Moderate Alcohol Consumption and Cardiovascular Disease: Is There Evidence for a Preventive Effect?

It is well-known that the intake of large quantities of alcohol is hazardous to the health. During the last few decades, moderate alcohol consumption has been claimed to have a protective effect in the cardiovascular system. For this study, literature search and review on moderate alcohol consumption and cardiovascular disease was performed. Data from ecological studies indicate that the consumption of wine, but not hard liquor or beer, are associated with a reduced mortality from cardiovascular diseases. Data from case-referent studies indicate no beneficial effect at all, whereas data from prospective cohort studies indicate a beneficial effect from all types of alcohol. There are several interpretational problems involved in this issue. No results from interventional studies are available. In the absence of such data, less valid conclusions are drawn from other types of studies. The soundness of conclusions based on comparisons of moderate drinkers and abstainers in case-referent and cohort studies has been questioned, because abstainers may have a higher than normal incidence of cardiovascular disease due to self-selection. Several possible modes of action have been proposed. However, provided that there is a protective effect of moderate alcohol consumption, there is no hard evidence that any of the proposed modes of action would be the sole one. Probably more than one mechanism is involved.     

Comparison of Social Abilities of Children with Fetal Alcohol Syndrome to Those of Children with Similar IQ Scores and Normal Controls

Children diagnosed with fetal alcohol syndrome (FAS) were assessed with items from the social skills domain of the Vineland Adaptive Behavior Scales (VABS) via interviews with their caregivers. Their scores were compared with scores from children in two control groups. The control groups included children matched for IQ to the FAS group (specifically on verbal IQ, henceforth, the VIQ group) and children with IQ scores in the average to above-average range (normal control group). Forty-five children (age range, 5 years 7 months to 12 years 11 months) were assessed ( n /group = 15). All groups differed with regard to social ability, as measured by the VABS (NC > VIQ > FAS), even when the effects of socioeconomic status were held constant. The three subdomains of the VABS social scale (interpersonal relationship skills, use of play and leisure time, and coping skills) were assessed, and results showed that the children with FAS were most impaired on the subdomain that assessed interpersonal relationship skills. An additional measure was constructed by obtaining an age-equivalent score for the VABS social scale and calculating a difference score by subtracting the child's chronological age from his/her age-equivalent score. There was a significant correlation between chronological age and difference scores for children in the FAS group but not for children in the two control groups. Specifically, in older children with FAS, there was an increased discrepancy between their ages and their age-equivalent scores, a discrepancy that was not present in children in the control groups. These results suggest that social deficits in children with FAS are beyond what can be explained by low IQ scores and indicate that there may be arrested, and not simply delayed, development of social abilities in children with FAS.     

Longitudinal analysis of alcohol consumption and health of middle-aged women in Australia

Aims To assess the prospective association between alcohol consumption and self‐rated health: in particular whether there is a relationship between stable alcohol intake and health; whether health is affected by changes in alcohol consumption; whether having a chronic condition alters the relationships between stable and changing alcohol intake and health; and whether the health of longer‐term abstainers is different from more recent and intermittent abstainers. Design Longitudinal analysis of a prospective, population‐based study. Setting Australia. Participants A total of 13 585 randomly selected 45–50‐year‐old women surveyed in 1996, of whom 9396 (69%) were resurveyed in 1998, 2001 and 2004. Measurements Estimates for the General Health subscale of the SF‐36 for different levels of alcohol intake adjusted for having a chronic condition, depression, smoking and other factors. Findings Longitudinal models of consistent alcohol intake showed mean scores for general health of moderate drinkers were significantly better than that of non‐drinkers [mean difference = 4.3, standard error (SE) = 0.61], occasional drinkers (mean difference = 3.1, SE = 0.52) and heavy drinkers (mean difference = 2.1, SE = 1.00). Among moderate drinkers, a decrease or variation in alcohol consumption was associated with a significant decline of three to four points in general health. Similar results were obtained when women with an existing chronic condition were excluded from these models. The health of recent abstainers and intermittent drinkers was the same as longer‐term abstainers. Conclusions Consistent moderate drinkers had the best health even after adjustment for having a chronic condition, depression and life‐style factors. Poorer health was associated with decreased alcohol intake among occasional and moderate drinkers.     

An abundant proneurotensin polymorphism, 479A>G, and a test of its association with alcohol dependence in a Finnish population

BACKGROUND: Neurotensin is a 13-amino acid neuropeptide that endogenously modulates dopamine release in the central nervous system. In substance dependence, the mesolimbic dopamine system has been postulated to be a central structure that mediates rewarding and reinforcing effects. Neurotensin receptors in the neurons of the ventral tegmental area facilitate dopamine release, making the neurotensin gene an excellent candidate gene for alcohol dependence and for other behaviors that involve reinforcement. METHODS: A total of 639 psychiatrically interviewed Finns were genotyped for proneurotensin 479A>G polymorphism. We used the polymorphism as a marker to study the association between proneurotensin gene and alcohol dependence by comparing 229 unrelated Finnish healthy controls to 134 unrelated alcohol-dependent (DSM-III-R criteria) subjects who were also criminal offenders. In addition, 276 relatives of the alcohol-dependent and control subjects were genotyped. RESULTS: The frequencies of the genotypes in the whole sample (n = 639) were 0.84 for 479A/A, 0.16 for 479A/G, and 0.003 for 479G/G. The frequency of the rarer 479G allele was 0.07 and 0.06 in controls and alcohol-dependent subjects, respectively, and this difference was not statistically significant (chi2 = 0.264, df = 1, p = 0.61, controls vs. alcohol-dependent subjects). CONCLUSIONS: The results of the comparison between psychiatrically interviewed controls and alcoholics from a relatively well defined population indicate that the proneurotensin 479A>G polymorphism is not strongly associated with alcohol dependence. The results do not rule out a role for this gene in the pathogenesis of alcoholism or in differential vulnerability.     

Infants' growth charts for southern Iran

Currently there are no growth charts based on local norms available for infants in Iran, and their growth is assessed by the National Centre for Health Statistics (NCHS) reference data, which is misleading. Growth charts for a cohort of 317 infants (164 girls and 153 boys) born in Shiraz (Southern Iran) in 1996 and followed for 2 years from birth are presented. All the centiles of length and weight charts are slightly above those of the NCHS charts under the age of 6 months and fall substantially below those over the age of 6 months. However, the spread is similar, so there is no suggestion that the difference is due to the prevalence of gross malnutrition. The difference shows that the use of locally based growth charts are essential for assessing the growth of children in Iran. The representativeness of our data leads us to conclude that the charts presented here are likely to be applied to the urban infant population of Iran.

Gegenwärtig stehen im Iran für Kleinkinder keine auf lokalen Normdaten basierende Wachstumsdiagramme zur Verfügung. Das Wachstum dieser Kinder wird anhand der Referenzdaten des Nationalen Zentrums für Gesundheitsstatistik (NCHS) eingeschätzt, was zu Fehleinschätzungen führt. Es werden Wachstumsdiagramme für eine Kohorte von 317 Kleinkindern (164 Mädchen und 153 Jungen) vorgestellt, die 1996 in Shiraz (Südiran) geboren wurden und nach ihrer Geburt 2 Jahre lang untersucht wurden. Alle Längen- und Gewichtszentilen liegen bis zu einem Alter von unter 6 Monaten leicht über denjenigen der NCHS-Diagramme und fallen ab einem Alter von 6 Monaten beträchtlich unterhalb diese. Allerdings ist die Spannweite ähnlich und daher gibt es kein Anzeichen dafür, dass der Unterschied auf das Vorliegen einer schweren Unterernährung zurückzuführen ist. Die Unterschiede zeigen, dass die Verwendung von lokalen Wachstumsdiagrammen für die Einschätzung des Wachstums von Kindern im Iran notwendig ist. Die Tatsache, dass unsere Daten als repräsentativ anzusehen sind, veranlasst uns zu der Schlussfolgerung, dass die hier vorgestellten Charts wahrscheinlich für die städtische Kleinkinderpopulation im Iran anwendbar sind.

On ne dispose pas actuellement en Iran de tables normatives de la croissance établies sur des données locales, si bien que la croissance des enfants iraniens est inadéquatement observéeen référence aux données du National Centre for Health Statistics (NCHS). On présente ici des courbes de croissance établies à partir d'une cohorte de 317 enfants (164 filles et 153 garçons) nés à Shiraz (Iran méridional) en 1996 et suivis pendant leurs deux premières années. Tous les centiles de taille et de poids sont légèrement supérieurs à ceux des tables NCHS avant l'âge de six mois, puis leurs deviennent nettement inférieurs par la suite. L'évolution des courbes étant similaire, il n'y a donc pas raison de suspecter que la différence est due à de la malnutrition. Cet écart entre les deux tables montre que l'utilisation de courbes fondées sur des données locales est essentielle pour le suivi de la croissance des enfants en Iran. La représentativité de nos données nous conduit à estimer que les tables présentées dans ce travail sont applicables à la population infantile urbaine en Iran.     

Alcohol consumption in Mozambique: Results from a national survey including primary and surrogate respondents

Background: Data on the correspondence between information on alcohol consumption obtained from household members directly interviewed and those evaluated through surrogate respondents are scarce in developing countries.

Aim: To estimate alcohol consumption in Mozambique and to compare the information self-reported by subjects directly interviewed with data provided by surrogate respondents referring to household members that were absent during interview.

Subjects and methods: A representative sample of 20 033 Mozambicans aged 25–64 years was evaluated in 2003 as part of a national household survey. Face-to-face interviews were conducted using a structured questionnaire assessing socio-demographic and behavioural factors (12 902 participants were directly interviewed and for 7238 data were provided by surrogate respondents).

Results: Nearly a quarter of women and half the men were current drinkers, of which about 60% drank 1–2 days/week and more than 75% reported traditional beverages as the most frequently consumed. No meaningful differences were observed between the estimates obtained using only data reported directly by the participants and when surrogate reports were also considered.

Conclusion: Alcohol consumption was frequent in Mozambique, especially consumption of traditional beverages. Proxy respondents provided valid information on alcohol intake, which may be used to improve the efficiency of household surveys in this setting.     

Changing Trends in Liver Cirrhosis Etiology and Severity in Korea: the Increasing Impact of Alcohol

BackgroundChronic hepatitis B is the most common cause of liver cirrhosis in South Korea. However, alcoholic liver disease has shown an increasing trend. Although the clinical implications surrounding liver cirrhosis have been changing over the years, few studies have recently examined cirrhosis epidemiology. Therefore, we aimed to investigate changes in liver cirrhosis etiology and severity in Korea.MethodsWe retrospectively reviewed 16,888 records of cirrhotic patients from six tertiary hospitals in Korea from 2008 to 2017. Continuous and non-continuous variables were processed via linear and Poisson regression, expressed as beta (B) coefficients and as exponentiated values of coefficients (Exp[B]), respectively.ResultsChronic hepatitis B showed a decreasing trend (Exp[B] = 0.975, P < 0.001), whereas alcohol showed an increasing trend (Exp[B] = 1.013, P = 0.003), occupying the most common etiology in 2017. The Child-Turcotte-Pugh (CTP) score and decompensated liver cirrhosis prevalence did not change over the 10-year period. The incidence of variceal bleeding, severe ascites, hepatic encephalopathy, and spontaneous bacterial peritonitis significantly decreased from 12.3% to 7.7%, 7.8% to 4.1%, 1.0% to 0.5%, and 1.9% to 1.1%, respectively (P < 0.05 for all). In the subgroup analysis, the chronic hepatitis B group showed improving CTP scores (B = −0.025, P < 0.001) and decreasing decompensated liver cirrhosis rates (Exp[B] = 0.977, P = 0.016), whereas the alcohol group demonstrated increasing CTP class C (Exp[B] = 1.031, P = 0.005) and model for end-stage liver disease scores (B = 0.081, P = 0.005) over 10 years.ConclusionThe chronic hepatitis B group exhibited improved results, whereas the alcohol group still presented poor liver functions and outcomes. Future national policies and systematic approaches addressing the incidence, prevention, and treatment of alcoholic liver cirrhosis are indispensable.     

Analysis of methanol and its derivatives in illegally produced alcoholic beverages

IntroductionIllegal alcohol production remains as a common issue worldwide. Methanol poisoning mostly occurs because of the methanol used in production of counterfeit alcohol instead of ethyl alcohol due to its low price or by drinking the liquids containing methyl alcohol. Pectolytic enzymes results in an increase of methanol levels in many fermentation products such as ciders or wines. Methanol poisonings are infrequently encountered in forensic medicine practice. However, sporadic cases due to methanol intoxication as well as epidemic cases have been reported. In this study, we aimed to identify existence of methanol and its metabolites in illegally produced alcoholic beverages used in Antakya region.Material and methodsTwelve legally produced alcohol samples and Fifty-six different illegally produced alcohol samples were collected from the markets and local producers. Existence of methanol, formic acid, methyl amine, methyl formate and trioxan were determined using GC–MS method in these samples.ResultsFifty-six different illegal alcohol samples were analyzed in this study and methanol was detected in 39 (75%) of samples. Formic acid was detected in 3, formamide in 1, methyl amine in 6, methyl formate in 10 and trioxan in 2 samples.ConclusionOverwhelming majority of illegal alcoholic beverages was detected to contain methanol. Interestingly this study also revealed the presence of trioxane, which has not previously reported among toxic agents in illegal alcohol samples.     

Intra-amygdala infusion of the NPY Y1 receptor antagonist BIBP 3226 attenuates operant ethanol self-administration

BACKGROUND: Neuropeptide Y (NPY) is the most abundant and widely distributed peptide in the mammalian central nervous system. Evidence suggests that NPY transmission at Y1 receptors may regulate alcohol self-administration in rodent models. The purpose of the present study was to test the involvement of NPY Y1 receptors in the amygdala in the reinforcing effects of alcohol. METHODS: Long-Evans rats were trained to self-administer ethanol (10% v/v) vs. water on a concurrent FR-1 schedule of reinforcement using a sucrose fading procedure. After a 1 month baseline period, bilateral injector cannulae were surgically implanted to terminate 1 mm dorsal to the central nucleus of the amygdala. Daily (Monday through Friday) operant self-administration sessions were conducted for 6 months after surgery. Then, the effects of intra-amygdala infusion of the high-affinity nonpeptide NPY Y1 receptor antagonist BIBP 3226 (1, 10, or 20 microMg) were determined on parameters of operant alcohol self-administration. RESULTS: Intra-amygdala administration of 10 microM or 20 microM BIBP 3226 decreased total alcohol-reinforced responding and dose of self-administered ethanol (g/kg) without significantly altering total water responses or intake compared with vehicle control. Response onset was unaffected. Analysis of the temporal pattern of ethanol- and water-reinforced responding showed that BIBP 3226 decreased cumulative ethanol-reinforced responding during the 30 to 60 min period of the sessions. Water-reinforced responses were increased by the low dose of BIBP 3226 (1 microM) during the 50 to 60 min period. CONCLUSIONS: Results from this study indicate that alcohol-reinforced responding is reduced by acute blockade of NPY Y1 receptors in the amygdala of rats with a long-term history of alcohol self-administration. These data are consistent with the hypothesis that alcohol self-administration is maintained by NPY neurotransmission at Y1 receptors in the central nucleus of the amygdala.