Obesity, diabetes, coffee, tea and cannabis use alter risk for alcohol-related cirrhosis in two large cohorts of high-risk drinkers

Whitfield, John B.; Masson, Steven; Liangpunsakul, Suthat; Mueller, Sebastian; Aithal, Guruprasad P.; Eyer, Florian; Gleeson, Dermot; Thompson, Andrew; Stickel, Felix; Soyka, Michael; Daly, Ann K.; Cordell, Heather J.; Foroud, Tatiana; Lumeng, Lawrence; Pirmohamed, Munir; Nalpas, Bertrand; Jacquet, Jean-Marc; Moirand, Romain; Nahon, Pierre; Naveau, Sylvie; Perney, Pascal; Haber, Paul S.; Seitz, Helmut K.; Day, Christopher P.; Mathurin, Philippe; Morgan, Timothy R.; Seth, Devanshi

Abstract

Background:
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 multi-centre case-control study (GenomALC) comparing 1293 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 6573 controls from UK Biobank.

Results:
The GenomALC case and control groups reported similar lifetime alcohol intake (1374 versus 1412 kg). Cases had a higher prevalence of diabetes (20.5% (262/1288) versus 6.5% (48/734), p = 2.27 x 10 -18 ) and higher pre-morbid BMI (26.37 ± 0.16 kg/m 2 ) than controls (24.44 ± 0.18 kg/m 2 , p = 5.77 x 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 from liver disease than controls (OR 2.25 95% CI 1.55 to 3.26). Data from UK Biobank confirmed these findings for diabetes, BMI, proportion of alcohol as wine and coffee consumption.

Conclusions:
If these relationships are causal, measures such as weight loss, intensive treatment of diabetes or pre-diabetic states, and coffee consumption should reduce risk of alcoholrelated cirrhosis.

Citation

Whitfield, J. B., Masson, S., Liangpunsakul, S., Mueller, S., Aithal, G. P., Eyer, F., …Seth, D. (2021). Obesity, diabetes, coffee, tea and cannabis use alter risk for alcohol-related cirrhosis in two large cohorts of high-risk drinkers. American Journal of Gastroenterology, 116(1), 106-115. https://doi.org/10.14309/ajg.0000000000000833

• Journal Article Type: Article
• Acceptance Date: Jun 18, 2020
• Online Publication Date: Aug 31, 2020
• Publication Date: Jan 1, 2021
• Deposit Date: Jun 25, 2020
• Publicly Available Date: Mar 1, 2021
• Journal: American Journal of Gastroenterology
• Print ISSN: 0002-9270
• Publisher: Lippincott, Williams & Wilkins
• Peer Reviewed: Peer Reviewed
• Volume: 116
• Issue: 1
• Pages: 106-115
• DOI: https://doi.org/10.14309/ajg.0000000000000833
• Keywords: Alcohol, cirrhosis, coffee, familial risk, cannabis, diabetes
• Public URL: https://nottingham-repository.worktribe.com/output/4709670
• Publisher URL: https://journals.lww.com/ajg/Abstract/9000/Obesity,_Diabetes,_Coffee,_Tea,_and_Cannabis_Use.99148.aspx