年龄和性别对酒精使用障碍与躯体疾病关系的影响：挪威全国注册研究。
Effects of age and gender on the relationship between alcohol use disorder and somatic diseases: a national register study in Norway.
机构信息
Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
出版信息
BMJ Open. 2021 Nov 10;11(11):e050608. doi: 10.1136/bmjopen-2021-050608.
OBJECTIVE
This study aimed to examine how age and gender moderate the associations between alcohol use disorders (AUD) and several somatic diseases.
DESIGN AND SETTING
We performed a retrospective, register-based cohort study with 6-year follow-up of patients with AUD and the general population. Data were acquired from the Norwegian Patient Registry. Cox regressions were used to estimate HRs of somatic diseases.
PARTICIPANTS
Patients with AUD (17 023; 0.4%) were compared with the population without AUD (4 271 559; 99.6%), with adults aged 18 years or older who were registered residents of Norway on 1 January 2008.
MAIN OUTCOMES
Dichotomous variables of 12 specific somatic diseases (cardiovascular diseases, endocrine, nutritional, and metabolic diseases, cancer, and infectious diseases) were assessed. Diagnoses were set in specialist healthcare services.
RESULTS
Patients with AUD, compared with a population without AUD, experienced a significantly greater burden of all studied somatic diseases. Middle-aged adults with AUD had increased risks (p<0.05) for hypertension; ischaemic diseases; pulmonary diseases; cerebrovascular diseases; malnutrition; metabolic disorders; cancer; and influenza and pneumonia than younger and older adults with AUD. For most somatic diseases, we found no differences between younger versus older adults with AUD, and between females versus males with AUD (p>0.05). Males with AUD had significantly higher risks for pulmonary heart diseases (HR=3.9, 95% CI 3.3 to 4.6) and metabolic disorders (HR 4.7, 95% CI 4.5 to 5.0), while females with AUD had a significantly higher risk for viral hepatitis (HR=4.4, 95% CI 3.8 to 5.1).
CONCLUSIONS
Age moderated the associations between AUD and most somatic diseases, with middle-aged adults with AUD having a greater increased risk of somatic diseases compared with younger and older adults with AUD. Gender only moderated associations between AUD and pulmonary heart diseases, metabolic disorders and viral hepatitis. This has implications for the prioritisation of somatic resources among patients with AUD.
目的
本研究旨在探讨年龄和性别如何调节酒精使用障碍（AUD）与多种躯体疾病之间的关联。
设计和设置
我们进行了一项回顾性、基于登记的队列研究，对 AUD 患者和普通人群进行了 6 年随访。数据来自挪威患者登记处。使用 Cox 回归估计躯体疾病的 HR。
参与者
将 AUD 患者（17023 例；0.4%）与无 AUD 的人群（4271559 例；99.6%）进行比较，这些患者为 2008 年 1 月 1 日登记为挪威常住居民的 18 岁及以上成年人。
主要结局
评估了 12 种特定躯体疾病（心血管疾病、内分泌、营养和代谢疾病、癌症和传染病）的二分类变量。诊断是在专科医疗保健服务中确定的。
结果
与无 AUD 的人群相比，AUD 患者的所有研究躯体疾病负担明显更重。中年 AUD 患者发生高血压、缺血性疾病、肺部疾病、脑血管疾病、营养不良、代谢紊乱、癌症、流感和肺炎的风险增加（p<0.05），而年龄较小和较大的 AUD 患者风险增加（p<0.05）。对于大多数躯体疾病，我们未发现年轻与年长 AUD 患者之间、女性与男性 AUD 患者之间存在差异（p>0.05）。AUD 男性患肺心病的风险显著升高（HR=3.9，95%CI 3.3 至 4.6）和代谢紊乱（HR 4.7，95%CI 4.5 至 5.0），而 AUD 女性患病毒性肝炎的风险显著升高（HR=4.4，95%CI 3.8 至 5.1）。
结论
年龄调节了 AUD 与大多数躯体疾病之间的关联，与年轻和年长的 AUD 患者相比，中年 AUD 患者发生躯体疾病的风险增加幅度更大。性别仅调节了 AUD 与肺心病、代谢紊乱和病毒性肝炎之间的关联。这对 AUD 患者躯体资源的优先排序具有重要意义。
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