BACKGROUND: The relationship of the full range of alcohol consumption with risk of incident atrial fibrillation has been inconsistent in previous, mainly case-control studies. METHODS AND RESULTS: In a prospective cohort study, we studied the association between self-reported alcohol use and incident atrial fibrillation among 16,415 women and men enrolled in the Copenhagen City Heart Study. We ascertained use of beer, wine, and spirits individually at up to 3 study visits with a structured questionnaire. We identified cases of atrial fibrillation by routine study ECGs and a validated nationwide registry of all hospitalizations. A total of 1071 cases occurred during follow-up. Among both women and men, alcohol consumption throughout the moderate range was not associated with risk of atrial fibrillation. However, consumption of 35 or more drinks per week among men was associated with a hazard ratio of 1.45 (95% CI 1.02 to 2.04); few women consumed this amount of alcohol. Approximately 5% of cases of atrial fibrillation among men were attributable to heavy alcohol use. Further adjustment for blood pressure and incident coronary heart disease and congestive heart failure did not attenuate the association (hazard ratio 1.63; 95% CI 1.15 to 2.31). CONCLUSIONS: Heavy alcohol consumption is associated with a higher risk of atrial fibrillation, at least among men. This relationship does not appear to be related to the adverse effects of heavy drinking on coronary heart disease or blood pressure.
OBJECTIVE: The available epidemiological evidence indicates that drinking alcohol per se is associated with breast cancer. However, it has not been investigated how the breast cancer risk for a given total alcohol consumption depends on the drinking frequency. METHODS: Within the prospective study on 'Diet, Cancer and Health', we examined the relationship between breast cancer, intake of total alcohol and frequency of drinking among 23,778 postmenopausal women, among whom 425 cases of breast cancer accrued during a median follow-up of 4.8 years. RESULTS: The dose-response relationship between total alcohol intake and breast cancer showed an increase in the rate ratio of 1.10 per 10 g/day (95% CI: 1.04-1.16) with no evidence for differences by type of alcohol beverage. No interaction was found between drinking frequency and total alcohol intake in the risk of breast cancer (p = 0.40). CONCLUSIONS: The present study supports previous ones in showing a monotonic increase in the risk of breast cancer among postmenopausal women with increasing average daily intake of alcohol, and this relationship with alcohol intake did not depend on drinking frequency.
BACKGROUND: The risk of myocardial infarction is lower among light-to-moderate alcohol drinkers compared with abstainers. We tested associations between alcohol intake and risk of myocardial infarction and risk factors and whether these associations are modified by variations in alcohol dehydrogenases. METHODS AND RESULTS: We used information on 9584 men and women from the Danish general population in the Copenhagen City Heart Study. During follow-up, from 1991 to 2007, 663 incident cases of myocardial infarction occurred. We observed that increasing alcohol intake was associated with decreasing risk of myocardial infarction, decreasing low-density lipoprotein cholesterol and fibrinogen, increasing diastolic and systolic blood pressure and high-density lipoprotein cholesterol, and with U-shaped nonfasting triglycerides. In contrast, ADH1B and ADH1C genotypes were not associated with risk of myocardial infarction or with any of the cardiovascular biochemical risk factors, and there was no indication that associations between alcohol intake and myocardial infarction and between alcohol intake and risk factors were modified by genotypes. CONCLUSIONS: Increasing alcohol intake is associated with decreasing risk of myocardial infarction, decreasing low-density lipoprotein cholesterol and fibrinogen, increasing diastolic and systolic blood pressure and high-density lipoprotein cholesterol, and U-shaped nonfasting triglycerides. These associations were not modified by ADH1B and ADH1C are genotypes.
BACKGROUND: Our aim was to examine the association between use of alcohol and subsequent incidence of primary infertility. METHODS: The study subjects were chosen from a population-based cohort of Danish women aged 20-29 years. Eligible women were nulliparous and not pregnant (n = 7760). Information on alcohol intake and potential confounders (age, education, marital status, diseases in the reproductive organs, and cigarette smoking) was assessed at enrollment. The incidence of fertility problems during follow-up was obtained by record linkage with the Danish Hospital Discharge Register and the Danish Infertility Cohort Register. Main outcome measures were hazard ratios of infertility according to alcohol intake at baseline estimated in a multivariate Cox proportional hazards model. RESULTS: During a mean follow-up of 4.9 years, 368 women had experienced infertility. Alcohol intake at baseline was unassociated with infertility among younger women, but was a significant predictor for infertility among women above age 30. In this age group, the adjusted hazard ratio for consuming seven or more drinks per week was 2.26 (95% confidence interval: 1.19-4.32) compared with women consuming less than one drink per week. CONCLUSIONS: These findings suggest that alcohol intake is a predictor for infertility problems among women in the later reproductive age group.
BACKGROUND: Prostate cancer is one of the most common cancers among men, and it is unknown whether alcohol is associated with the development of prostate cancer. METHODS: The relationship between amount or type of alcohol and prostate cancer was studied in a pooled prospective setting conducted from 1976 to 1994 in Copenhagen, Denmark. The study population consisted of 12,989 subjects drawn from three different cohorts. During a mean follow-up of 12.3 yr, 233 subjects developed prostate cancer. RESULTS: None of the estimates for consumed amount of total alcohol diverged significantly from unity. Furthermore, drinkers of more than 13 beers, 13 glasses of wine, and 13 drinks of spirits had a risk of 1.03 (CI: 0.67, 1.60), 0.92 (CI: 0.42, 1.99), and 1.01 (CI: 0.52, 1.98), respectively, compared with abstainers of the given beverage of alcohol. CONCLUSION: These results suggest that neither amount nor type of alcohol is associated with the risk of prostate cancer.
AIMS: To address the prospective association between alcohol drinking pattern and all-cause mortality. DESIGN: Population-based cohort study conducted between 1993 and 2003. SETTING: Denmark. PARTICIPANTS: A total of 26 909 men and 29 626 women aged 55-65 years. MEASUREMENTS: We obtained risk estimates for all-cause mortality for different levels of quantity and frequency of alcohol intake adjusted for life-style factors, including diet. FINDINGS: During follow-up, 1528 men and 915 women died. For the same average consumption of alcohol, a non-frequent intake implied a higher risk of death than a frequent one. CONCLUSIONS: Drinking pattern and not just the total amount of alcohol consumed is important for the association between alcohol intake and mortality. These results suggest that future public guidelines concerning sensible alcohol drinking should include messages about drinking pattern together with quantity of alcohol.
Previous studies have linked smoking and alcohol consumption to a considerable disease burden and large healthcare expenditures. However, findings from studies based on individual level data are sparse and inconclusive. Our objective was to assess the association between alcohol consumption, smoking and patterns of hospitalization, defined as admission and duration of hospitalization.
The study was based on 12 698 men and women, aged 20 years or more, enrolled in the Copenhagen City Heart Study. We related smoking and alcohol to hospital admission from any cause, smoking- and alcohol-related diseases and duration of hospitalization in a two-part random effects model.
Smoking status was strongly associated with admission and duration of hospitalization. For smoking-related admissions, odds ratios (OR) of 2.77 (95% CI 2.13-3.59) in men and 6.30 (95% CI 4.80-8.26) in women were observed among smokers of >20 g/day compared to never-smokers. For any admission (excl. smoking-related causes), corresponding ORs were 1.32 (95% CI 1.15-1.51) and 1.80 (95% CI 1.58-2.06), respectively. In men, a U-shaped association between alcohol consumption and risk of admission was found, both regarding any admission and admissions due to alcohol-related diseases. Alcohol was associated with alcohol-related admissions in women but not with duration of hospitalization.
Smoking was associated with increased risk of hospital admission and duration of hospitalization. A U-shaped relation was observed for alcohol consumption and risk of hospitalization in men, but no effect on duration was observed. In women, however, alcohol consumption was only vaguely associated with admission and duration of hospitalization.
To examine whether maternal alcohol intake, including binge drinking (intake > or =5 drinks, equivalent to 60 g pure ethanol on a single occasion), is associated with autistic spectrum disorders (ASD) and infantile autism.
Participants were 80,552 children and their mothers enrolled in the Danish National Birth Cohort from 1996 to 2002. Alcohol consumption was obtained by self-report during pregnancy. Information on ASD was obtained from the Danish Central Psychiatry Register. Follow-up ended on February 2008. Data were analysed by means of Cox regression.
In total, 401 children were diagnosed with ASD and 157 with infantile autism. No association was found between average alcohol consumption and ASD or infantile autism, respectively. For binge drinking, the adjusted hazard ratio (HR) for ASD was 0.72 [95% confidence interval (CI): 0.53-0.97] among women who binge drank once during pregnancy compared with women who did not binge drink. The corresponding HR for infantile autism was 0.61 (95% CI: 0.36-1.02). However, the HR for ASD was 0.84 (95% CI: 0.51-1.36) when restricting the analysis to first-time pregnancies conceived within 6 months of trying. No estimate was made for infantile autism due to low number of cases. No association was seen for more than one binge episode and for the timing of binge drinking.
Our findings do not support that a low prenatal alcohol exposure increases the risk of ASD or infantile autism. The lower risk for women who binge drank once during pregnancy is most likely non-causal.
Copenhagen Centre for Prospective Population Studies, Danish Epidemiology Science Centre, Institute of Preventive Medicine, Copenhagen University Hospital, Svanemøllevej 25, DK-2100 Copenhagen, Denmark.
OBJECTIVE: To address the role of alcohol intake and tobacco smoking and the combination of the two on subsequent risk of Dupuytren's disease. STUDY DESIGN AND SETTING: Cohort study of 7,254 subjects enrolled in the Copenhagen City Heart Study (1981-1983). Both self-reported information on lifestyle and objective measures at the baseline examination were linked to presence of Dupuytren's disease at a subsequent examination (1991-1994) using multivariate logistic regression analysis. RESULTS: A total of 772 subjects had signs of Dupuytren's disease at follow-up. After adjustment for age, sex, educational level, diabetes, and either alcohol or tobacco consumption, respectively, odds ratios for having the disease increased in a dose-dependent manner with increasing levels of alcohol or tobacco intake; however, there was no statistical interaction between heavy smoking and heavy drinking. CONCLUSION: Alcohol intake and tobacco smoking are independently associated with increased risk of Dupuytren's disease, and the combination of the two conveys a very large risk.