Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020,The Lancet

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Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020
The Lancet ( IF 168.9 ) Pub Date : 2022-07-14 , DOI: 10.1016/s0140-6736(22)00847-9
Dana Bryazka , Marissa B Reitsma , Max G Griswold , Kalkidan Hassen Abate , Cristiana Abbafati , Mohsen Abbasi-Kangevari , Zeinab Abbasi-Kangevari , Amir Abdoli , Mohammad Abdollahi , Abu Yousuf Md Abdullah , E S Abhilash , Eman Abu-Gharbieh , Juan Manuel Acuna , Giovanni Addolorato , Oladimeji M Adebayo , Victor Adekanmbi , Kishor Adhikari , Sangeet Adhikari , Qorinah Estiningtyas Sakilah Adnani , Saira Afzal , Wubetu Yimam Agegnehu , Manik Aggarwal , Bright Opoku Ahinkorah , Araz Ramazan Ahmad , Sajjad Ahmad , Tauseef Ahmad , Ali Ahmadi , Sepideh Ahmadi , Haroon Ahmed , Tarik Ahmed Rashid , Chisom Joyqueenet Akunna , Hanadi Al Hamad , Md Zakiul Alam , Dejene Tsegaye Alem , Kefyalew Addis Alene , Yousef Alimohamadi , Atiyeh Alizadeh , Kasim Allel , Jordi Alonso , Saba Alvand , Nelson Alvis-Guzman , Firehiwot Amare , Edward Kwabena Ameyaw , Sohrab Amiri , Robert Ancuceanu , Jason A Anderson , Catalina Liliana Andrei , Tudorel Andrei , Jalal Arabloo , Muhammad Arshad , Anton A Artamonov , Zahra Aryan , Malke Asaad , Mulusew A Asemahagn , Thomas Astell-Burt , Seyyed Shamsadin Athari , Desta Debalkie Atnafu , Prince Atorkey , Alok Atreya , Floriane Ausloos , Marcel Ausloos , Getinet Ayano , Martin Amogre ayanore Ayanore , Olatunde O Ayinde , Jose L Ayuso-Mateos , Sina Azadnajafabad , Melkalem Mamuye Azanaw , Mohammadreza Azangou-Khyavy , Amirhossein Azari Jafari , Ahmed Y Azzam , Ashish D Badiye , Nasser Bagheri , Sara Bagherieh , Mohan Bairwa , Shankar M Bakkannavar , Ravleen Kaur Bakshi , Awraris Hailu Balchut/Bilchut , Till Winfried Bärnighausen , Fabio Barra , Amadou Barrow , Pritish Baskaran , Luis Belo , Derrick A Bennett , Isabela M Benseñor , Akshaya Srikanth Bhagavathula , Neeraj Bhala , Ashish Bhalla , Nikha Bhardwaj , Pankaj Bhardwaj , Sonu Bhaskar , Krittika Bhattacharyya , Vijayalakshmi S Bhojaraja , Bagas Suryo Bintoro , Elena A Elena Blokhina , Belay Boda Abule Bodicha , Archith Boloor , Cristina Bosetti , Dejana Braithwaite , Hermann Brenner , Nikolay Ivanovich Briko , Andre R Brunoni , Zahid A Butt , Chao Cao , Yin Cao , Rosario Cárdenas , Andre F Carvalho , Márcia Carvalho , Joao Mauricio Castaldelli-Maia , Giulio Castelpietra , Luis F S Castro-de-Araujo , Maria Sofia Cattaruzza , Promit Ananyo Chakraborty , Jaykaran Charan , Vijay Kumar Chattu , Akhilanand Chaurasia , Nicolas Cherbuin , Dinh-Toi Chu , Nandita Chudal , Sheng-Chia Chung , Chuchu Churko , Liliana G Ciobanu , Massimo Cirillo , Rafael M Claro , Simona Costanzo , Richard G Cowden , Michael H Criqui , Natália Cruz-Martins , Garland T Culbreth , Berihun Assefa Dachew , Omid Dadras , Xiaochen Dai , Giovanni Damiani , Lalit Dandona , Rakhi Dandona , Beniam Darge Daniel , Anna Danielewicz , Jiregna Darega Gela , Kairat Davletov , Jacyra Azevedo Paiva de Araujo , Antonio Reis de Sá-Junior , Sisay Abebe Debela , Azizallah Dehghan , Andreas K Demetriades , Meseret Derbew Molla , Rupak Desai , Abebaw Alemayehu Desta , Diana Dias da Silva , Daniel Diaz , Lankamo Ena Digesa , 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, Alireza Ghajar , Seyyed-Hadi Ghamari , Lilian A Ghandour , Mohammad Ghasemi Nour , Ahmad Ghashghaee , Sherief Ghozy , Franklin N Glozah , Ekaterina Vladimirovna Glushkova , Justyna Godos , Amit Goel , Salime Goharinezhad , Mahaveer Golechha , Pouya Goleij , Mohamad Golitaleb , Felix Greaves , Michal Grivna , Giuseppe Grosso , Temesgen Worku Gudayu , Bhawna Gupta , Rajeev Gupta , Sapna Gupta , Veer Bala Gupta , Vivek Kumar Gupta , Nima Hafezi-Nejad , Arvin Haj-Mirzaian , Brian J Hall , Rabih Halwani , Tiilahun Beyene Handiso , Graeme J Hankey , Sanam Hariri , Josep Maria Haro , Ahmed I Hasaballah , Hossein Hassanian-Moghaddam , Simon I Hay , Khezar Hayat , Golnaz Heidari , Mohammad Heidari , Delia Hendrie , Claudiu Herteliu , Demisu Zenbaba Heyi , Kamal Hezam , Mbuzeleni Mbuzeleni Hlongwa , Ramesh Holla , Md Mahbub Hossain , Sahadat Hossain , Seyed Kianoosh Hosseini , Mehdi hosseinzadeh , Mihaela Hostiuc , Sorin Hostiuc , Guoqing Hu , Junjie Huang , Salman Hussain , Segun Emmanuel 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Stanislav S Otstavnov , Bilcha Oumer , Mahesh P A , Alicia Padron-Monedero , Raffaele Palladino , Adrian Pana , Songhomitra Panda-Jonas , Anamika Pandey , Ashok Pandey , Shahina Pardhan , Tarang Parekh , Eun-Kee Park , Charles D H Parry , Fatemeh Pashazadeh Kan , Jay Patel , Siddhartha Pati , George C Patton , Uttam Paudel , Shrikant Pawar , Amy E Peden , Ionela-Roxana Petcu , Michael R Phillips , Marina Pinheiro , Evgenii Plotnikov , Pranil Man Singh Pradhan , Akila Prashant , Jianchao Quan , Amir Radfar , Alireza Rafiei , Pankaja Raghav Raghav , Vafa Rahimi-Movaghar , Azizur Rahman , Md Mosfequr Rahman , Mosiur Rahman , Amir Masoud Rahmani , Shayan Rahmani , Chhabi Lal Ranabhat , Priyanga Ranasinghe , Chythra R Rao , Drona Prakash Rasali , Mohammad-Mahdi Rashidi , Zubair Ahmed Ratan , David Laith Rawaf , Salman Rawaf , Lal Rawal , Andre M N Renzaho , Negar Rezaei , Saeid Rezaei , Mohsen Rezaeian , Seyed Mohammad Riahi , Esperanza Romero-Rodríguez , Gregory A Roth , Godfrey M 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Augusto Santos Silva , Natacha Torres da Silva , Jasvinder A Singh , Surjit Singh , Valentin Yurievich Skryabin , Anna Aleksandrovna Skryabina , David A Sleet , Marco Solmi , YONATAN SOLOMON , Suhang Song , Yimeng Song , Reed J D Sorensen , Sergey Soshnikov , Ireneous N Soyiri , Dan J Stein , Sonu Hangma Subba , Miklós Szócska , Rafael Tabarés-Seisdedos , Takahiro Tabuchi , Majid Taheri , Ker-Kan Tan , Minale Tareke , Elvis Enowbeyang Tarkang , Gebremaryam Temesgen , Worku Animaw Temesgen , Mohamad-Hani Temsah , Kavumpurathu Raman Thankappan , Rekha Thapar , Nikhil Kenny Thomas , Chalachew Tiruneh , Jovana Todorovic , Marco Torrado , Mathilde Touvier , Marcos Roberto Tovani-Palone , Mai Thi Ngoc Tran , Sergi Trias-Llimós , Jaya Prasad Tripathy , Alireza Vakilian , Rohollah Valizadeh , Mehdi Varmaghani , Shoban Babu Varthya , Tommi Juhani Vasankari , Theo Vos , Birhanu Wagaye , Yasir Waheed , Mandaras Tariku Walde , Cong Wang , Yanzhong Wang , Yuan-Pang Wang , Ronny Westerman , Nuwan Darshana Wickramasinghe , Abate Dargie Wubetu , Suowen Xu , Kazumasa Yamagishi , Lin Yang , Gesila Endashaw E Yesera , Arzu Yigit , Vahit Yiğit , Ayenew Engida Ayenew Engida Yimaw , Dong Keon Yon , Naohiro Yonemoto , Chuanhua Yu , Siddhesh Zadey , Mazyar Zahir , Iman Zare , Mikhail Sergeevich Zastrozhin , Anasthasia Zastrozhina , Zhi-Jiang Zhang , Chenwen Zhong , Mohammad Zmaili , Yves Miel H Zuniga , Emmanuela Gakidou

Background

The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year.

Methods

For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol.

Findings

The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male.

Interpretation

There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol.

Funding

Bill & Melinda Gates Foundation.

中文翻译：

按数量、地理位置、年龄、性别和年份划分的人群饮酒风险：2020 年全球疾病负担研究的系统分析

背景

与适量饮酒相关的健康风险仍然存在争议。少量饮酒可能会降低某些健康结果的风险，但会增加其他健康结果的风险，这表明总体风险部分取决于背景疾病发生率，而背景疾病发生率因地区、年龄、性别和年份而异。

方法

在这项分析中，我们构建了 22 种健康结果的负担加权剂量反应相对风险曲线，以估计理论最低风险暴露水平 (TMREL) 和不饮酒者当量 (NDE)，即健康风险相当于的消费水平使用 2020 年全球疾病负担、伤害和风险因素研究 (GBD) 中针对 21 个地区（包括 204 个国家和地区）的疾病率，按 5 岁年龄组、性别和年份对个人进行了非饮酒者的数据统计1990 年至 2020 年，年龄在 15 岁至 95 岁及以上的人群。根据 NDE，我们量化了饮酒有害量的人口。

发现

饮酒的负担加权相对风险曲线因地区和年龄而异。2020 年，在 15-39 岁的个体中，TMREL 在 0（95% 不确定性区间 0-0）和 0·603（0·400-1·00）个标准饮酒之间变化，NDE 在 0·002 之间变化每天 (0–0) 和 1·75 (0·698–4·30) 标准饮料。在 40 岁及以上的个体中，所有地区的负担加权相对风险曲线均呈 J 形，2020 年 TMREL 范围为 0·114 (0–0·403) 至 1·87 (0·500–3)每天 30) 个标准饮料，濒死体验范围为每天 0·193 (0–0·900) 到 6·94 (3·40–8·30) 个标准饮料。2020 年饮酒过量的人群中，59·1% (54·3–65·4) 年龄在 15–39 岁，76·9% (73·0–81·3) 是男性。