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Alcohol and cirrhosis: dose--response or threshold effect?
Mads Kamper-Jørgensen1, Morten Grønbaek, Janne Tolstrup
1Centre for Alcohol Research, National Institute of Public Health, Copenhagen, Denmark. mkj@niphy.dk
Journal of Hepatology
|July 13, 2004
Summary
Alcohol misuse significantly increases alcoholic cirrhosis mortality. However, exceeding five drinks daily showed no additional risk, suggesting a threshold effect, not a dose-response relationship, for alcoholic cirrhosis deaths.
Area of Science:
- Hepatology
- Toxicology
- Public Health
Background:
- General population studies link alcohol intake to alcoholic cirrhosis mortality.
- The dose-response or threshold effect of alcohol on cirrhosis mortality is unknown.
- The relationship between alcohol misuse and cirrhosis mortality has not been extensively studied.
Purpose of the Study:
- To investigate the relationship between alcohol consumption patterns and alcoholic cirrhosis mortality in a cohort of alcohol misusers.
- To determine if alcohol intake has a dose-response or threshold effect on alcoholic cirrhosis mortality among individuals with alcohol misuse.
Main Methods:
- A prospective cohort study of 6152 alcohol misusing men and women aged 15-83.
- Data collected through interviews on drinking patterns and social issues.
- Follow-up for 84,257 person-years with Cox-regression models to analyze alcoholic cirrhosis mortality.
Main Results:
- Alcohol misusers experienced a 27-fold increased mortality from alcoholic cirrhosis in men and 35-fold in women compared to the general Danish population.
- No significant association was found between the number of drinks per day and death from alcoholic cirrhosis.
- Exceeding an average of five drinks per day (>60 g alcohol) did not confer additional risk for alcoholic cirrhosis mortality in either men or women.
Conclusions:
- Alcohol consumption appears to have a threshold effect, rather than a dose-response effect, on mortality from alcoholic cirrhosis in individuals with alcohol misuse.
- These findings suggest a specific level of alcohol intake beyond which the risk of alcoholic cirrhosis mortality does not further increase significantly.