Department of Medicine, Mount Sinai, St. Luke's, and Roosevelt Hospitals, Icahn School of Medicine at Mount Sinai, New York, NY.
Department of Medicine, Mount Sinai, St. Luke's, and Roosevelt Hospitals, Icahn School of Medicine at Mount Sinai, New York, NY; Division of Gastroenterology, Mount Sinai, St. Luke's, and Roosevelt Hospitals, Icahn School of Medicine at Mount Sinai, New York, NY.
Ann Glob Health. 2015 Sep-Oct;81(5):711-7. doi: 10.1016/j.aogh.2015.12.006.
The alcohol-attributable fraction (AAF) quantifies alcohol's disease burden. Alcoholic liver disease (ALD) is influenced by alcohol consumption per capita, duration, gender, ethnicity, and other comorbidities. In this study, we investigated the association between AAF/alcohol-related liver mortality and alcohol consumption per capita, while stratifying to per-capita gross domestic product (GDP).
Data obtained from the World Health Organization and World Bank for both genders on AAF on liver disease, per-capita alcohol consumption (L/y), and per-capita GDP (USD/y) were used to conduct a cross-sectional study. Countries were classified as "high-income" and "very low income" if their respective per-capita GDP was greater than $30,000 or less than $1,000. Differences in total alcohol consumption per capita and AAF were calculated using a 2-sample t test. Scatterplots were generated to supplement the Pearson correlation coefficients, and F test was conducted to assess for differences in variance of ALD between high-income and very low income countries.
Twenty-six and 27 countries met the criteria for high-income and very low income countries, respectively. Alcohol consumption per capita was higher in high-income countries. AAF and alcohol consumption per capita for both genders in high-income and very low income countries had a positive correlation. The F test yielded an F value of 1.44 with P = .357. No statistically significant correlation was found among alcohol types and AAF. Significantly higher mortality from ALD was found in very low income countries relative to high-income countries.
Previous studies had noted a decreased AAF in low-income countries as compared to higher-income countries. However, the non-statistically significant difference between AAF variances of low-income and high-income countries was found by this study. A possible explanation is that both high-income and low-income populations will consume sufficient amount of alcohol, irrespective of its type, enough to weigh into equivalent AAF.
No significant difference of AAF variance was found between high-income and very low income countries relating to sex-specific alcohol consumption per capita. Alcohol consumption per capita was greater in high-income countries. Type of preferred alcohol did not correlate with AAF. ALD related mortality was less in high-income countries as a result of better developed healthcare systems. ALD remains a significant burden globally, requiring prevention from socioeconomic, medical, and political realms.
酒精归因分数（AAF）量化了酒精对疾病的负担。酒精性肝病（ALD）受人均饮酒量、持续时间、性别、种族和其他合并症的影响。在这项研究中，我们调查了 AAF/与酒精相关的肝死亡率与人均饮酒量之间的关联，同时按人均国内生产总值（GDP）进行分层。
使用世界卫生组织和世界银行提供的男女两性关于肝病的 AAF、人均酒精消费量（L/y）和人均 GDP（USD/y）数据，进行横断面研究。如果一个国家的人均 GDP 大于 30000 美元或小于 1000 美元，则将其归类为“高收入”和“非常低收入”国家。使用双样本 t 检验计算人均总酒精消费量和 AAF 的差异。生成散点图补充 Pearson 相关系数，使用 F 检验评估高收入和非常低收入国家之间 ALD 方差的差异。
分别有 26 个和 27 个国家符合高收入和非常低收入国家的标准。高收入国家的人均酒精消费量较高。高收入和非常低收入国家的男女两性 AAF 和人均酒精消费量均呈正相关。F 检验的 F 值为 1.44，P 值为.357。未发现酒精类型和 AAF 之间存在统计学上的相关性。与高收入国家相比，非常低收入国家的 ALD 死亡率明显更高。
以前的研究表明，与高收入国家相比，低收入国家的 AAF 较低。然而，本研究发现，低收入和高收入国家之间的 AAF 方差没有统计学意义。一个可能的解释是，无论其类型如何，高收入和低收入人群都会消费足够数量的酒精，足以达到相当的 AAF。
在与性别特异性人均酒精消费量相关的高收入和非常低收入国家之间，AAF 方差没有显著差异。高收入国家的人均酒精消费量较高。首选酒精类型与 AAF 无关。由于更发达的医疗保健系统，高收入国家的 ALD 相关死亡率较低。ALD 仍然是全球的一个重大负担，需要从社会经济、医疗和政治等方面进行预防。
