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ObjectivesThis study estimates the effect of chronic disease diagnoses (CDDs) on elderly Chinese individuals’ alcohol consumption behaviour.Subjects and participantsOur analysis was applied to a publicly available dataset that covers 5724 individuals aged 50 or above and spans 15 years (2000–2015: six waves) from the China Health and Nutrition Survey.DesignThe outcome variables are elderly individuals’ weekly consumption of alcoholic beverages: beer, red wine, Chinese spirits and total alcohol intake. The explanatory variable of primary interest is the number of chronic diseases diagnosed (including hypertension, diabetes, stroke and myocardial infarction). Other covariates concern sample individuals’ sociodemographic and health-related characteristics. A Chamberlain-Mundlak correlated random-effect Tobit model is adopted to simultaneously account for the clustering of ‘zeros’ in the outcome variable and endogeneity issues such as omitted variables and reverse causality.ResultsOur estimation suggests that, on average, an additional chronic disease diagnosed by medical doctors reduced an elderly Chinese individual’s weekly consumption of beer, red wine and Chinese spirits, respectively, by 1.49 (95% CI −2.85 to –0.13), 0.93 (95% CI −1.63 to –0.23) and 0.89 (95% CI −1.23 to –0.54) ounces. These effects translate into a reduction of 0.95 (95% CI −1.29 to –0.60) ounces in total weekly alcohol consumption and a reduction of 24% (95% CI −0.35 to –0.14) in the incidence of excessive drinking. Further explorations suggest that elderly Chinese individuals’ alcohol consumption is most responsive to diabetes and stroke diagnoses, but the effects vary across different beverages. Moreover, males, rural residents, smokers and those living with non-drinkers respond to CDDs more strongly than their respective counterparts.ConclusionWhile CDDs reduced alcohol consumption among elderly Chinese individuals, they failed to stop all heavy drinkers from excessive drinking. Relevant policies and measures are thus needed to urge heavy drinking patients to quit excessive drinking.

BackgroundPast studies have found a strong relationship between alcohol drinking and human health.MethodsIn this study, we first tested the association of rs671 with alcohol use in 2349 participants in southeast China. We then evaluated the causal impact between alcohol use and cardiovascular traits through a Mendelian randomisation (MR) analysis.ResultsWe found strong evidence for the association of rs671 in the ALDH2 gene with alcohol drinking (p=6.08×10-47; ORadj G=4.50, 95% CI 3.67 to 5.52). We found that female G carriers of rs671 had a higher proportion of non-drinkers than male G carriers (88.01% vs 38.70%). In non-drinkers, the female G allele frequency was higher than the male G allele frequency (71.1% vs 55.2%). MR analysis suggested that alcohol use had a causal effect on blood pressure (increasing 9.46 mm Hg for systolic blood pressure (p=9.67×10-4) and 7.50 mm Hg for diastolic blood pressure (p=9.62×10-5)), and on hypertension in men (p=0.011; OR =1.19, 95% CI 1.04 to 1.36) and in pooled samples (p=0.013; OR =1.20, 95% CI 1.04 to 1.39), but not in women. We did not observe a causal effect of alcohol use on body mass index and lipid levels; further studies are needed to clarify the non-causal relationship.ConclusionsCompared to never-drinkers, current and previous alcohol use had a causal effect on blood pressure and hypertension in pooled samples and in men. These results reflect Chinese culture which does not encourage women to drink.

Alcohol consumption causes liver steatosis in humans. Metabolic disorders of lipids are one of the factors that cause liver steatosis in hepatocytes. Hepatic Niemann‑Pick C1‑like 1 (NPC1L1) regulates lipid homeostasis in mammals. The relationship between NPC1L1 and autophagy in those with a history of alcohol abuse is unclear. The present study aimed to investigate the function of NPC1L1 in the activation of hepatic autophagy in a mouse model with a human (h)NPC1L1 transgene under alcohol feeding conditions. The mice expressing hNPC1L1 (Ad‑L1) or controls (Ad‑null) were created by retro‑orbital adenovirus injection. The Ad‑L1 and Ad‑null mice were fed with alcohol or a non‑alcoholic diet to mimic chronic alcohol consumption in humans. Hepatic autophagy was demonstrated in isolated primary hepatocytes by monitoring autophagic vacuoles under fluorescence microscopy, and by western blotting for autophagic makers. Isolated hepatocytes from the livers of Ad‑L1 mice were treated with different doses of ezetimibe to study the restoration of autophagy. Chronic alcohol feeding caused liver injury and steatosis, shown by significantly higher levels of plasma alanine transaminase and aspartate transaminase activity, and by hematoxylin and eosin staining in Ad‑L1 and Ad‑null mice. Compared to Ad‑null control mice, the microtubule‑associated proteins 1A/1B light chain 3 (LC3) particles in the isolated hepatocytes of Ad‑L1 mice were decreased, both under alcohol and non‑alcoholic feeding. The ratio of LC3II/LC3I was significantly decreased, and the level of p62/sequestosome‑1 protein was significantly increased in Ad‑L1 mice compared with Ad‑null mice after alcohol feeding. Levels of LC3II protein were statistically increased in hepatocytes isolated from Ad‑L1 mice with ezetimibe treatment. The increase in LC3II expression was dose dependent. Within the tested range, it reached its highest level at 40 µM. The livers of Ad‑L1 mice represent a more human‑like state for the study of hepatic autophagy. Hepatic expression of human NPC1L1 resulted in an inhibition of autophagy; it may contribute to alcoholic fatty liver disease in humans.

Chronic heavy alcohol consumption is a risk factor for cortical bone fractures in males. The increase in fracture risk may be due, in part, to reduced bone quality. Intracortical (osteonal) bone remodeling is the principle mechanism for maintaining cortical bone quality. However, it is not clear how alcohol abuse impacts intracortical bone remodeling. This study investigated the effects of long-duration heavy alcohol consumption on intracortical bone remodeling in a non-human primate model. Following a 4-month induction period, male rhesus macaques (Macaca mulatta, n = 21) were allowed to voluntarily self-administer water or alcohol (4% ethanol w/v) for 22 h/d, 7 d/wk for 12 months. Control monkeys (n = 13) received water and an isocaloric maltose-dextrin solution. Tetracycline hydrochloride was administered orally 17 and 3 days prior to sacrifice for determination of active mineralization sites. Animals in the alcohol group consumed 2.7 ± 0.2 g alcohol/kg/d (mean ± SE) during the 12 months of self-administration, resulting in a mean daily blood alcohol concentration of 77 ± 9 mg/dl from samples taken at 7 h after the start of a daily session. However, blood alcohol concentration varied widely from day to day, with peak levels exceeding 250 mg/dl, modeling a binge-drinking pattern of alcohol consumption. The skeletal response to alcohol was determined by densitometry, microcomputed tomography and histomorphometry. Significant differences in tibial bone mineral content, bone mineral density, and cortical bone architecture (cross-sectional volume, cortical volume, marrow volume, cortical thickness, and polar moment of inertia) in the tibial diaphysis were not detected with treatment. However, cortical porosity was lower (1.8 ± 0.5 % versus 0.6 ± 0.1 %, p = 0.021) and labeled osteon density was lower (0.41 ± 0.2/mm2 versus 0.04 ± 0.01/mm2, p < 0.003) in alcohol-consuming monkeys compared to controls, indicating a reduced rate of intracortical bone remodeling. In concordance, plasma CTx was lower (2.5 ± 0.3 ng/ml versus 1.7 ± 0.1 ng/ml, p = 0.028) in the alcohol group. These results suggest that chronic heavy alcohol consumption may negatively impact bone health, in part, by suppressing intracortical bone remodeling.

Aims Previous studies have shown inconsistent findings with regard to the association between amount of spending money and adolescent smoking. Drinking alcohol may be a mediator of the association between spending money and adolescent smoking. However, no studies have examined this potential role. The objective of this study was to investigate the association between amount of spending money and adolescent smoking and the potential mediation role of alcohol use in this association. Design The 2003 Ontario Student Drug Use Survey of students in grades 7–12. Measurements Multivariable logistic, probit and linear regression models were used to investigate the association between amount of spending money and smoking, and the contribution of drinking alcoholic beverages to this relationship. Findings Spending money was associated positively with experimental smoking, current smoking and daily consumption of cigarettes (P