According to the World Health Organization, excessive alcohol drinking is the most common cause of cirrhosis worldwide. A new worldwide study presented at The International Liver CongressTM 2015 has shown the significant influence of daily drinking on this disease burden. New data shows that the cirrhosis burden caused by alcohol increased by 11.13% when moving from the moderate to heavy daily drinking (up to one drink/day for women; two drinks/day for men) classification (p<.001).
Most studies assessing the prevalence of alcohol abuse as a risk factor for alcoholic cirrhosis focus on total annual amount drunk per person. However, the researchers highlight that clinical studies suggest that it is a high daily consumption which is the strongest predictor of alcoholic cirrhosis. This new research concluded that heavy daily drinkers most significantly and independently influence a country's cirrhosis burden.
According to the World Health Organization's Global Status Report on Alcohol and Health, around 6% of global deaths are caused by drinking alcohol, the majority from alcoholic cirrhosis - scarring of the liver as a result of continuous, long-term liver damage. Half of all cases of cirrhosis are caused by alcohol.
The researchers analysed the WHO's Global Status Report on Alcohol and Health, which included parameters of alcohol consumption and drinking patterns from 193 countries.
Reducing heavy drinking should therefore be considered as an important target for public health monitoring and policies.
Abstract O127: A WORLDWIDE STUDY REVEALS THAT THE AMOUNT OF DAILY ALCOHOL INTAKE IS A BETTER PREDICTOR OF THE WEIGHT OF ALCOHOL IN THE CIRRHOSIS BURDEN THAN THE TOTAL PER CAPITA COMSUMPTION
Ramon Bataller1, Eva Stein* 2, Jose T. Altamirano3, Monica Cruz-Lemini4, Jueyon Cheong2
1Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chael Hill, 2Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, United States, 3Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), 4Institut dÍnvestigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
Background and Aims: Approximately 6% of global deaths are caused by alcohol consumption, with a major contribution from alcoholic cirrhosis (Global Status Report on Alcohol and Health, WHO, 2014). Moreover, of diseases not explicitly defined by alcohol consumption, cirrhosis has the highest alcohol-attributable fraction (50% of all cases worldwide). Most studies assessing the prevalence of alcohol abuse as a risk factor for alcoholic cirrhosis focus on total annual per capital consumption. However, clinical studies indicate that high daily consumption is the strongest predictor of alcoholic cirrhosis. We hypothesize that the counties with the highest daily alcohol consumption are at highest risk of having a greater burden of alcoholic cirrhosis.
Methods: We performed a comprehensive analysis of the WHO Global Status Report on Alcohol and Health, which included parameters of alcohol consumption and drinking patterns from 193 countries. We categorized countries by heavy or moderate drinking using the average daily consumption among drinkers, according to the US Dietary Guidelines threshold for heavy drinking (up to 1 drink/day for women, up to 2 drinks/day for men). Moreover, global rates of HCV and HBV were obtained from published seroprevalence estimates, and obesity data were obtained from the WHO Data Repository. Uni- and multivariate models were fitted to determine the correlation between alcohol parameters and the outcome measure of alcohol-attributable fraction (AAF) of cirrhosis, adjusting for the cofactors' effects.
Results: In an integrative model that adjusted for cirrhosis cofactors, the classification of countries by moderate or heavy daily drinking had the strongest influence on the weight of alcohol in the cirrhosis burden. Of note, the cirrhosis burden due to alcohol increased by 11.13% with a transition from the moderate to heavy classification (p<.001). In contrast, total yearly per capita consumption had a correlation coefficient of only 2.22 with the AAF of cirrhosis (p<.001). Importantly, drinking patterns such as heavy episodic drinking and the type of alcoholic beverages (wine, beer or spirits) did not independently correlate with AAF.
Conclusions: The presence of heavy daily drinkers in a population most significantly and independently influences the weight of alcohol in a country's cirrhosis burden. Reducing heavy drinking should therefore be considered as an important target for public health monitoring and policies.
Disclosure of Interest: R. Bataller: Consultant: ONCOZYME, SANDHILL, VITAL THERAPEUTICS, E. Stein: : None Declared, J. Altamirano: : None Declared, M. Cruz-Lemini: : None Declared, J. Cheong: : None Declared