BACKGROUND & AIMS High alcohol consumption is associated with an increased risk of severe liver disease. Current recommendations suggest it is safe for men to consume 30 grams of alcohol per day. We investigated the association between alcohol consumption early in life and later development of severe liver disease. METHODS We used data on alcohol consumption at conscription to military service from 43,296 men (18-20 years) in Sweden between 1969 and 1970. Outcomes were defined as incident diagnoses of severe liver disease from systematic national registration of clinical events until the end of 2009. A Cox regression model adjusted for body mass index, smoking, use of narcotics, cognitive ability and cardiovascular capacity was applied. RESULTS During a mean follow-up of 37.8 years, 383 men developed severe liver disease. Alcohol consumption was associated with an increased risk of development of severe liver disease in a dose-response pattern (adjusted hazard ratio for every one gram/day increase 1.02; 95% CI 1.01-1.02). No evidence of a threshold effect was found. Importantly, a clear trend pointed towards an increased risk of severe liver disease in men who consumed less than 30 grams of alcohol per day. CONCLUSION Alcohol consumption in young men is associated with an increased risk of severe liver disease, up to 39 years later in life. The risk was dose-dependent, with no sign of a threshold effect. Current guidelines for safe alcohol intake in men might have to be revised. LAY SUMMARY We investigated more than 43,000 Swedish men in their late teens enlisted for conscription in 1969-1970. After almost 40 years of follow-up, we found that alcohol consumption was a significant risk factor for developing severe liver disease, independent of confounders. This risk was dose-dependent, and was most pronounced in men consuming two drinks per day or more.

中文翻译：

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青春期后期饮酒与晚年患严重肝病的风险增加有关

背景和目的 大量饮酒与严重肝病风险增加有关。目前的建议表明，男性每天摄入 30 克酒精是安全的。我们调查了生命早期饮酒与后期严重肝病发展之间的关联。方法 我们使用了 1969 年至 1970 年间瑞典 43,296 名男性（18-20 岁）在征兵入伍时饮酒的数据。结果被定义为从临床事件的系统国家登记到 2009 年底的严重肝病事件诊断. 应用了根据体重指数、吸烟、麻醉品使用、认知能力和心血管能力调整的 Cox 回归模型。结果 在平均 37.8 年的随访期间，383 名男性发生了严重的肝病。在剂量反应模式中，饮酒与患严重肝病的风险增加有关（每增加 1 克/天，调整后的风险比为 1.02；95% CI 为 1.01-1.02）。没有发现阈值效应的证据。重要的是，一个明显的趋势表明，每天饮酒少于 30 克的男性患严重肝病的风险会增加。结论 年轻男性饮酒与严重肝病风险增加有关，最长可达 39 年后。风险是剂量依赖性的，没有阈值效应的迹象。目前的男性安全饮酒指南可能需要修改。概述 我们调查了超过 43,000 名 1969 年至 1970 年应征入伍的十几岁的瑞典男性。经过近 40 年的随访，我们发现，与混杂因素无关，饮酒是发生严重肝病的重要危险因素。这种风险是剂量依赖性的，在每天喝两杯或更多酒的男性中最为明显。