Alcohol abuse is related to more than 200 diseases and around three million people die each year (5.3% of all deaths) from this cause, according to the World Health Organization (WHO), which also warns that “a causal relationship exists between the harmful use of alcohol and a variety of mental and behavioral disorders, other noncommunicable conditions, and injuries.”
New research conducted in China adds new evidence on this public health problem because it has found that drinking alcohol increases the risk of developing more than 60 diseases in men, including many pathologies that until now have not been related to alcohol. The results have been published in Nature Medicine.
Alcohol use is increasing in many low- and middle-income countries, such as China, and while many of its detrimental health effects, such as cirrhosis of the liver, stroke, and various types of cancer, are already known, the new study has systematically evaluated the impact of alcohol consumption on a wide variety of diseases in the same population.
“Alcohol use is negatively related to a much broader range of diseases than previously established, and these associations are likely to be causal.”
The work was carried out by researchers from Oxford Population Health and Peking University, who analyzed data from the China Kadoorie Biobank (CKB), a collaborative study involving more than 512,000 adults recruited between 2004 and 2008 in 10 urban areas and various rural areas of China. These people answered questions about their lifestyle and behaviors, including detailed patterns of alcohol use.
The researchers found that about a third of the men drank alcohol regularly (at least once a week), but only 2% of the women did. They studied how alcohol consumption affected health in 207 different diseases in men, which had been identified through hospital records for about 12 years. In addition, they also carried out a genetic analysis to determine whether or not alcohol consumption was the cause of the disease.
Main findings on the impact of alcohol consumption on health
The results of the study have demonstrated the influence that alcohol consumption can have on disease risk in populations around the world. His main findings have been:
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Among the 207 diseases studied, self-reported alcohol intake was associated with increased risks of 61 diseases in men, including 28 diseases previously linked to alcohol by the WHO, such as cirrhosis of the liver, stroke and various gastrointestinal cancers, and 33 diseases whose relationship to alcohol had not been previously established, such as gout, cataracts, some fractures, gastroenteritis, and ulcers.
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There were more than 1.1 million hospitalizations recorded in the study, and men who had ever drank alcohol regularly had a significantly higher risk of developing any disease and were admitted to the hospital more frequently, compared with men who only they had drunk alcohol occasionally.
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Certain drinking patterns, such as daily drinking, “binge” drinking, or drinking outside of meals, especially increased the risks of certain diseases, specifically cirrhosis of the liver.
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In genetic analyses, evidence of a dose-dependent causal effect was found in collectively identified alcohol-related illnesses, with every four drinks per day associated with a 14% increased risk of established alcohol-related illnesses, up 6%. increased risk of diseases not previously known to be alcohol-related; and a two-fold increased risk of cirrhosis of the liver and gout.
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In genetic analyses, higher alcohol intake was significantly associated with increased risk of stroke in a dose-responsive fashion (consistent with previous findings in the CKB study), but no increased risk of ischemic heart disease was observed. . Moderate alcohol consumption (one or two drinks a day) had no protective effect against ischemic heart disease.
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In China, it is unusual for women to drink alcohol, and because less than 2% of those included in the study drank regularly, these women provided a useful control group in genetic analyses, helping to confirm that excess disease risk in men it was caused by alcohol consumption, not by other factors related to genetic variants.
Pek Kei Im, a research associate at Oxford Population Health and lead author of the paper, said: “Alcohol use is negatively related to a much broader range of diseases than previously established, and our findings show that it is likely that These associations are causal. Iona Millwood, Associate Professor at Oxford Population Health and lead author of the study, added: “It is becoming increasingly clear that the harmful use of alcohol is one of the most important risk factors for poor health, both in China and globally. ”.
East Asian populations have common genetic variants that greatly decrease their tolerance for alcohol because drinking triggers a very unpleasant flushing reaction. Therefore, individuals who carry these gene variants tend to drink less alcohol, and because these gene variants are not related to other lifestyle factors (such as smoking, or socioeconomic status), researchers can use this information to accurately assess greater precision the cause and effect relationships of alcohol in a wide variety of diseases.
“This study provides important causal evidence of the scale of alcohol-related harm, which is critical to inform prevention strategies in different countries,” concludes Professor Zhengming Chen, Richard Peto Professor of Epidemiology at Oxford Population Health and lead author. and co-PI from CKB.
