한빛사 논문
Sinn, Dong Hyun MD1; Kang, Danbee PhD2; Guallar, Eliseo PhD, MPh3,4; Chang, Yoosoo MD, PhD2,5,6; Ryu, Seungho MD, PhD2,5,6; Zhao, Di PhD4; Hong, Yun Soo MD4; Cho, Juhee PhD2,3,4; Gwak, Geum-Youn MD, PhD1
1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;
2Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea;
3Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea;
4Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA;
5Center for Cohort Studies, Total Healthcare Screening Center, Kangbuk Samsung Hospital, Seoul, South Korea;
6Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Seoul, South Korea.
Correspondence: Geum-Youn Gwak, MD, PhD, Juhee Cho, PhD
Abstract
INTRODUCTION:
We evaluated the association between alcohol intake and all-cause and cause-specific mortality in subjects with chronic viral hepatitis, using nationwide population-based cohort study.
METHODS:
A total of 364,361 men and women aged 40–84 years who underwent health screening examination between January 2002 and December 2013 that included assessment of frequency and amount of alcohol consumption were assessed for all-cause and cause-specific mortality.
RESULTS:
In participants without chronic viral hepatitis, the fully adjusted hazard ratios (HRs) for all-cause mortality comparing light, moderate, and heavy drinkers with nondrinkers were 0.92 (95% confidence interval [CI] 0.87–0.98), 1.08 (95% CI 1.01–1.16), and 1.51 (95% CI 1.33–1.72), respectively. In participants with chronic viral hepatitis, the corresponding HRs were 1.19 (95% CI 1.05–1.36), 1.23 (95% CI 1.06–1.43), and 1.69 (95% CI 1.28–2.24), respectively (P value for alcohol intake by chronic viral hepatitis interaction <0.001). Compared with participants without chronic viral hepatitis, those with chronic viral hepatitis had substantially elevated liver cancer or liver disease (HR 10.85, 95% CI 9.74–12.09) and extrahepatic cancer mortality (HR 1.37, 95% CI 1.26–1.49). In patients with chronic viral hepatitis, the high mortality due to liver cancer or liver disease and the positive association of alcohol intake with liver cancer or liver disease mortality explained the positive association of alcohol intake with all-cause mortality.
DISCUSSION:
Even light to moderate alcohol intake was associated with increased all-cause mortality in individuals with chronic viral hepatitis. Clinicians and public health campaigns should advise against any amount of alcohol intake in individuals with chronic viral hepatitis.
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