Background Alcoholic cirrhosis is an advanced form of alcohol-related liver disease. In the United States (US), between 2010 and 2016, alcohol-related liver disease was the leading cause of nearly 1 in 3 liver transplants, surpassing hepatitis C. Methods We used the US Centers for Disease Control and Prevention’s Wide Online Data for Epidemiologic Research (WONDER) to compare mortality trends from alcoholic cirrhosis in the US in 1999 and 2019. ) code K70.3 (Alcoholic liver cirrhosis). We calculated mortality rates and mortality rate ratios (MRR) per 100,000 of alcoholic cirrhosis in 10-year age groups 25 to 85+ as measures of effect and 95% confidence intervals to test significance. Results In 1999 there were 6,007 deaths from alcoholic cirrhosis among 180,408,769 aged 25 to 85 years or older, giving a mortality rate of 3.3 per 100,000. In 2019 there were 23,780 deaths from alcoholic cirrhosis among 224,981,167 aged 25 to 85 years or older, giving a mortality rate of 10.6 per 100,000. The overall MRR of 3.2 was statistically significant. (p<0.001) that were evident in each 10-year age group. Conclusions These alarming trends in alcoholic cirrhosis mortality in the US contribute to many hypotheses. These require testing in analytical studies designed a priori to do so. In the meantime, clinical and public health efforts are needed to curb the epidemics of excessive alcohol consumption, as well as overweight and obesity in the US, which may be contributing to these alarming trends. |
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Americans may have a collective problem with alcohol, made worse by the obesity epidemic, new research suggests. The new study found that deaths from alcoholic cirrhosis have more than tripled in 20 years.
In 1999, alcoholic cirrhosis, an advanced form of alcohol-related liver disease, killed just over 6,000 Americans (a rate of 3 per 100,000). By 2019, deaths from the condition had skyrocketed to nearly 24,000 (a rate of 11 per 100,000).
"The hypothesis is that people drink more and start younger," said lead researcher Dr. Charles Hennekens, first Sir Richard Doll Professor and senior academic advisor to the dean of the Charles E. Schmidt School of Medicine at Atlantic University. of Florida in Boca Raton.
But there could be other factors at play, Hennekens added, including a dramatic increase in obesity, along with more sedentary lifestyles.
"That leads to fatty liver ," Hennekens said. "The same thing that alcohol does. My hypothesis is that the reason we see more liver disease earlier is not only that people drink more , but that they eat more and exercise less , so the damage to the liver is being reduced." speeding up".
Obesity and lack of exercise are also at the root of the diabetes epidemic, as well as heart disease, stroke and some types of cancer. "The risk factors are the same," he noted.
Hennekens said when it comes to alcohol consumption, people should limit the amount of alcohol they drink to no more than two drinks a day for men and no more than one for women.
Doctors should advise their patients that those who consume a lot of alcohol have the highest mortality rates from both cirrhosis and heart disease, he added.
Alcoholic cirrhosis accounts for one-third of all liver transplants in the United States, the study authors noted.
"Although data indicates that those who drink one or two drinks a day have lower risks of cardiovascular disease than those who do not drink, it is also true that the difference between drinking smaller and larger amounts of alcohol means the difference between preventing and causing a premature death," Hennekens said.
For the study, Hennekens and colleagues used data from the U.S. Centers for Disease Control and Prevention to look at trends in deaths from alcoholic cirrhosis from 1999 to 2019.
The researchers found that during those two decades there were statistically significant increases in deaths from alcoholic cirrhosis in all age groups ages 25 and older. The largest increase was sevenfold among those aged 24 to 35 and the steepest increase was seen among those aged 65 to 74.
Dr. Tiffany Wu, a gastroenterologist at the Mayo Clinic in Rochester, Minnesota, said alcohol-associated liver disease is a leading cause of liver-related deaths in the United States.
"The increasing prevalence of high-risk drinking and alcohol use disorder has driven these trends in the development of chronic liver disease and its complications," he said. "Although effective treatments are available for alcohol use disorder, they are currently underutilized."
Barriers to care include other medical conditions, stigma around addiction and limited access to care, Wu said.
"Existing care delivery models have been further restricted due to challenges related to the pandemic," he said. "Therefore, there is an urgent need to improve methods to identify people at high risk of developing diseases and also use new digital platforms and technology to personalize treatment and prevention."
The report was recently published online in the American Journal of Medicine .
