Alcohol and mortality in Mexico: prospective study of 150 000 adults.

Autor:	Trichia E; Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Alegre-Díaz J; Experimental Research Unit, National Autonomous University of Mexico, Mexico City, Mexico., Aguilar-Ramirez D; Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Ramirez-Reyes R; Experimental Research Unit, National Autonomous University of Mexico, Mexico City, Mexico., Garcilazo-Ávila A; Experimental Research Unit, National Autonomous University of Mexico, Mexico City, Mexico., González-Carballo C; Experimental Research Unit, National Autonomous University of Mexico, Mexico City, Mexico., Bragg F; Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Health Data Research UK Oxford, University of Oxford, Oxford, UK., Friedrichs LG; Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Herrington WG; Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Holland L; Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Torres J; Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Wade R; Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Collins R; Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Peto R; Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Berumen J; Experimental Research Unit, National Autonomous University of Mexico, Mexico City, Mexico., Tapia-Conyer R; Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico. Electronic address: tapiaconyer@gmail.com., Kuri-Morales P; Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico; Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Mexico., Emberson JR; Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. Electronic address: jonathan.emberson@ndph.ox.ac.uk.
Jazyk:	angličtina
Zdroj:	The Lancet. Public health [Lancet Public Health] 2024 Nov; Vol. 9 (11), pp. e907-e915.
DOI:	10.1016/S2468-2667(24)00228-7
Abstrakt:	Background: Alcohol consumption is a leading cause of premature death globally, but there is no large-scale prospective evidence from Mexico. Methods: The Mexico City Prospective Study recruited 150 000 adults aged 35 years or older between 1998 and 2004. Participants were followed up until Oct 1, 2022 for cause-specific mortality. Cox regression in those with no self-reported chronic disease at entry (adjusted for age, sex, district, education, physical activity, smoking, and diabetes) was used to relate baseline-reported alcohol consumption (never, former, occasional [less than monthly], and regular [at least monthly, split into <70, ≥70 to <140, ≥140 to <210, and ≥210 g/week]) to mortality at ages 35-74 from all causes, and from a pre-specified alcohol-related set of underlying causes. Heavy episodic drinking (normally consuming >5 [men] or >4 [women] drinks on a single occasion) and type of preferred drink were also examined. Findings: Among 138 413 participants aged 35-74 years at recruitment, 21 136 (15%) were regular alcohol drinkers (14 863 [33%] men, 6273 [7%] women), of whom 13 383 (63%) favoured spirits and 6580 (31%) favoured beer. During follow-up, there were 13 889 deaths at ages 35-74 years, including 3067 deaths from the pre-specified alcohol-related causes. Overall, J-shaped associations with mortality were observed. Compared with occasional drinkers, those with baseline-reported consumption ≥210 g/week had 43% higher all-cause mortality (rate ratio [RR] 1·43 [95% CI 1·30-1·56]) and nearly three times the mortality from the pre-specified alcohol-related causes (2·77 [2·39-3·20]). Death from liver disease was strongly related to alcohol consumption; the RR comparing regular drinkers of ≥140 g/week with occasional drinkers was 4·03 (3·36-4·83). Compared with occasional light drinking, occasional heavy episodic drinking was associated with 20% higher alcohol-related mortality (1·20 [1·06-1·35]), and regular heavy episodic drinking was associated with 89% higher alcohol-related mortality (1·89 [1·67-2·15]). Drinks with alcohol percentages higher than spirits were associated with the greatest increased mortality risk, even after accounting for the total alcohol consumed. Interpretation: In this Mexican population, higher alcohol consumption, episodic drinking, and very high percentage alcoholic products were all associated with increased mortality. Funding: Wellcome Trust, the Mexican Health Ministry, the National Council of Science and Technology for Mexico, Cancer Research UK, British Heart Foundation, and the UK Medical Research Council. Translation: For the Spanish translation of the abstract see Supplementary Materials section. Competing Interests: Declaration of interests JRE and RC report grants to the University of Oxford from AstraZeneca and Regeneron Pharmaceuticals. RC reports having a patent for a statin-related myopathy genetic test licensed to the University of Oxford from Boston Heart Diagnostics (RC has waived any personal reward with any share in royalty and other payments waived in favour of the Nuffield Department of Population Health, University of Oxford) and being deputy chair of not-for-profit clinical trial company PROTAS, Chief Executive of UK Biobank, and Chair of the steering committee of the ORION-4 clinical trial of inclisiran. All other authors declare no competing interests. (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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