Alcohol consumption increases the risks of over 60 diseases in Chinese men, including many diseases not previously linked to alcohol, based on a brand new study by researchers from Oxford Population Health, Peking University, and the Chinese Academy of Medical Sciences. The study is published today in Nature Medicine.

Alcohol consumption is estimated to be chargeable for about 3 million deaths worldwide annually, and it’s increasing in lots of low- and middle-income countries akin to China. The harmful effects of heavy drinking for certain diseases (akin to liver cirrhosis, stroke and a number of other kinds of cancer) are well-known, but only a few studies have systematically assessed the impact of alcohol use on an intensive range of diseases throughout the same population.

The study shows that alcohol use increases the risks of 61 diseases in men in China, including many non-fatal diseases not known to be alcohol-related as a consequence of limited previous evidence. The findings of this study display the influence that alcohol intake can have on risk of disease in populations world wide.

The researchers used data from the China Kadoorie Biobank (CKB), a collaborative study of over 512,000 adults recruited during 2004-08 from ten diverse urban and rural areas across China. Study participants were interviewed about their lifestyle and behaviours, including detailed alcohol drinking patterns. A few third of men, but only 2% of girls, drank alcohol recurrently (ie at the least once every week). The researchers comprehensively assessed the health effects of alcohol use on over 200 different diseases in men identified through linkage to hospital records over a period of about 12 years. Importantly, additionally they undertook a genetic evaluation to make clear whether or not alcohol intake was chargeable for causing disease.

Key findings:

• Amongst 207 diseases studied, self-reported alcohol intake was related to higher risks of 61 diseases in men. This included 28 diseases previously established by the World Health Organization as alcohol-related, akin to liver cirrhosis, stroke, and a number of other gastrointestinal cancers, and 33 diseases not previously established as alcohol-related, akin to gout, cataract, some fractures, and gastric ulcer;
• There have been over 1.1 million hospitalisations recorded within the study, and men who had ever drank alcohol recurrently had significantly higher risk of developing any disease and experienced more frequent stays in hospital, compared with men who had only drunk alcohol occasionally;
• Certain drinking patterns, akin to drinking day by day, drinking in heavy “binge” episodes, or drinking outside mealtimes, particularly increased the risks of certain diseases, particularly liver cirrhosis;
• Within the genetic analyses, there was evidence for a dose-dependent causal effect on the identified alcohol-related diseases collectively, with every 4 drinks per day related to a 14% higher risk of established alcohol-related diseases, 6% higher risk of diseases not previously known to be alcohol-related, and over two-fold higher risk of liver cirrhosis and gout;
• Within the genetic analyses, higher alcohol intake was significantly related to higher risk of stroke in a dose-response manner (consistent with previous findings within the CKB study), but showed no increased risk with ischaemic heart disease (IHD). Furthermore, moderate drinking (ie one-two drinks/day) didn’t have any protective effects against IHD;
• As few women in China drink alcohol (lower than 2% of girls within the study drank recurrently), women on this study provided a useful control group within the genetic analyses, which helped confirm that the surplus disease risks in men were brought on by drinking alcohol, not by another mechanisms related to the genetic variants.

Alcohol consumption is adversely related to a much wider range of diseases than has previously been established, and our findings show these associations are prone to be causal.”

Pek Kei Im, Research Fellow at Oxford Population Health and lead creator of the paper

Professor Liming Li, a senior creator and CKB co-PI from Peking University, said ‘Levels of alcohol consumption are rising in China, particularly amongst men. This massive collaborative study demonstrates a have to strengthen alcohol control policies in China.’

Iona Millwood, Associate Professor at Oxford Population Health and a senior creator of the study, said ‘It’s becoming clear that the harmful use of alcohol is one of the vital necessary risk aspects for poor health, each in China and globally.’

Professor Zhengming Chen, Richard Peto Professor of Epidemiology at Oxford Population Health and a senior creator and CKB co-PI, said ‘This study provides necessary causal evidence of the dimensions of alcohol-related harms, which is critical to tell prevention strategies in several countries.’

In East Asian populations, there are common genetic variants that greatly reduce alcohol tolerability, because they cause a particularly unpleasant flushing response after drinking alcohol. Individuals with these genetic variants are inclined to drink less alcohol and since these genetic variants are unrelated to other lifestyle aspects (akin to smoking or socioeconomic status), the researchers can use this information to more accurately assess the cause-and-effect relationships of alcohol with a wide selection of diseases.