Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki University, Helsinki, Finland.
Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki University, Helsinki, Finland.
Liver Int. 2017 Sep;37(9):1373-1381. doi: 10.1111/liv.13408. Epub 2017 Mar 28.
BACKGROUND & AIMS: Binge drinking or heavy episodic drinking is increasingly prevalent, but the health effects are incompletely understood. We investigated whether binge drinking increases the risk for liver disease above and beyond the risk due to average alcohol consumption.
6366 subjects without baseline liver disease who participated in the Finnish population-based Health 2000 Study (2000-2001), a nationally representative cohort. Follow-up data from national registers until 2013 were analysed for liver-related admissions, mortality and liver cancer. Binge drinking (≥5 drinks per occasion, standard drink 12 g ethanol) was categorised as weekly, monthly, or as less often or none. Multiple confounders were considered.
Eighty-four subjects developed decompensated liver disease. Binge drinking frequency showed a direct association with liver-disease risk after adjustment for average daily alcohol intake and age. After adjustment, the hazard ratios (HRs) for weekly and monthly binge drinking were 3.45 (P=.001) and 2.26 (P=.007) and were higher after excluding regular heavy drinkers. The HR for weekly binging was 6.82 (P=.02) in women; 2.34 (P=.03) in men; and 4.29 (P=.001) in subjects with the metabolic syndrome. Weekly binge drinking and the metabolic syndrome produced supra-additive increases in the risk of decompensated liver disease. Weekly, and to a lesser extent monthly, binging retained significance in sequential multivariate models that additionally adjusted for beverage preference and lifestyle, metabolic, and socioeconomic factors.
Binge drinking is associated with an increased risk for liver disease independently of average alcohol intake and confounders. The rising prevalence of binge drinking and the metabolic syndrome is particularly concerning.
binge drinking 或 heavy episodic drinking（狂饮或重度周期性饮酒）的发病率日益增高，但此类行为对健康的影响尚不完全清楚。我们旨在研究 binge drinking 是否会增加肝脏疾病的风险，超过因平均酒精摄入量而导致的风险。
本研究纳入了无基线肝脏疾病的 6366 名受试者，他们参与了芬兰基于人群的 Health 2000 研究（2000-2001 年），这是一项具有全国代表性的队列研究。通过国家登记处的数据对随访至 2013 年的与肝脏相关的住院治疗、死亡率和肝癌进行分析。binge drinking（≥5 次/次，标准饮料 12g 乙醇）被分为每周、每月、较少或无。考虑了多种混杂因素。
共有 84 例受试者发生了代偿失调性肝脏疾病。调整平均每日酒精摄入量和年龄后，binge drinking 频率与肝脏疾病风险呈直接关联。调整后，每周和每月 binge drinking 的风险比（HRs）分别为 3.45（P=.001）和 2.26（P=.007），排除经常大量饮酒者后风险更高。女性每周 binge drinking 的 HR 为 6.82（P=.02）；男性为 2.34（P=.03）；代谢综合征患者为 4.29（P=.001）。每周 binge drinking 和代谢综合征使代偿失调性肝脏疾病的风险呈超相加增加。在依次调整饮料偏好、生活方式、代谢和社会经济因素的多变量模型中，每周 binge drinking 仍然具有统计学意义，在一定程度上每月 binge drinking 也具有统计学意义。
binge drinking 与肝脏疾病的风险增加相关，独立于平均酒精摄入量和混杂因素。 binge drinking 的流行率上升和代谢综合征的流行尤其令人担忧。
