Meta-analysis for combining relative risks of alcohol consumption and prostate cancer

BACKGROUND: Prostate cancer has become the most common cancer among men in the United States, but little is known about factors associated with prostate cancer incidence. METHODS: A meta-analysis of studies published prior to July 1998 was conducted to pool relative risk (RR) estimates from the existing literature on the association between prostate cancer and alcohol consumption, in an attempt to determine whether there is an association, and if so, what its magnitude is. RESULTS: The overall pooled RR estimate was 1. 05 for both fixed and random effects models, based on six cohort studies and 27 case-control studies. The RR estimate varied little by study design. Among types of consumption, the highest risk was found for beer (RR = 1.27), but this was based on only eight studies that reported type of alcohol consumed. A linear dose-response was fit to the 15 studies reporting amount of alcohol consumed, finding a RR of 1.05 (95% confidence interval (CI), 0.91-1.20) for each additional drink of alcohol per day or a RR of 1.21 for 4 drinks per day. When the average drinks per day consumed in the 15 studies were used to estimate the overall risk for all 33 studies, a RR of 1.02 was found for each additional drink of alcohol per day. CONCLUSIONS: Overall, no association between prostate cancer and alcohol consumption was seen. While some categories of consumption showed an increased risk, the studies reporting such categories appeared to be biased towards reporting a positive association among the categories.     

Changes in Alcohol Consumption and Subsequent Risk of Type 2 Diabetes in Men

OBJECTIVE

The objective of this study was to investigate the association of 4-year changes in alcohol consumption with a subsequent risk of type 2 diabetes.

RESEARCH DESIGN AND METHODS

We prospectively examined 38,031 men from the Health Professionals Follow-Up Study who were free of diagnosed diabetes or cancer in 1990. Alcohol consumption was reported on food frequency questionnaires and updated every 4 years.

RESULTS

A total of 1,905 cases of type 2 diabetes occurred during 428,497 person-years of follow-up. A 7.5 g/day (approximately half a glass) increase in alcohol consumption over 4 years was associated with lower diabetes risk among initial nondrinkers (multivariable hazard ratio [HR] 0.78; 95% CI: 0.60–1.00) and drinkers initially consuming <15 g/day (HR 0.89; 95% CI: 0.83–0.96), but not among men initially drinking ≥15 g/day (HR 0.99; 95% CI: 0.95–1.02; P_interaction < 0.01). A similar pattern was observed for levels of total adiponectin and hemoglobin A_1c, with a better metabolic profile among abstainers and light drinkers who modestly increased their alcohol intake, compared with men who either drank less or among men who were already moderate drinkers and increased their intake. Likewise, compared with stable light drinkers (0–4.9 g/day), light drinkers who increased their intake to moderate levels (5.0–29.9 g/day) had a significantly lower risk of type 2 diabetes (HR 0.75; 95% CI: 0.62–0.90).

CONCLUSIONS

Increases in alcohol consumption over time were associated with lower risk of type 2 diabetes among initially rare and light drinkers. This lower risk was evident within a 4-year period following increased alcohol intake.Alcohol consumption has been consistently associated with a reduced risk of type 2 diabetes compared with abstention or excessive consumption (1,2). Most prospective studies measure alcohol consumption at only one point in time which assumes intake is fairly stable over time. However, alcohol consumption is dynamic, especially over longer periods of follow-up (3). Importantly, changes in alcohol consumption over time have been associated with subsequent changes in risk of cardiovascular diseases (4–6) and mortality (7), although some inconsistency exists (8,9). Variability in intake over time thus highlights the constraints of single measures of alcohol consumption.To our knowledge, no observational studies have examined the association between changes in alcohol consumption over time and future risk of type 2 diabetes, despite the importance of such studies both in assessing the robustness of the alcohol-diabetes association and in addressing a topic of direct clinical importance—what happens when individuals adopt or cease drinking? Short-term randomized trials of alcohol have shown changes in insulin sensitivity and adiponectin concentrations within 6 to 8 weeks, suggesting that changes in subsequent risk of diabetes could plausibly occur with a short latency (10–12). Therefore, we attempted to examine whether initiation of light to moderate alcohol consumption is associated with a lower subsequent risk of type 2 diabetes, and likewise whether a reduction in alcohol consumption is associated with higher type 2 diabetes risk.To accomplish these aims, we examined men enrolled in the Health Professionals Follow-Up Study (HPFS), an ongoing prospective cohort of men who have repeatedly reported their alcohol consumption over time and in whom validated diagnoses of diabetes have been ascertained for two decades.     

Orthopaedic trauma in men: the relative risk among drinkers and the prevalence of problem drinking in male orthopaedic admissions

Admissions to an acute male orthopaedic ward (n = 369) were asked about their accident, their alcohol consumption, and alcohol-related problems in the past 2 years. Comparing their consumption with that of males from a community survey revealed an increased risk of orthopaedic admission in drinkers consuming 21 units of alcohol/week or over, relative to drinkers consuming less than 21 units/week, in the age group 31-50 years. In all, 34% of the sample met a criterion for problem drinking based on self-reported alcohol consumption and/or medical and social problems associated with alcohol. In 13%, alcohol was viewed by the patient as having contributed to the accident, and in 19% according to the interviewer's perception of whom 76% were classifiable as problem drinkers. Twenty-six men said the accident had made them think about changing their drinking habits. Detection of problem drinking in orthopaedic male admissions is possible and could be usefully linked to a counselling service.     

Coffee consumption and risk of type 2 diabetes mellitus in Asians: A meta-epidemiological study of population-based cohort studies

BACKGROUNDPrevious systematic reviews have consistently reported that coffee consumption has a preventive effect on the occurrence of type 2 diabetes mellitus (T2DM). However, further evaluations between coffee consumption and the risk of T2DM in Asian populations are needed.AIMTo conduct a meta-epidemiological study on systematic reviews evaluating the association between coffee consumption and the risk of T2DM in Asian people. METHODSThe selection criterion was defined as a population-based prospective cohort study evaluating the association between coffee consumption and the risk of T2DM in Asian populations, reporting the adjusted relative risk (RR) and its 95% confidence interval (CI) for potential confounders. A fixed-effect model meta-analysis was applied to calculate the summary RR and its 95%CI in less than 50% of the I² value indicating the level of heterogeneity. A two-stage fixed-effects dose-response meta-analysis (DRMA) was performed to calculate the risk per unit dose (a cup per day). RESULTSA total of seven studies were selected in this meta-epidemiological study. The risk of T2DM in Asian populations was significantly reduced in the highest to the lowest dose group (summary RR = 0.73, 95%CI: 0.66-0.82; I² value = 0.0%). The DRMA showed that drinking one cup of coffee per day reduced the risk of T2DM in Asian populations by 8% (RR = 0.92, 95%CI: 0.90-0.95). CONCLUSIONThese findings support the conclusion that coffee consumption has a protective effect on the occurrence of T2DM in Asian men and women.     

饮酒对中年男性2型糖尿病患者骨密度的影响

目的 探讨饮酒对中年男性2型糖尿病患者骨密度的影响。方法 选取中年男性2型糖尿病患者90例,分为不饮酒组及饮酒组,各45例。饮酒组根据日饮酒量分为3个等级：少量饮酒(<50 g/d);中等量饮酒(50~100 g/d);大量饮酒(>100 g/d)。按饮酒年限分为3级（<10年、10~20年、>20年)。测定各组股骨颈、大转子及腰椎骨密度,分析日饮酒量及饮酒年限与不同部位骨密度的相关性。结果 与不饮酒组相比,摄入酒精50~100 g/d、>100 g/d组和饮酒10~20年、>20年受试者的股骨颈、大转子、腰椎骨密度显著降低(P<0.01)。每日饮酒量>50g,饮酒年限>10年,与股骨颈、大转子、腰椎骨密度呈负相关。结论 中年男性2型糖尿病患者每日饮酒量>50g,饮酒年限>10年,骨密度明显降低,骨质疏松发生率升高。     

An assessment of the effects of exposure to vibration, smoking, alcohol and diabetes on the prevalence of Dupuytren's disease in 97,537 miners

A consecutive sample of 97,537 miners seeking compensation for Hand-Arm Vibration Syndrome were examined in a medical assessment process which included documentation of age, hand dominance, Dupuytren's disease, years of vibration exposure, history of diabetes, smoking habits and units of alcohol consumption per week. The prime determinant of prevalence of Dupuytren's disease was age, and all other factors investigated were corrected for age. There was no statistically significant correlation between years of exposure to vibration and the prevalence of Dupuytren's disease. There was a statistically significant association with smoking, alcohol consumption and diabetes mellitus, with the heaviest smokers having an odds ratio (OR) of 1.31 (95% CI, 1.17, 1.47), the heaviest drinkers (in excess of 22 units a week) having an OR of 1.59 (95% CI, 1.47, 1.72) and diabetes mellitus patients having an increase in the odds of having Dupuytren's disease of 1.52 (95% CI 1.30, 1.77).     

Alcohol consumption and the risk of end-stage renal disease among Chinese men

We examined the relationship between alcohol consumption and incidence of end-stage renal disease (ESRD) in a prospective cohort of 65 601 Chinese men aged 40 years and older. Information on the amount and type of alcohol consumed was collected at a baseline examination with follow-up evaluations conducted 8-9 years later. During the 500 876 person-years of follow-up, 176 participants initiated renal replacement therapy or died from renal failure. Compared to non-drinkers, the relative risk of ESRD was 0.67 among men consuming less than 21 drinks per week and 0.52 among men consuming this amount or more after adjustment for age, geographic region, urbanization, education, body mass index, physical activity, and cigarette smoking. The inverse association between alcohol consumption and ESRD existed even after adjustment for systolic blood pressure, and history of diabetes and cardiovascular disease. Our results suggest an inverse relationship between alcohol consumption and risk of ESRD in Chinese men. Heavy alcohol consumption, however, may lead to increased risk of morbidity and mortality from other causes; therefore, the implications from these findings should be interpreted cautiously.     

Alcohol Use Disorders Identification Test-consumption Predicts the Risk of Excessive Alcohol Consumption After Liver Transplantation

Excessive alcohol consumption has a negative impact on graft survival after liver transplantation (LT). However, it is difficult to predict alcohol relapse before LT. This study surveyed the alcohol consumption of LT recipients to identify the risk factors for harmful drinking. We surveyed the alcohol consumption of LT recipients by using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). AUDIT-C scores ≥ 5 points in men and ≥ 4 points in women indicated a high risk for harmful and hazardous drinking. Excessive alcohol consumption was considered to be > 20 g per day. Ninety-nine LT recipients completely filled out the questionnaire. Alcohol consumption after LT was detected in 26 recipients (26.5%); 4 of them had alcoholic liver disease before transplantation and 22 did not have alcoholic liver disease. The amount of alcohol consumption per day significantly decreased after LT (alcohol consumption per day: 49.6 g before LT vs 8.1 g after LT, P < .05). Fourteen recipients (14.1%) consumed alcohol excessively after LT. The AUDIT-C score before LT and smoking were risk factors for excessive alcohol consumption in the multivariate analysis. To properly manage post-transplant recipients, assessing the risk of excessive alcohol consumption by using the AUDIT-C is necessary.     

Alcohol dehydrogenase type 3 (ADH3) and the risk of bladder cancer.

OBJECTIVES: The polymorphic enzyme alcohol dehydrogenase (ADH) catalyses the conversion of ethanol into the carcinogenic metabolite acetaldehyde which is partly excreted into the urine. Objectives of this pilot study are to determine whether this polymorphism may be related to bladder cancer and whether it modifies the relation between alcohol intake and bladder cancer. METHODS: 120 bladder cancer patients and 133 convenience controls were recruited at the University Medical Centre Nijmegen. A self-administered questionnaire was used to assess alcohol intake and potential confounders. DNA was isolated from peripheral blood, and ADH3 genotype was determined using PCR/RFLP. People with the ADH3 genotype gamma1gamma1 were compared to people with other ADH3 genotypes. Above moderate drinkers (>14 glasses of alcohol per week) were compared to moderate drinkers. Odds ratios (ORs) and 95% confidence intervals were computed using logistic regression analyses. RESULTS: After correction for sex, age and smoking, ORs for ADH3 genotype and alcohol intake were 2.10 (1.05-4.22) and 1.21 (0.60-2.44), respectively. Moderate drinkers with the 'high-risk' (gamma1gamma1) ADH3 genotype appeared to have a threefold higher risk of bladder cancer compared to moderate drinkers with a 'low-risk' (gamma1gamma2 or gamma2gamma2) genotype. Surprisingly, the ORs for above moderate drinkers with the low-risk genotype (1.95; 95% CI: 0.85-4.48) and with the high-risk genotype (2.18; 95% CI: 0.82-5.77) were almost similar, suggesting no interaction. CONCLUSIONS: ADH3 genotype is a possible risk factor for bladder cancer. Although moderate drinkers with the gamma1gamma1 genotype seem to have the highest risk, we did not get a clear indication that ADH3 genotype modifies the relationship between alcohol intake and bladder cancer.     

Blackout Drinking Predicts Sexual Revictimization in a College Sample of Binge‐Drinking Women

Sexual victimization is prevalent on U.S. college campuses. Some women experience multiple sexual victimizations with heightened risk among those with prior victimization histories. One risk factor for sexual revictimization is alcohol use. Most research has focused on associations between alcohol consumption and revictimization. The current study's objective was to understand potential mechanisms by which drinking confers risk for revictimization. We hypothesized that specific drinking consequences would predict risk for revictimization above and beyond the quantity of alcohol consumed. There were 162 binge‐drinking female students (mean age = 20.21 years, 71.3% White, 36.9% juniors) from the University of Washington who were assessed for baseline victimization (categorized as childhood vs. adolescent victimization), quantity of alcohol consumed, and drinking consequences experienced, then assessed 30 days later for revictimization. There were 40 (24.6%) women who were revictimized in the following 30 days. Results showed that blackout drinking at baseline predicted incapacitated sexual revictimization among women previously victimized as adolescents, after accounting for quantity of alcohol consumed (OR = 1.79, 95% CI [1.07, 3.01]). Other drinking consequences were not strongly predictive of revictimization. Adolescent sexual victimization was an important predictor of sexual revictimization in college women; blackout drinking may confer unique risk for revictimization.     

Vitamin E and risk of type 2 diabetes in the women's health study randomized controlled trial

We directly assessed the efficacy of vitamin E supplements for primary prevention of type 2 diabetes among apparently healthy women in the Women's Health Study randomized trial. Between 1992 and 2004, 38,716 apparently healthy U.S. women aged >or=45 years and free of diabetes, cancer, and cardiovascular disease were in two randomly assigned intervention groups and received 600 IU of vitamin E (alpha-tocopherol, n = 19,347) or placebo (n = 19,369) on alternate days. During a median 10-year follow-up, there were 827 cases of incident type 2 diabetes in the vitamin E group and 869 in the placebo group, a nonsignificant 5% risk reduction (relative risk [RR] 0.95 [95% CI 0.87-1.05], P = 0.31). There was no evidence that diabetes risk factors including age, BMI, postmenopausal hormone use, multivitamin use, physical activity, alcohol intake, and smoking status modified the effect of vitamin E on the risk of type 2 diabetes. In a sensitivity analysis taking compliance into account, women in the vitamin E group had an RR of 0.93 (95% CI 0.83-1.04) (P = 0.21) compared with those randomized to placebo. In this large trial with 10-year follow-up, alternate-day doses of 600 IU vitamin E provided no significant benefit for type 2 diabetes in initially healthy women.     

Alcohol consumption and the risk of nosocomial infection in general surgery

BACKGROUND: Alcohol consumption increases community-acquired infections and affects the immune system. The aim of this report was to analyse whether drinking increases the risk of nosocomial infection. METHODS: This was a prospective study of 1505 patients admitted consecutively to a general surgical department. Alcohol consumption was assessed by a structured questionnaire. Postoperative infection was classified using the Centers for Disease Control criteria. Confounding was controlled for by logistic regression analysis, and the results were stratified by gender and drinking pattern. RESULTS: Most women were light drinkers and no increased risk of postoperative infection was noted. In men, drinking was associated with a lower American Society of Anesthesiologists grade and fewer co-morbidities. Heavy alcohol consumption (more than 108 g/day) in men increased the rate of all-site nosocomial infection (adjusted odds ratio (OR) 2.51, 95 per cent confidence interval (c.i.) 1.06 to 5.96) and the rate of in-hospital surgical-site infection (SSI) (adjusted OR 2.16, 95 per cent c.i. 0.84 to 5.58). An intake of above 72 g/day increased the rate of lower respiratory tract infection (adjusted OR 5.22, 95 per cent c.i. 1.04 to 26.2). Alcohol consumption was not related to the rate of SSI after hospital discharge. When drinking was limited to weekends, there was no relationship with nosocomial infection. CONCLUSION: Heavy alcohol consumption increased the risk of nosocomial infection in men who underwent general surgical procedures.     

A controlled trial of brief intervention versus brief advice for at-risk drinking trauma center patients

BACKGROUND: Numerous reports document that preinjury alcohol use is associated with all modes of injury requiring treatment in a trauma center, with 25% to 50% or more of patients testing positive for alcohol at the time of admission. There is evidence that in trauma patients unaddressed alcohol use problems result in recurrent injury requiring readmission to a trauma center and/or death. METHODS: A randomized clinical trial was conducted to assess the effectiveness of two types of brief interventions to reduce drinking and the consequences of drinking. Trauma patients defined as at-risk alcohol users (n=497) were randomized into two treatment options: a brief personalized motivational intervention (PMI), or brief information and advice (BIA). After a brief assessment, PMI subjects received a motivational session, feedback letter, and two postdischarge telephone contacts, whereas the BIA group received a brochure and one postdischarge telephone contact. Both groups were reassessed at 6 and 12 months postinjury. RESULTS: Both the PMI and BIA groups had statistically significant reductions in drinking, binge episodes, and consequences related to drinking that persisted from the 6- to the 12-month follow-up. However, although not statistically significant, for those classified as lower-level drinkers (相似文献   

Parental alcohol misuse is a powerful predictor for the risk of traumatic brain injury in childhood

Background: Although the positive relationship between parental alcohol use and children's injuries is well established, it is not known whether parental alcohol misuse is a risk factor for traumatic brain injuries (TBIs) of their children and whether subjects with childhood TBI have hazardous drinking habits in adolescence.

Methods: The authors conducted a longitudinal cohort study at Oulu University Hospital. The cohort consisted of 12 058 subjects born in 1966, of which 207 had sustained TBI before the age of 14 years. Data on parental alcohol problems were obtained from the Finnish Hospital Discharge Register and the adolescents' drinking habits were analysed based on a postal inquiry at the age of 14 years.

Results: Parental alcohol misuse (RR 1.99, CI 1.19-3.33) and male gender (RR 1.53, CI 1.12-2.08) significantly predicted the risk of childhood TBI. Drinking to intoxication at the age of 14 was significantly associated with parental alcohol misuse (RR 1.62, CI 1.34-1.96), belonging to a one-parent family (RR 1.80, CI 1.61-2.02) and mild TBI (RR 1.67, CI 1.20-2.33).

Conclusions: It was observed that parental alcohol misuse is a major risk factor for TBI in children and drinking to intoxication is a common drinking pattern of adolescents who have sustained TBI in childhood.     

Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies

Alcohol is long regarded as a risk factor for erectile dysfunction (ED), but epidemiological evidence has been equivocal. We aimed to investigate the ED risk associated with various levels of alcohol consumption by meta-analysis. We searched for population-based studies on ED through Medline, PubMed, PsychInfo, and scanned through reference lists. Eleven cross-sectional studies were included and analyzed with random effects model. We reviewed the results from one cross-sectional study and two cohort studies. Regular alcohol consumption was negatively associated with ED (odds ratio (OR)=0.79; 99% confidence interval (CI), 0.67-0.92; P<0.001). Consumption of 8 or more drinks/week significantly reduced the risk of ED (OR=0.85; 99% CI, 0.73-0.99; P=0.007), but consumption of less alcohol (1-7 drinks/week) was not significant (OR=0.73; 99% CI, 0.44, 1.20; P=0.101). Begg's test and Egger's test detected no significant publication bias. Our estimates (in sensitivity analyses) were rendered nonsignificant when International Index of Erectile Function definition was used and when statistical adjustment was made only for age. Meta-analysis of cross-sectional studies yielded a protective association of alcohol on ED, but the two cohort studies did not demonstrate any significant findings for alcohol consumption. More research is needed to confirm whether alcohol is protective or is unrelated to ED development.     

Mass screening-based case-control study of diet and prostate cancer in Changchun, China

Aim： To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. Methods： We carded out a mass screening of prostate cancer in Changchun, China, using a prostate-specific antigen assisted by Japan International Cooperation Agency. From June 1998 to December 2000, 3 940 men over 50 years old were screened. Of these, 29 men were diagnosed with prostate cancer. We selected 28 cases and matched them with controls of low prostate-specific antigen value （〈 4.1 ng/mL） by 1：10 according to age and place of employment. A case-control study of diet and prostate cancer was then carded out. Results： After adjustment for education, body mass index （BMI）, smoking, alcohol consumption, marriage and diet, intake of soybean product was discovered to be inversely related to prostate cancer. Men who consumed soybean product more than twice per week on different days had a multivariate odds ratio （OR） of 0.38 （95% confidence interval [CI], 0.13-1.12）. In addition, men who consumed soybean products more than once per day had a multivariate OR of 0.29 （95% CI, 0.11-0.79） compared with men who consumed soybean products less than once per week. The P for trend was 0.02, which showed significant difference. There was no significant difference in P trend for any dairy food. Even when we matched the cases and controls by other criteria, we found that soybean food was the only preventive factor associated with prostate cancer. Conclusion： Our study suggests that consumption of soybeans, one of the most popular foods in Asia, would decrease the risk of prostate cancer.     

术前吸烟及饮酒状态对食管鳞状细胞癌术后复发和转移的影响

目的 分析术前吸烟及饮酒状态对可手术食管鳞状细胞癌(鳞癌)患者预后的影响.方法 回顾性分析2007 ～ 2016年在陕西省人民医院接受手术治疗的483例食管鳞癌患者的临床资料.男352例、女131例,中位年龄为64(37～ 80)岁.其中吸烟者311例,饮酒者172例.分析术前饮酒及吸烟状态与食管鳞癌患者的临床病理特征...     

Determinants of erectile dysfunction risk in a large series of Italian men attending andrology clinics

OBJECTIVE: To assess determinants of ED in men who asked for a free of charge andrologic consultation during a week focused on andrologic prevention in Italy. METHODS: Men were invited to attend 178 participating andrology centers for a free of charge visit for counselling about urologic or andrologic conditions. Data were recorded with a simple questionnaire used by all centers. RESULTS: 2499 (19.9%) were diagnosed having ED. The frequency of ED increased with age, ranging from 4.6% in men under 25 years, to 37.6% in men over 74. In comparison with men with primary education the OR of ED was 0.8 (95% CI 0.7-0.9) in men with secondary education and 0.7 (95% CI 0.6-0.9) in those with university degree. After adjusting for age, the risk of ED was significantly higher in men consuming more than 3 glasses/day of alcoholic drinking (OR 1.4, 95% CI 1.1-2.0), in subjects smoking more than 10 cigarettes/day (OR 1.2, CI 95% 1.1-1.4) and in former smokers (OR 1.2, CI 95% 1.1-1.4). Men performing at least two hours per week of physical activity had a decreased risk of ED (OR 0.8, CI 95% 0.7-0.9). We found an increased risk of ED in men with diabetes (OR 1.2, 95% CI 1.1-1.4), hypertension (OR 1.3, 95% CI 1.1-1.4), cardiopathy (OR 1.5, 95% CI 1.3-1.8) and hypercholesterolemia (OR 1.4, 95% CI 1.2-1.6). CONCLUSIONS: This study provides further data on determinants of ED risk in a large data set and underlines the relationship between ED and cardiovascular diseases.     

The association of smoking and erectile dysfunction: results from the Fangchenggang Area Male Health and Examination Survey (FAMHES)

To describe the prevalence of erectile dysfunction (ED) and its association with smoking and other risk factors among a large male population. Data were collected from 2686 men attending the Fangchenggang Area Male Health and Examination Survey from September 2009 to December 2009. ED was assessed using the 5-item International Index of Erectile Function. Self-reported smoking history was obtained from the questionnaire. Prevalence of ED was 49.5% among 2686 Chinese men in Fangchenggang aged 20-79 years. After adjusting for age, alcohol drinking, physical activity, hypertension, diabetes, dyslipidemia, and obesity, smokers who smoked ≥20 cigarettes daily had a significantly increased risk of ED than never smokers (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.03-1.49; P = .02). After further adjustment for education, the risk of ED was still significantly higher in men smoking more than 23 years than never smokers (OR, 1.60; 95% CI, 1.22-2.09; P = .001). Association of age and education with ED was statistically significant after adjusting for the other variables. A history of diabetes and hypertension all increased the risk of ED, but statistically significant differences did not exist after adjustment for other variables. The association between smoking and ED risk in men was higher with a habit of drinking alcohol (OR, 1.32; 95% CI, 1.01-1.74) or physical inactivity (OR, 1.33; 95% CI, 1.05-1.67), or with a with a history of hypertension (OR, 1.71; 95% CI, 1.11-2.62), dyslipidemia (OR, 1.39; 95% CI, 1.06-1.81), and diabetes (OR, 2.69; 95% CI, 1.4-6.98). Our results show that heavy smoking might cause ED and that the duration of the habit increases the risk of ED. Furthermore, it highlights the potential interaction of smoking with other life habits or medical history on ED risk.     

Self-reported alcohol use in the cystic fibrosis community

IntroductionExcessive alcohol use (EAU), a harmful pattern of drinking that includes binge drinking and heavy use, occurs in 25% (binge) and 6% (heavy use) of the US population, respectively. Little is known about alcohol use in individuals with cystic fibrosis (CF). The objective of this investigation is to examine alcohol consumption patterns in individuals with CF using a health survey administered from a social media platform.MethodsIndividuals with CF, 18 years of age or older, were recruited for participation through social media and internet-based platforms.Results1135 individuals initially participated in the survey and 84% (n = 952) were eligible and completed the survey. Of the respondents, 77% (n = 729) currently consume alcohol, 18% (n = 171) formerly consumed alcohol, and 5% (n = 52) never consumed alcohol. Amongst the people with CF who currently consume alcohol, 54% (N = 391) met criteria for EAU. Thirty percent of current drinkers experienced symptoms of harmful alcohol use. Of those who met criteria for EAU, 7% wore oxygen, 6% had a lung transplant, 10% had liver disease and 32% had diabetes. Those with EAU reported more hospitalizations than those without EAU [244 (62%) vs 182 (54%), p = .034]. Characteristics associated with EAU after multivariable adjustment included younger age, unmarried status, male gender and younger age at initiation of drinking.ConclusionEAU is occurring at a much higher proportion in individuals with CF. A substantial percentage of CF individuals with EAU also have medical co-morbidities. Screening, brief intervention, and referral to treatment for EAU in CF clinics is warranted.