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Alcohol abuse and the risk of pancreatic cancer.

https://arctichealth.org/en/permalink/ahliterature9936
Source
Gut. 2002 Aug;51(2):236-9
Publication Type
Article
Date
Aug-2002
Author
W. Ye
J. Lagergren
E. Weiderpass
O. Nyrén
H-O Adami
A. Ekbom
Author Affiliation
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. weiye@mbox.ki.se
Source
Gut. 2002 Aug;51(2):236-9
Date
Aug-2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alcoholism - complications
Chi-Square Distribution
Chronic Disease
Female
Humans
Incidence
Liver Cirrhosis, Alcoholic - complications
Male
Middle Aged
Pancreatic Neoplasms - epidemiology - etiology
Pancreatitis - complications
Prospective Studies
Registries
Research Support, Non-U.S. Gov't
Retrospective Studies
Risk
Smoking - adverse effects
Sweden - epidemiology
Abstract
BACKGROUND: Although most epidemiological studies do not support a role for alcohol in the aetiology of pancreatic cancer, an increased risk among heavy drinkers cannot be excluded. METHODS: In a retrospective cohort based on the Swedish Inpatient Register, we analysed the risk of pancreatic cancer among patients admitted to hospital for alcoholism (n=178 688), alcoholic chronic pancreatitis (n=3500), non-alcoholic chronic pancreatitis (n=4952), alcoholic liver cirrhosis (n=13 553), or non-alcoholic liver cirrhosis (n=7057) from 1965 to 1994. Follow up through to 1995 was accomplished by linkage to nationwide registers. Standardised incidence ratios (SIRs) express the relative risks by taking the general Swedish population as reference. To minimise the possible influence of selection bias, we excluded the first year observations. RESULTS: Alcoholics had only a modest 40% excess risk of pancreatic cancer (SIR 1.4, 95% confidence interval (CI) 1.2-1.5). Overrepresented smokers among alcoholics might confound a true SIR of unity among alcoholics to approximately 1.4. SIR among alcoholic chronic pancreatitis patients (2.2, 95% CI 0.9-4.5) was considerably lower than that among non-alcoholic chronic pancreatitis patients (8.7, 95% CI 6.8-10.9), and decreased with increasing duration of follow up in both groups, indicating that most of the excess might be explained by reversed causation from undiagnosed cancers. Among patients with alcoholic liver cirrhosis, the increased risk of pancreatic cancer was also moderate (SIR 1.9, 95% CI 1.3-2.8) while no significant excess risk was found among non-alcoholic liver cirrhosis patients (SIR 1.2, 95% CI 0.6-2.2). CONCLUSIONS: The excess risk for pancreatic cancer among alcoholics is small and could conceivably be attributed to confounding by smoking.
PubMed ID
12117886 View in PubMed
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Alcohol and liver injury: dose-related or permissive effect?

https://arctichealth.org/en/permalink/ahliterature12327
Source
Br J Addict. 1989 Jun;84(6):581-9
Publication Type
Article
Date
Jun-1989
Author
T I Sørensen
Source
Br J Addict. 1989 Jun;84(6):581-9
Date
Jun-1989
Language
English
Publication Type
Article
Keywords
Alcoholic Beverages - adverse effects
Alcoholism - mortality
Cohort Studies
Denmark
Dose-Response Relationship, Drug
Humans
Liver Cirrhosis, Alcoholic - mortality
Prospective Studies
Research Support, Non-U.S. Gov't
Retrospective Studies
Risk factors
Abstract
The studies addressing the risk of development of cirrhosis of the liver in relation to alcohol consumption have been based on comparisons at the aggregate population level and at the individual level, on case-control studies and cohort studies, and on retrospective and prospective assessment of alcohol consumption. The ideal, but unfeasible, study design for estimation of the risk function is a prospective monitoring of alcohol consumption and recording of rate of development of cirrhosis per unit of time. Two recent studies, approaching this design, suggested that above a rather low, but not precisely determined, level of alcohol consumption, the risk of development of cirrhosis is not further influenced by the amount of alcohol consumed. A critical analysis of previous studies suggests that this risk function actually is compatible with their findings. The contention that alcohol abuse has a permissive rather than a dose-dependent role in the development of alcoholic liver injury encourages research into the additional factors that must act before the liver injury occurs.
PubMed ID
2665882 View in PubMed
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Alcohol consumption and serum liver-derived enzymes in a Danish population aged 30-50 years.

https://arctichealth.org/en/permalink/ahliterature11094
Source
Int J Epidemiol. 1997 Feb;26(1):92-9
Publication Type
Article
Date
Feb-1997
Author
F H Steffensen
H T Sørensen
A. Brock
H. Vilstrup
T. Lauritzen
Author Affiliation
Danish Epidemiology Science Centre, University of Aarhus, Denmark.
Source
Int J Epidemiol. 1997 Feb;26(1):92-9
Date
Feb-1997
Language
English
Publication Type
Article
Keywords
Adult
Alanine Transaminase - metabolism
Alcohol Drinking - epidemiology - metabolism
Aspartate Aminotransferases - metabolism
Body mass index
Denmark - epidemiology
Female
Health education
Humans
Incidence
Liver - enzymology
Liver Function Tests
Logistic Models
Male
Middle Aged
Odds Ratio
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Smoking - epidemiology
gamma-Glutamyltransferase - metabolism
Abstract
BACKGROUND: Based on the increased consumption of alcohol in Denmark the aim of this study was to measure prevalence of abnormal liver-derived enzymes in a homogeneous Danish population and possible associations with alcohol consumption, smoking and body mass index (BMI). METHOD: In a representative population sample of 905 people (aged 30-50) from the baseline survey of the Ebeltoft Health Promotion Project in Denmark, we examined prevalence of abnormal liver-derived enzymes and its possible association with self-reported alcohol consumption, smoking and BMI, applying logistic regression analyses. RESULTS: In a significant proportion, 12% (women 8%; men 16%) of the cohort we found raised levels of liver-derived enzymes associated with moderate self-reported alcohol intake adjusted for BMI and smoking. If the intake was higher than moderate, i.e. > 28 units per week (one unit equals 12 g of alcohol), the odds ratio (OR) for raised liver enzymes increased further; S-gamma-glutamyltransferase (GGT) (OR: for women 24.4; men 18.4). S-aspartate-aminotransferase (ASAT) (24.2; 5.8) and S-alanine-aminotransferase (ALAT) (27.2; 3.0). Furthermore, daily smoking increased the risk of raised liver enzymes in women (OR: 3.4-4.2), and obesity (BMI > or = 30 kg/m2) in men showed a positive association with all three enzymes (OR: 3.0-9.0). CONCLUSIONS: The occurrence of raised liver-derived enzymes was frequent in the Danish population sample and associated with moderate self-reported alcohol consumption adjusted for BMI and smoking.
PubMed ID
9126508 View in PubMed
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Alcohol drinking pattern and risk of alcoholic liver cirrhosis: a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature269609
Source
J Hepatol. 2015 May;62(5):1061-7
Publication Type
Article
Date
May-2015
Author
Gro Askgaard
Morten Grønbæk
Mette S Kjær
Anne Tjønneland
Janne S Tolstrup
Source
J Hepatol. 2015 May;62(5):1061-7
Date
May-2015
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - adverse effects - epidemiology - physiopathology - psychology
Alcoholic Beverages - adverse effects - classification
Cohort Studies
Denmark - epidemiology
Female
Humans
Incidence
Liver Cirrhosis, Alcoholic - epidemiology - etiology
Male
Middle Aged
Prospective Studies
Risk factors
Surveys and Questionnaires
Time Factors
Abstract
Alcohol is the main contributing factor of alcoholic cirrhosis, but less is known about the significance of drinking pattern.
We investigated the risk of alcoholic cirrhosis among 55,917 participants (aged 50-64 years) in the Danish Cancer, Diet, and Health study (1993-2011). Baseline information on alcohol intake, drinking pattern, and confounders was obtained from a questionnaire. Follow-up information came from national registers. We calculated hazard ratios (HRs) for alcoholic cirrhosis in relation to drinking frequency, lifetime alcohol amount, and beverage type.
We observed 257 and 85 incident cases of alcoholic cirrhosis among men and women, respectively, none among lifetime abstainers. In men, HR for alcoholic cirrhosis among daily drinkers was 3.65 (95% CI: 2.39; 5.55) compared to drinking 2-4 days/week. Alcohol amount in recent age periods (40-49 and 50-59 years) was associated with an increased risk, whereas the amount in 20-29 and 30-39 years was not. In men drinking 14-28 drinks/week, HR was 7.47 (95% CI: 1.68; 33.12), 3.12 (95% CI: 1.53; 6.39), and 1.69 (95% CI: 0.79; 3.65) in drinkers of little (
Notes
Comment In: J Hepatol. 2015 May;62(5):1000-125646887
PubMed ID
25634330 View in PubMed
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Analysis of survival predictors in a prospective cohort of patients undergoing transarterial chemoembolization for hepatocellular carcinoma in a single Canadian centre.

https://arctichealth.org/en/permalink/ahliterature127146
Source
HPB (Oxford). 2012 Mar;14(3):162-70
Publication Type
Article
Date
Mar-2012
Author
Karim M Eltawil
Robert Berry
Mohamed Abdolell
Michele Molinari
Author Affiliation
Department of Surgery, Queen Elizabeth II Health Sciences Center, Dalhousie University, Halifax, NS, Canada.
Source
HPB (Oxford). 2012 Mar;14(3):162-70
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular - blood - mortality - pathology - therapy
Chemoembolization, Therapeutic - adverse effects - mortality
Female
Humans
Kaplan-Meier Estimate
Liver Neoplasms - blood - mortality - pathology - therapy
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Nova Scotia
Palliative Care
Proportional Hazards Models
Prospective Studies
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Tumor Burden
alpha-Fetoproteins - metabolism
Abstract
Despite advances in the treatment of hepatocellular carcinoma (HCC), a great proportion of patients are eligible only for palliative therapy for reasons of advanced-stage disease or poor hepatic reserve. The use of transarterial chemoembolization (TACE) in the palliation of non-resectable HCC has shown a survival benefit in European and Asian populations. The aim of this study was to assess the efficacy of TACE by analysing overall 5-year survival, interval changes of tumour size and serum alpha-fetoprotein (AFP) levels in a prospective North American cohort.
From September 2005 to December 2010, 46 candidates for TACE were enrolled in the study. Collectively, they underwent 102 TACE treatments. Data on tumour response, serum AFP and survival were prospectively collected.
In compensated cirrhotic patients, serial treatment with TACE had a stabilizing effect on tumour size and reduced serum AFP levels during the first 12 months. Overall survival rates at 1, 2 and 3 years were 69%, 58% and 20%, respectively. Younger individuals and patients with a lower body mass index, affected by early-stage HCC with involvement of a single lobe, had better survival in univariate analysis. After adjustment for risk factors, early tumour stage (T1 and T2 vs. T3 and T4) at diagnosis was the only statistically significant predictor for survival.
In compensated cirrhotic patients, TACE is an effective palliative intervention and HCC stage at diagnosis seems to be the most important predictor of longterm outcomes.
Notes
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PubMed ID
22321034 View in PubMed
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Appearance of hepatobiliary diseases in a population-based cohort with inflammatory bowel diseases (Inflammatory Bowel Disease Cohort of the Uppsala Region).

https://arctichealth.org/en/permalink/ahliterature271575
Source
J Gastroenterol Hepatol. 2015 Aug;30(8):1288-92
Publication Type
Article
Date
Aug-2015
Author
Anders Rönnblom
Tommy Holmström
Hans Tanghöj
Fredrik Rorsman
Daniel Sjöberg
Source
J Gastroenterol Hepatol. 2015 Aug;30(8):1288-92
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Alkaline Phosphatase - blood
Biomarkers - blood
Child
Cholangitis, Sclerosing - diagnosis - epidemiology - mortality - surgery
Cohort Studies
Colitis, Ulcerative - epidemiology
Comorbidity
Crohn Disease - epidemiology
Female
Hepatitis, Autoimmune - diagnosis - epidemiology
Humans
Liver Function Tests
Liver Transplantation - mortality
Male
Middle Aged
Prevalence
Prospective Studies
Survival Rate
Sweden - epidemiology
Young Adult
Abstract
To prospectively follow the evolution of hepatobiliary diseases in a population-based cohort of patients with inflammatory bowel diseases.
Between 2005 and 2009, 790 incident cases of ulcerative colitis and Crohn's disease were registered in the Uppsala Health Region, corresponding to an average incidence of 20.0 and 9.9 new cases/100?000 inhabitants/year, respectively. Liver function tests were analyzed in 97.1% and the results of ensuing investigations were summarized.
Seventeen patients with primary sclerosing cholangitis were diagnosed corresponding to an overall prevalence of 2.2% (ulcerative colitis 1.7% and Crohn's disease 3.0%, respectively). The median age at diagnosis was 25 years (interquartile range: 17.0-34.0). Among the 92 patients below 17 years of age, three had autoimmune hepatitis and three primary sclerosing cholangitis, summing up to a prevalence of 6.5% immune-mediated hepatobiliary diseases among the pediatric patients. Three patients have undergone liver transplantation and one died of colonic carcinoma. Ten patients have demonstrated persistent elevation of alkaline phosphatases but had a normal magnetic resonance cholangiopancreatography (two patients) or refused further investigation (one patient).
In this first large prospective population-based cohort of 526 patients with ulcerative colitis (UC) and 264 with Crohn's disease, 17 cases of primary sclerosing cholangitis were found, among whom three (17%) so far have been liver transplanted and one has died of colon carcinoma. The average age of those affected by primary sclerosing cholangitis is considerably lower than usually reported. Ten patients had or have had elevated alkaline phosphatase without confirmed liver or biliary disease.
PubMed ID
25777994 View in PubMed
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Are liver function tests, pancreatitis and cholecystitis predictors of common bile duct stones? Results of a prospective, population-based, cohort study of 1171 patients undergoing cholecystectomy.

https://arctichealth.org/en/permalink/ahliterature132934
Source
HPB (Oxford). 2011 Aug;13(8):519-27
Publication Type
Article
Date
Aug-2011
Author
Per Videhult
Gabriel Sandblom
Claes Rudberg
Ib Christian Rasmussen
Author Affiliation
Department of Surgery, Central Hospital, Västerås, Sweden. pervidehult@yahoo.se
Source
HPB (Oxford). 2011 Aug;13(8):519-27
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Alkaline Phosphatase - blood
Bilirubin - blood
Biological Markers - blood
Cholangiography
Cholecystectomy
Cholecystitis - diagnosis - epidemiology - surgery
False Negative Reactions
False Positive Reactions
Female
Gallstones - diagnosis - epidemiology - surgery
Humans
Liver Function Tests
Logistic Models
Male
Middle Aged
Odds Ratio
Pancreatitis - diagnosis - epidemiology
Predictive value of tests
Prospective Studies
Registries
Risk assessment
Risk factors
Sex Factors
Sweden - epidemiology
Abstract
The purpose of this study was to explore the accuracy of elevated liver function values, age, gender, pancreatitis and cholecystitis as predictors of common bile duct stones (CBDS).
All patients operated on for gallstone disease over a period of 3 years in a Swedish county of 302,564 citizens were registered prospectively. Intraoperative cholangiography (IOC) was used to detect CBDS.
A total of 1171 patients were registered; 95% of these patients underwent IOC. Common bile duct stones were found in 42% of patients with elevated liver function values, 20% of patients with a history of pancreatitis and 9% of patients with cholecystitis. The presence of CBDS was significantly predicted by elevated liver function values, but not by age, gender, history of acute pancreatitis or cholecystitis. A total of 93% of patients with normal liver function tests had a normal IOC. The best agreement between elevated liver function values and CBDS was seen in patients undergoing elective surgery without a history of acute pancreatitis or cholecystitis.
Although alkaline phosphatase (ALP) and bilirubin levels represented the most reliable predictors of CBDS, false positive and false negative values were common, especially in patients with a history of cholecystitis or pancreatitis, which indicates that other mechanisms were responsible for elevated liver function values in these patients.
Notes
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PubMed ID
21762294 View in PubMed
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Aspirin, hydroxychloroquine, and hepatic enzyme abnormalities with methotrexate in rheumatoid arthritis.

https://arctichealth.org/en/permalink/ahliterature228097
Source
Arthritis Rheum. 1990 Nov;33(11):1611-9
Publication Type
Article
Date
Nov-1990
Author
J F Fries
G. Singh
L. Lenert
D E Furst
Author Affiliation
Department of Medicine, Stanford University School of Medicine, California 94305.
Source
Arthritis Rheum. 1990 Nov;33(11):1611-9
Date
Nov-1990
Language
English
Publication Type
Article
Keywords
Alanine Transaminase - blood
Analysis of Variance
Arthritis, Rheumatoid - drug therapy - enzymology
Aspartate Aminotransferases - blood
Aspirin - administration & dosage - adverse effects
Canada
Drug Therapy, Combination
Follow-Up Studies
Humans
Hydroxychloroquine - administration & dosage - adverse effects
Liver - drug effects - enzymology
Methotrexate - administration & dosage - adverse effects
Product Surveillance, Postmarketing
Prospective Studies
Regression Analysis
United States
Abstract
Levels of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) in patients with rheumatoid arthritis from 5 centers involved in the Arthritis, Rheumatism, and Aging Medical Information System were correlated with the use of specific antirheumatic medications. Elevated levels of SGOT and SGPT were most frequent in patients taking salicylates and methotrexate (MTX) and least frequent in patients taking hydroxychloroquine. The combination of MTX and salicylates greatly increased the frequency of abnormal liver enzyme values. In contrast, the addition of hydroxychloroquine to a regimen of either MTX or aspirin essentially eliminated the SGOT and SGPT abnormalities. Results from all 5 centers were consistent and remained so after adjustment for age, sex, and disease duration. Knowledge of these important drug interactions may permit continuation of MTX therapy in patients in whom the drug might otherwise be discontinued.
Notes
Comment In: Arthritis Rheum. 1992 Jan;35(1):126-81346249
PubMed ID
2242059 View in PubMed
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Association of fatty liver index with the risk of incident cardiovascular disease and acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature296183
Source
Eur J Gastroenterol Hepatol. 2018 09; 30(9):1047-1054
Publication Type
Journal Article
Date
09-2018
Author
Olubunmi O Olubamwo
Jyrki K Virtanen
Ari Voutilainen
Jussi Kauhanen
Jussi Pihlajamäki
Tomi-Pekka Tuomainen
Author Affiliation
Department of Public Health and Clinical Nutrition, Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland.
Source
Eur J Gastroenterol Hepatol. 2018 09; 30(9):1047-1054
Date
09-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Algorithms
Cardiovascular Diseases - diagnosis - epidemiology
Decision Support Techniques
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - diagnosis - epidemiology
Non-alcoholic Fatty Liver Disease - diagnosis - epidemiology
Prognosis
Proportional Hazards Models
Prospective Studies
Risk assessment
Risk factors
Time Factors
Abstract
Fatty liver disease (FLD) has been identified as constituting cardiometabolic risk. However, evidence on the association of fatty liver index (FLI) with cardiovascular disease (CVD) is largely cross-sectional, with limited evidence on the predictability of incident CVD, and specifically, acute myocardial infarction (AMI). Therefore, we aimed to investigate the prospective associations between fatty liver as estimated by FLI and incident CVD, and specifically AMI, in the Kuopio Ischaemic Heart Disease Risk Factor Study cohort.
Our patients were 1205 middle-aged men free of CVD at baseline. The associations of baseline FLI with incident CVD and incident AMI were analyzed using multivariable-adjusted Cox regression models.
During a median follow-up of 17 years, a total of 690 incident cases of CVD and 269 cases of AMI were recorded through Finnish registries. For incident CVD, for the high (FLI=60) versus the low (=30) FLI category, the hazard ratio (HR) was 1.77 [95% confidence interval (CI): 1.46-2.14] in the minimally adjusted model. With increasing adjustment, the association was attenuated progressively. In the most adjusted model, the HR was 1.41 (95% CI: 1.10-1.79). For incident AMI, for the high FLI category, the HR was 1.65 (95% CI: 1.22-2.23) in the minimally adjusted model, but in most comprehensive models when we included metabolic factors, the HR was not significant (HR=1.136, 95% CI: 0.777-1.662).
FLI can predict incident CVD. However, the predictability of AMI using FLI is subject to interactions of metabolic factors. Individuals with FLI in the moderate to high category should be evaluated and monitored for subclinical or overt cardiovascular (including coronary) disease.
PubMed ID
29912803 View in PubMed
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121 records – page 1 of 13.