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Biomedical subjects

Ulrik Becker

Publications and source records attributed to Ulrik Becker.

13 recordsLinked to original sources
PubMed2006

Drinking patterns and biochemical signs of alcoholic liver disease in Danish and Greenlandic patients with alcohol addiction.

OBJECTIVES: High alcohol intake per capita and a high prevalence of hepatitis B in the population of Greenland is well documented. However, very few studies have been concerned with alcoholic liver diseases in Greenlanders, suggesting a lower prevalence of alcoholic liver disease among Greenlanders. This study was designed to document the prevalence of alcoholic liver diseases in Greenlanders with a high alcohol intake, and to describe and compare the populations of patients with alcohol addiction in Greenland and Denmark. STUDY DESIGN: Clinical cross-sectional study of patients attending alcohol treatment centres in Greenland and Denmark regarding clinical and biochemical signs of liver disease. METHODS: One hundred patients from each country answered a questionnaire about demographic variables, social conditions and alcohol consumption patterns. Each patient was examined clinically and biochemically with respect to signs of liver disease, and, when indicated, liver biopsies were taken. RESULTS: 42 % of the Greenlanders and 91% of Danes had abnormal liver function tests. The average Serum-Aspartate amino transferase (ALAT) was 40.0 U/L in Greenlanders and 52.0 U/L in Danes. No liver biopsies with cirrhosis or fibrosis were found in Greenland, whereas three with fibrosis and ten with cirrhosis were found in Denmark. CONCLUSIONS: There seems to be a lower prevalence of liver disease in Greenlanders with a high alcohol intake, compared to Danes with similar alcohol patterns.

Adolescent↗
PubMed2005

[Should the sensible drinking limits for adults be changed?].

The sensible drinking limits may be too high depending on sex, age, genetic variation and other factors. Recent research on the alcohol-related risk of breast cancer and the impact of drinking patterns on health calls for an update of the literature. We focus on studies of the effect of alcohol on morbidity and mortality and conclude that the maximum of 21 drinks per week for men and 14 for women may be maintained. We emphasize that episodic intake of alcohol increases the risk of death and that the beneficial effect of alcohol is reached at an intake of one drink per day. We also specify groups for whom the drinking limits are not valid.

Adult↗
PubMed2005

Histological characteristics and prognosis in patients with fatty liver.

OBJECTIVE: The clinical-pathological spectrum of fatty liver ranges from simple steatosis to end-stage fibrotic liver disease. However, no histological characteristics have been identified that can predict progression from pure steatosis to fibrotic liver disease in non-alcoholic fatty liver disease. The objective of this study was to investigate whether histological characteristics in patients with fatty liver without inflammation could predict mortality or development of cirrhosis. MATERIAL AND METHODS: A total of 417 patients had a liver biopsy performed, which showed fatty liver without inflammation. The population consisted of 170 non-alcoholic and 247 alcoholic fatty liver patients. The study cohort was linked through their unique personal identification number to The National Registry of Patients and the nationwide Registry of Causes of Death. RESULTS: Median follow-up time was 19.9 years in the non-alcoholic group and 12.8 years in the alcoholic group. Overall mortality in the non-alcoholic group was not related to morphological findings in the index liver biopsy. Mortality was significantly (p < 0.05) higher in alcoholic patients with severe steatosis. One non-alcoholic patient (0.6%) developed cirrhosis versus 54 alcoholic patients (22%) during the follow-up period. CONCLUSIONS: In patients with non-alcoholic fatty liver without inflammation, patients at risk for premature death cannot be identified by histological characteristics in the index liver biopsy. Patients with alcoholic fatty liver have a high risk for development of cirrhosis and increased mortality with the severity of steatosis in the index liver biopsy.

Adult↗
PubMed2005

Urbanization, migration and alcohol use in a population of Greenland Inuit.

OBJECTIVE: To analyse the effects of migration and urbanisation on alcohol intake among a population of Greenland Inuit. STUDY DESIGN: Population-based cross-sectional study of 4,139 Inuit randomly selected from Denmark and four areas of western Greenland. Data collection was based on interviews and self-administered questionnaires. METHODS: The association between different aspects of alcohol intake (quantity of intake, occasional heavy drinking, and the modified CAGE questionnaire) and place of living were analysed using a chi-square test and logistic regression analysis. RESULTS: The population living in Denmark had a higher mean alcohol intake than those living in Greenland. Drinking above the sensible drinking limits (21 drinks per week for men and 14 drinks per week for women; where one drink contains 12 g alcohol) was also more prevalent in the population living in Denmark, whereas a higher proportion of those living in Greenland was abstaining. In contrast to the higher alcohol intake in the population living in Denmark, a higher proportion of individuals with episodes of heavy drinking (binge drinking), was observed in both large and small communities in Greenland. A higher proportion of positive results on the modified CAGE test, measuring alcohol dependence, were also seen in large communities in Greenland. We found no statistically significant differences in alcohol intake between Inuit living in large and small communities in Greenland. When comparing Inuit living in Denmark according to length of stay in Denmark, we found a significantly increase in prevalence of binge drinking with length of stay, while no significant variation with length of stay was found for other alcohol parameters. CONCLUSION: Our findings suggest that the alcohol intake among Inuit, living in Denmark and in Greenland respectively, differs in relation to total intake, drinking patterns and a measure of alcohol dependence. Whether this may be attributed to urbanization, or to migration, is not clear.

Adult↗
PubMed2004

Alcohol and cirrhosis: dose--response or threshold effect?

BACKGROUND/AIMS: General population studies have shown a strong association between alcohol intake and death from alcoholic cirrhosis, but whether this is a dose-response or a threshold effect remains unknown, and the relation among alcohol misusers has not been studied. METHODS: A cohort of 6152 alcohol misusing men and women aged 15-83 were interviewed about drinking pattern and social issues and followed for 84,257 person-years. Outcome was alcoholic cirrhosis mortality. Data was analyzed by means of Cox-regression models. RESULTS: In this large prospective cohort study of alcohol misusers there was a 27 fold increased mortality from alcoholic cirrhosis in men and a 35 fold increased mortality from alcoholic cirrhosis in women compared to the Danish population. Number of drinks per day was not significantly associated with death from alcoholic cirrhosis, since there was no additional risk of death from alcoholic cirrhosis when exceeding an average daily number of five drinks (>60 g/alcohol) in neither men nor women. CONCLUSIONS: The results indicate that alcohol has a threshold effect rather than a dose-response effect on mortality from alcoholic cirrhosis in alcohol misusers.

Adolescent↗
PubMed2004

Changes in alcohol intake and mortality: a longitudinal population-based study.

BACKGROUND: Using alcohol intake at one point in time, numerous studies have shown a J- or U-shaped relation with all-cause mortality. Mortality is lowest among the light to moderate drinkers, with the risk of dying from coronary heart disease higher among nondrinkers and the risk of dying from cancer higher among heavy drinkers. We studied whether changes in individual alcohol intake result in corresponding changes in mortality. METHODS: In a longitudinal study of 6644 men and 8010 women, age 25 to 98 years, who had attended at least 2 health surveys with a 5-year interval between them, we addressed the risk of death after combinations of changes in alcohol intake. RESULTS: Mortality after changes in alcohol intake was consistent with the mortality observed among those who reported stable drinking. Stable drinkers showed a U-shaped all-cause mortality, with relative risks of 1.29 (95% confidence interval [CI] = 1.13-1.48) for nondrinkers (< 1 drink per week) and 1.32 (1.15-1.53) for heavy drinkers (> 13 drinks per week) compared with light drinkers (1 to 6 drinks per week). For coronary heart disease mortality, stable nondrinkers had a relative risk of 1.32 (0.97-1.79) compared with stable light drinkers and those who had reduced their drinking from light to none increased their risk (1.40; 1.00-1.95), and those who had increased from nondrinking to light drinking reduced their relative risk ratio (0.71; 0.44-1.14). Cancer mortality was increased in all groups of heavy drinkers. CONCLUSION: Persons with stable patterns of light and moderate alcohol intake had the lowest all-cause mortality. Individual changes in alcohol intake were followed by corresponding changes in mortality.

Adult↗
PubMed2004

Intake of beer, wine and spirits and risk of heavy drinking and alcoholic cirrhosis.

Studies have suggested that wine drinkers are at lower risk of death than beer or spirit drinkers. The aim of this study is to examine whether the risk of becoming a heavy drinker or developing alcoholic cirrhosis differs among individuals who prefer different types of alcoholic beverages. In a longitudinal setting we found that both the risk of becoming a heavy or excessive drinker (above 14 and 21 drinks per week for women and above 21 and 35 drinks per week for men) and the risk of developing alcoholic cirrhosis depended on the individuals preference of wine, beer or spirits. We conclude that moderate wine drinkers appear to be at lower risk of becoming heavy and excessive drinkers and that this may add to the explanation of the reported beverage-specific differences in morbidity and mortality.

Adult↗
PubMed2003

Plasma volume expansion by albumin in cirrhosis. Relation to blood volume distribution, arterial compliance and severity of disease.

BACKGROUND/AIMS: The aim of the study was to investigate the effect of a standard albumin load on blood volume distribution, arterial compliance, and the renin-angiotensin-aldosterone system in patients with different degrees of cirrhosis. METHODS: 31 patients with cirrhosis (Child classes A/B/C=8/14/9) received an intravenous infusion of 40 g human serum albumin during a haemodynamic investigation. RESULTS: Whereas plasma- and blood volume increased by 23 and 15%, respectively (P<0.001), a significant increase in central blood volume was found only in class A patients (+8%, P<0.05), but not in class B or class C patients (+2.7%, not significant (n.s.)). In contrast, arterial compliance only increased significantly in class C patients (+18%, P<0.05), but not in class A or class B patients (+6%, n.s.). Plasma renin activity (PRA) decreased significantly in class C patients (-31%, P<0.05). When all patients were compared, the change in arterial compliance was inversely correlated to the change in PRA (r=-0.50, P<0.01). CONCLUSIONS: Although infusion of albumin does not expand the central blood volume in patients with advanced cirrhosis, the results indicate a significant improvement in the low effective arterial blood volume of such patients, which may be important in the prevention of circulatory dysfunction.

Adult↗
PubMed2003

Serum levels of YKL-40 and PIIINP as prognostic markers in patients with alcoholic liver disease.

BACKGROUND/AIMS: YKL-40 (growth factor) and PIIINP (N-terminal propeptide of Type III procollagen) are potential markers of liver fibrosis. The aim was to evaluate the prognostic value of serum YKL-40 and PIIINP levels in patients with alcoholic liver disease. METHODS: Three hundred and seventy patients with alcoholic liver disease were studied in a trial of malotilate with a median follow-up period of 470 days; 75 patients died; 336 patients had a liver biopsy on entry. Serum levels of YKL-40 and PIIINP were determined by radioimmunoassay (RIA). RESULTS: Serum YKL-40 and PIIINP were elevated in the patients compared to controls. Patients with steatosis or no fibrosis had the lowest serum levels of YKL-40 and PIIINP, whereas patients with alcoholic hepatitis and/or cirrhosis had the highest levels. Serum YKL-40 was associated with the presence of fibrosis, and serum PIIINP was also associated with the different grades of fibrosis. Patients with elevated serum YKL-40 or PIIINP had shorter survival than patients with normal serum levels of YKL-40 (P<0.0001) or PIIINP (P=0.044). High degree of fibrosis predicted shorter survival (P=0.004). CONCLUSIONS: Serum levels of YKL-40 and PIIINP are elevated in alcoholic patients, related to the presence of liver fibrosis and may provide prognostic information.

Adipokines↗
PubMed2002

Lower risk for alcohol-induced cirrhosis in wine drinkers.

Although there is a well-known relationship between total alcohol intake and future risk for cirrhosis, other factors such as the type of alcohol consumed are sparsely studied. The aim of this study was to assess the effects of wine compared with other types of alcoholic beverages on risk for alcohol-induced cirrhosis. In 3 prospective studies, 30,630 participants from the Copenhagen area were followed-up for a total observation time of 417,325 person-years. Information on weekly intake of beer, wine, and spirits, and sex, age, body mass index, smoking habits, and education was obtained from questionnaires. The primary outcome measures were first admission or death, with alcohol-induced cirrhosis obtained from death certificates and from the National Hospital Discharge Register. Data were analyzed by means of multiplicative Poisson regression models. We confirmed the increasing risk for cirrhosis with increasing alcohol intake. Individuals who drank more than 5 drinks per day had a relative risk of 14 to 20 for developing cirrhosis compared with non- or light drinkers. However, compared with individuals who drank no wine (relative risk set at 1.0), individuals drinking 16% to 30% wine of their total intake had a relative risk of 0.4 (95% confidence limits, 0.3-0.6) and those drinking 51% or more of wine had a relative risk of 0.3 (95% confidence limits, 0.2-0.5) for developing cirrhosis. In conclusion, the results suggest that a high intake of all 3 types of alcohol conveys an increased risk for cirrhosis, but wine drinkers are at a lower risk than beer and spirits drinkers.

Adult↗
PubMed2002

Alcoholic beverage preference and risk of becoming a heavy drinker.

BACKGROUND: Studies have suggested that wine drinkers are at lower risk of death than beer or spirits drinkers. The aim of this study is to examine whether the risk of becoming a heavy or excessive drinker differs among individuals who prefer different types of alcoholic beverages. METHODS: In a longitudinal study of 10,330 moderate drinkers from Copenhagen, Denmark, we used logistic regression analyses to address the risk of becoming a heavy or excessive drinker (above 14 and 21 drinks per week, respectively, for women and above 21 and 35 drinks per week for men) according to preference of wine, beer, or spirits. RESULTS: Compared with those who preferred wine, those who preferred beer tended to have increased risk of becoming heavy and excessive drinkers. Women who preferred beer had odds ratios of 1.14 (95% CI = 0.87-1.50) for becoming heavy drinkers and 1.50 (95% CI = 0.93-2.43) for becoming excessive drinkers. For men who preferred beer the ORs were 1.16 (95% CI = 0.84-1.58) and 1.81 (95% CI = 0.85-3.82). CONCLUSION: The finding that moderate wine drinkers appear to be at lower risk of becoming heavy and excessive drinkers may add to the explanation of the reported beverage-specific differences in morbidity and mortality.

Adult↗