risk-of-suicide-in-a-swedish-population-based-cohort/

..The lifetime rate of suicide during the observation period was 3.54% for women and 3.94% for men with AUD, compared with 0.29% and 0.76% of women and men, respectively, without AUD. In adjusted analyses, AUD remained robustly associated with suicide: hazard ratios across observation periods ranged from 2.61 to 128.0 among women and from 2.44 to 28.0 among men. Co-relative analyses indicated that familial confounding …
Associations Between Medical Conditions and #Alcohol Consumption Levels in an Adult Primary Care Population
https://2medical.news/2020/05/17/associations-between-medical-conditions-and-alcohol-consumption-levels-in-an-adult-primary-care-population/

..Among the 2 720 231 included patients, 1 439 361 (52.9%) were female, 1 308 659 (48.1%) were white, and 883 276 (32.5%) were aged 18 to 34 years. Patients with any of the conditions (except injury or poisoning) had lower odds of drinking at low-risk and unhealthy levels relative to no reported use compared with those without the condition. Among 861 427 patients reporting alcohol use, patients with diabetes (odds ratio [OR], …
#Alcohol, Alcoholic Beverages and Risk of #Esophageal Cancer by Histological Type: A Dose–Response Meta-Analysis of Observational Studies
https://2medical.news/2020/06/10/alcohol-alcoholic-beverages-and-risk-of-esophageal-cancer-by-histological-type-a-dose-response-meta-analysis-of-observational-studies/

We conducted a dose–response meta-analysis to explore the association between alcohol and particular alcoholic beverages with risk of esophageal cancer (EC) by histological type [esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC)] and whether the association differs according to gender.. A total of 74 published articles involving 31,105 cases among 3,369,024 participants were included in this meta-analysis. The pooled RRs of the highest versus …
Association of Low to Moderate #Alcohol Drinking With #Cognitive Functions From Middle to Older Age Among US Adults
https://2medical.news/2020/07/02/association-of-low-to-moderate-alcohol-drinking-with-cognitive-functions-from-middle-to-older-age-among-us-adults/

..The mean (SD) age of 19 887 participants was 61.8 (10.2) years, and the majority of the HRS participants were women (11 943 [60.1%]) and of white race/ethnicity (16 950 [85.2%]). Low to moderate drinking (<8 drinks per week for women and <15 drinks per week for men) was significantly associated with a consistently high cognitive function trajectory and a lower rate of cognitive decline. Compared with never …
Effect of #Zinc Supplementation vs Placebo on Mortality Risk and #HIV Disease Progression Among HIV-Positive Adults With Heavy #Alcohol Use
https://2medical.news/2020/07/03/effect-of-zinc-supplementation-vs-placebo-on-mortality-risk-and-hiv-disease-progression-among-hiv-positive-adults-with-heavy-alcohol-use/

.. A total of 254 participants (184 men [72%]; mean [SD] age, 34 [6] years) were enrolled in the trial; 126 were randomized to receive zinc, and 128 were randomized to receive placebo. Participants had high CD4 cell counts (mean [SD], 521 [292] cells/mm3), and 188 (74%) reported heavy drinking in the past week. In the main analyses, zinc supplementation did not affect changes in …
Lifetime perspective on #alcohol and #brain health
https://2medical.news/2020/12/08/lifetime-perspective-on-alcohol-and-brain-health/

Harm prevention policies must take the long view The maintenance of brain health is central to health and wellbeing across the lifespan.1 Evidence suggests three periods of dynamic brain changes that may be particularly sensitive to the neurotoxic effects of alcohol: gestation (from conception to birth), later adolescence (15-19 years), and older adulthood (over 65 years). Highly prevalent patterns of alcohol use may cause harm …
U.S. #Diet Guidelines Sidestep Scientific Advice to Cut #Sugar and #Alcohol
https://2medical.news/2021/01/06/u-s-diet-guidelines-sidestep-scientific-advice-to-cut-sugar-and-alcohol/

..Evidence suggests that added sugars, particularly those in sweetened beverages, may contribute to obesity and weight gain, which are linked to higher rates of chronic health conditions like heart disease and Type 2 diabetes, the scientific panel noted. More than two-thirds of American adults are overweight or obese; obesity, diabetes and other related conditions also increase the risk of developing severe Covid-19 illness. The scientific …
The effects of #alcohol and #cannabis use on the cortical thickness of #cognitive control and salience brain networks in emerging adulthood: a cotwin control study
https://2medical.news/2021/01/28/the-effects-of-alcohol-and-cannabis-use-on-the-cortical-thickness-of-cognitive-control-and-salience-brain-networks-in-emerging-adulthood-a-cotwin-control-study/

Background Impairments in inhibitory control and its underlying brain networks (control/salience areas) are associated with substance misuse. Research often assumes a causal substance exposure effect on brain structure. This assumption remains largely untested and other factors (e.g., familial risk) may confound exposure effects. We leveraged a genetically-informative sample of 24-year-old twins and a quasi-experimental cotwin control design to separate alcohol or cannabis exposure effects during …
Increased #alcohol use during the #COVID-19 pandemic: The effect of mental health and age in a cross-sectional sample of social media users in the U.S.
https://2medical.news/2021/02/03/increased-alcohol-use-during-the-covid-19-pandemic-the-effect-of-mental-health-and-age-in-a-cross-sectional-sample-of-social-media-users-in-the-u-s/

The COVID-19 pandemic has triggered a public health crisis of unprecedented scale. Increased alcohol use has been extensively documented during other crises, particularly among persons with anxiety and depression. Despite COVID-19’s differential impact by age, the association of age, mental health and alcohol use during the pandemic has not been explored. This study aimed to examine whether age modified the association of anxiety and depressive …