Obesity, Diabetes, Coffee, Tea, and Cannabis Use Alter Risk for Alcohol-Related Cirrhosis in 2 Large Cohorts of High-Risk Drinkers : Official journal of the American College of Gastroenterology | ACG

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ARTICLE: LIVER

Obesity, Diabetes, Coffee, Tea, and Cannabis Use Alter Risk for Alcohol-Related Cirrhosis in 2 Large Cohorts of High-Risk Drinkers

Whitfield, John B. PhD, FRCPath1; Masson, Steven FRCP2; Liangpunsakul, Suthat MD3; Mueller, Sebastian MD, PhD4; Aithal, Guruprasad P. PhD, FRCP5; Eyer, Florian MD6; Gleeson, Dermot MD, FRCP7; Thompson, Andrew PhD8; Stickel, Felix MD, PhD9; Soyka, Michael MD10,11; Muellhaupt, Beat MD9; Daly, Ann K. PhD2; Cordell, Heather J. DPhil12; Foroud, Tatiana PhD13; Lumeng, Lawrence MD3,14; Pirmohamed, Munir PhD, FRCP8; Nalpas, Bertrand MD, PhD15,16; Jacquet, Jean-Marc MD15; Moirand, Romain MD, PhD17; Nahon, Pierre MD, PhD18,19,20; Naveau, Sylvie MD21; Perney, Pascal MD, PhD22; Haber, Paul S. MD, PhD23,24; Seitz, Helmut K. MD4; Day, Christopher P. MD, PhD25; Mathurin, Philippe MD, PhD26; Morgan, Timothy R. MD27,28; Seth, Devanshi PhD23,24,29;  for the GenomALC Consortium

Author Information

1Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, Australia;

2Faculty of Medical Sciences, Newcastle University Medical School, Newcastle upon Tyne, United Kingdom;

3Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, Indiana, USA;

4Department of Internal Medicine, Salem Medical Center and Center for Alcohol Research, University of Heidelberg, Heidelberg, Germany;

5NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals and the University of Nottingham, Nottingham, United Kingdom;

6Division of Clinical Toxicology, Department of Internal Medicine 2, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany;

7The Clinical Research Facility, Royal Hallamshire Hospital, Sheffield, United Kingdom;

8MRC Centre for Drug Safety Science, University of Liverpool, Liverpool; and Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom;

9Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland;

10Psychiatric Hospital University of Munich, Munich, Germany;

11Privatklinik Meiringen, Meiringen, Switzerland;

12Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, International Centre for Life, Newcastle upon Tyne, United Kingdom;

13Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA;

14Deceased: Dr. Lumeng died on June 21, 2017;

15Service Addictologie, CHRU Caremeau, Nîmes, France;

16DISC, INSERM, Paris, France;

17Univ Rennes, INRA, INSERM, CHU Rennes, Institut NUMECAN (Nutrition Metabolisms and Cancer), Rennes, France;

18APHP, Liver Unit, Hospital Jean Verdier, Bondy, France;

19University Paris 13, Bobigny, France;

20INSERM U1162 “Functional Genomics of Solid Tumors,” Paris, France;

21Hôpital Antoine-Béclère, Clamart, France;

22Hôpital Universitaire Carémeau, Nîmes, France;

23Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia;

24Faculty of Medicine and Health, The University of Sydney, Sydney, Australia;

25Newcastle University, Newcastle upon Tyne, United Kingdom;

26CHRU de Lille, Hôpital Claude Huriez, Lille Cedex, France;

27Department of Veterans Affairs, VA Long Beach Healthcare System, Long Beach, California, USA;

28Department of Medicine, University of California, Irvine, USA;

29Centenary Institute of Cancer Medicine and Cell Biology, The University of Sydney, Sydney, Australia.

Correspondence: John B. Whitfield, PhD, FRCPath. E-mail: [email protected]. Devanshi Seth, PhD. E-mail: [email protected]

SUPPLEMENTARY MATERIAL accompanies this paper at https://links.lww.com/AJG/B633

The American Journal of Gastroenterology 116(1):p 106-115, January 2021. | DOI: 10.14309/ajg.0000000000000833

Abstract

INTRODUCTION: 

Sustained high alcohol intake is necessary but not sufficient to produce alcohol-related cirrhosis. Identification of risk factors, apart from lifetime alcohol exposure, would assist in discovery of mechanisms and prediction of risk.

METHODS: 

We conducted a multicenter case-control study (GenomALC) comparing 1,293 cases (with alcohol-related cirrhosis, 75.6% male) and 754 controls (with equivalent alcohol exposure but no evidence of liver disease, 73.6% male). Information confirming or excluding cirrhosis, and on alcohol intake and other potential risk factors, was obtained from clinical records and by interview. Case-control differences in risk factors discovered in the GenomALC participants were validated using similar data from 407 cases and 6,573 controls from UK Biobank.

RESULTS: 

The GenomALC case and control groups reported similar lifetime alcohol intake (1,374 vs 1,412 kg). Cases had a higher prevalence of diabetes (20.5% (262/1,288) vs 6.5% (48/734), P = 2.27 × 10−18) and higher premorbid body mass index (26.37 ± 0.16 kg/m2) than controls (24.44 ± 0.18 kg/m2, P = 5.77 × 10−15). Controls were significantly more likely to have been wine drinkers, coffee drinkers, smokers, and cannabis users than cases. Cases reported a higher proportion of parents who died of liver disease than controls (odds ratio 2.25 95% confidence interval 1.55–3.26). Data from UK Biobank confirmed these findings for diabetes, body mass index, proportion of alcohol as wine, and coffee consumption.

DISCUSSION: 

If these relationships are causal, measures such as weight loss, intensive treatment of diabetes or prediabetic states, and coffee consumption should reduce the risk of alcohol-related cirrhosis.

© 2020 by The American College of Gastroenterology

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