Mortality associated with alcohol-related liver disease.

BACKGROUND: Excessive alcohol use has been reported to be responsible for 80 000 annual deaths in the United States. However, the exact cause of death related to the excessive use of alcohol has not been fully explored. AIM: To assess the effect of alcoholic liver disease (ALD) on all-cause, liver-related and cardiovascular mortality using population-based data. METHODS: Data were obtained from the Third National Health and Nutrition Examination Survey (NHANES III) Linked Mortality Files. Alcohol consumption was estimated as grams per day. Multivariate Cox proportional hazards model was utilised to assess the effects of ALD on follow-up time to mortality from all causes, cardiovascular disease and liver disease. RESULTS: A total of 8,306 participants were included [ALD (n = 148)]. Mortality follow-up data were available for a median time of 178.27 months. Participants with ALD had increased risk for liver-related mortality [adjusted hazard ratios or aHR 7.06 (2.09-23.79)], but not for overall mortality [aHR 1.14 (0.70-1.85)] or cardiovascular mortality [aHR 0.61 (0.11-3.25)]. CONCLUSION: Alcoholic liver disease increases the risks for liver-related mortality but not for cardiac or overall mortality.

Moderate, excessive or heavy alcohol consumption: each is significantly associated with increased mortality in patients with chronic hepatitis C.

BACKGROUND: The impact of moderate alcohol consumption on long-term outcomes of chronic hepatitis C (CH-C) infected patients remains controversial. AIM: To assess the impact of moderate alcohol consumption on long-term outcomes of CH-C patients using population-based data. METHODS: Data were obtained from the Third National Health and Nutrition Examination Survey (NHANES III)-mortality linked files. Alcohol consumption was estimated as grams/day. Multivariate Cox proportional hazards model was utilized to assess the effects of CH-C and alcohol consumption on mortality (all causes, cardiovascular disease, and liver disease). RESULTS: A total of 8985 participants were included as the study cohort. Of these, 218 had CH-C. The follow-up time was 162.95 months for CH-C and 178.27 months for controls. CH-C patients had increased risk for both overall mortality and liver-related mortality. CH-C patients with excessive alcohol consumption had even higher risks for overall mortality and liver-related mortality. The risk of overall mortality associated with CH-C increased with moderate alcohol consumption of 1-19 g/day and heavy alcohol consumption ≥30 g/day. CONCLUSION: Although chronic hepatitis C is associated with increased risks for overall and liver-related mortality, these risks are even higher for patients consuming moderate and excessive amounts of alcohol.

Smoking and weight loss attempts in overweight and normal-weight adolescents.

AIM: To explore the relationship between smoking and dieting in a cross-sectional nationally representative sample of young adolescents. METHODS: Smoking was assessed by serum cotinine concentrations in 1132 adolescents aged 12-18 y enrolled in the NHANES III study. Information on adolescents' weight loss attempts were obtained by questionnaire. Normal weight was defined as a body mass index (BMI) less than the 85th percentile for age and gender. Overweight was defined as a BMI equal to or greater than the 85th percentile for age and gender. Nutritional intake was assessed with a 24 h recall and food frequency questionnaire. RESULTS: There was a two-fold increase in smoking among normal-weight adolescent girls who reported trying to lose weight (23.7% vs 12.6%, P<0.01). In contrast, prevalence of smoking was similar among overweight adolescent girls who tried to lose weight compared to those who did not (15.8% vs 14.1%, P=0.76). Similar trends were observed in boys. However, overweight boys who were trying to lose weight were less likely to smoke than overweight boys who were not trying to lose weight (9.8% vs 24.5%, P<0.05). There were no differences in body weight, BMI, caloric intake or fat intake among smokers and non-smokers. However, smokers reported eating less fruit and vegetables compared to non-smokers, and were over five times more likely to drink alcohol compared to non-smokers (odds ratio: > or =1x/month, 5.28 (3.82-7.28), > or =4x/month, 5.29 (3.58-7.82). CONCLUSION: Tobacco use is common among normal weight adolescents trying to lose weight. Tobacco use is also associated with a cluster of other unhealthy dietary practices in adolescents.