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[Alcohol consumption, alcohol abuse, and subjective feeling: a representative inquiry in the Federal Republic of Germany].

The investigation was carried out in a representative sample of subjects of the Federal Republic of Germany, including West Berlin (n = 1952). The subjects were 20--64 years old. The following were investigated: 1. Social and abusive drinking patterns 2. Relations between drinking behavior and sociodemographic data 3. Relations between drinking behavior and subjective feeling. Of the subjects, 47% consumed alcohol daily or several times a week, 6% called themselves teetotallers. Beer was the preferred beverage. The drinking behavior varied among income classes and vocational groups. Of the whole sample, 8% drank regularly whilst working; 25% of the skilled workers did so. Comparing alcohol consumption and subjective feeling, there was a slight association between elevated mood and frequent alcohol consumption. Of the subjects, 4% were identified as alcohol misusers (7% of the males, 1% of the females). Persons at high risk were men living alone (especially widowed and divorced subjects) and persons of medium income. Regular consumers of hard liquor were at higher risk than consumers of beer or wine. The highest percentage of misuse was found among unskilled and skilled workers and among inhabitants of large cities. There was a slight association between high alcohol misuse index and depressive states, subjective complaints, and paranoid attitudes.

Adult

Nonalcoholic liver disease. Overlooked causes of liver injury in patients with heavy alcohol consumption.

Alcoholic subjects with abnormal liver chemistry studies are often assumed to have alcoholic liver disease, even though the diagnosis is not established by liver biopsy. To determine the magnitude of nonalcoholic liver disease in patients with heavy alcohol consumption, the data on 145 consecutive patients judged to consume at least 80 g of alcohol daily for prolonged periods, and who underwent liver biopsy at the University of Chicago, were reviewed. Nonalcoholic liver disease was suspected clinically and confirmed by liver biopsy in 40 (28 per cent), whereas alcoholic liver disease was suspected in 105 but confirmed in only 83 (80 per cent). The remaining 22 patients had liver disorders, including cholangitis or pericholangitis, acute hepatitis or some form of chronic hepatitis, for which they required appropriate therapy. Neither clinical features, hepatitis B surface antigen (HBsAg), anti-HBsAg nor serum glutamic oxaloacetic transaminase to serum glutamic pyruvic transaminase (SGOT:SGPT) ratios distinguished these 22 patients from those with alcoholic liver disease. Thus, liver biopsy is necessary for the identification of nonalcoholic liver disease in patients suspected of harboring alcoholic liver disease, since other clinical features do not allow identification of these patients.

Acute Disease

Relationship between neuropsychological performance and alcohol consumption in alcoholics.

Cognitive performance in drug-free alcoholic patients (n = 95) within 7 days of their last drink was significantly predicted by chronic and recent drinking practices. Conceptually distinct cognitive functions were differentially influenced by various combinations of drinking variables. Consideration of curvilinear relationships enhanced the amount of variance explained, and it is suggested that certain patterns of consumption may accelerate the alcohol-induced decline of brain function.

Adult

Coagulation factors and other plasma proteins during abstinence after heavy alcohol consumption in chronic alcoholics.

Coagulation factors and other plasma proteins were studied in 19 male chronic alcoholics during the first abstinence week after a period of heavy alcohol consumption. In spite of a decade of chronic alcoholism and a daily alcohol consumption before admission of more than twice the 'normal' alcohol-metabolizing capacity, the data indicated a well-preserved protein-synthesizing capacity. In fact, the mean levels of some liver-synthesized proteins were above the upper reference limits. Minor changes within the reference ranges during the abstinence suggested a declining acute inflammatory reaction after cessation of intoxication.

Adult

Changes in "routine laboratory tests" during abstinence after heavy alcohol consumption in chronic alcoholics.

Standard laboratory tests were studied in 61 male chronic alcoholics admitted for detoxication after a period of heavy alcohol consumption. Results obtained within three days after the end of the last debauche were compared with those obtained one week later. Almost half of the patients was considered to have thrombocytopenia, two thirds of the patients had subnormal serum urea values and more than two thirds of the patients were considered to have increased ASAT values. Abnormal values often normalized within one week after admission. Significant alterations within the reference limits were observed for hemoglobin, erythrocyte sedimentation rate, sodium, potassium and bilirubin. The latter test often showed strikingly low values after one week. Most of the aberrations and the changes could be related to details in the case histories.

Alcoholism

Serum lipids and lipoproteins during abstinence after heavy alcohol consumption in chronic alcoholics.

Serum lipids, liver function tests and liver histology were studied during a withdrawal period in sixty-one male chronic alcoholics with a well-documented earlier clinical history. In these alcoholics with a mean daily ethanol consumption of 340 g during the débauche, the FFA were initially high and decreased during the first week, concomitantly with an increase in serum triglycerides. 38% of the patients had a type IV hyperlipoproteinaemia with elevated serum triglycerides still after 17 days of abstinence. 51% were normolipidaemic at that time. The cholesterol content in the alpha-lipoproteins were initially elevated and normalized during the first week of abstinence. No relationships were observed between serum lipids and liver function tests or degree of liver steatosis or alcohol consumption. The present findings stress the importance of stating the duration of abstinence in studies of biochemical changes after withdrawal.

Adult

Alcohol consumption and atherosclerosis.

A study was made of the material obtained in 737 autopsies carried out on men aged 30-69 years (including 88 visitors) who had died in Yalta from various diseases, accidents, and violence. Information on the consumption of alcohol was obtained by questioning the subjects' near relations, neighbours, and associates, as well as from medical records. The most reliable part of this information-the average number of days per month on which the subject consumed alcohol-was taken as the basic criterion for grouping the observations. People taking alcohol on 16 or more days per month had more extensive atherosclerotic raised lesions in the aorta than those drinking on not more than 3 days per month. This difference was most significant in the case of calcified lesions. Fatty streak in the aorta was more extensive in the medium group (drinking on 4-15 days per month) than in either of the extreme groups. As regards the coronary arteries, a significant difference positively associated with alcohol consumption was established only in the case of calcification. The few differences concerning myocardial and cerebral infarction had a negative association with alcohol consumption.

Adult

The aversive control of excessive alcohol consumption by chronic alcoholics in the laboratory setting.

The efficacy of several methods of aversive control of excessive alcoholic drinking was investigated in a semi-naturalistic setting that permitted objective measurement of the drinking behavior of chronic alcoholics. Studies 1A and 1B compared an excape-conditioning precedure with a control procedure in which aversive electrical shocks were administered before drinking. Neither procedure effectively decreased subjects' pretreatment, baseline alcoholic drinking behavior. In Study 2, aversive response-contingent shocks effectively suppressed alcoholic drinking, but drinking subsequently returned to its former levels after withdrawal of punishment. Self-administered shock appeared to be as effective as experimenter-administered punishment for controlling drinking, even when the punishment contingency was faded out over time. Study 3 replicated the suppressant effect of punishment, and demonstrated that contingent shock was significantly more effective than yoked, noncontingent shock. A direct comparison of self-versus experimenter-administered punishment suggested a possible slight advantage for the latter.

Adult

Ascitic cirrhosis in relation to alcohol consumption.

The average daily alcohol consumption of 184 male patients with ascitic cirrhosis and a random population sample of 778 males was ascertained by interview. Relative risks of ascitic cirrhosis are calculated for different levels of daily alcohol consumption: the logarithm of risk is shown to be a linear function of consumption. The proportion of cases attributable to alcohol is calculated and shown to be over 90%. The potential saving of ascitic cirrhosis if individual consumption of alcohol does not exceed 40g. per day is estimated at 80%.

Adult

FGF21 suppresses alcohol consumption through an amygdalo-striatal circuit.

Excessive alcohol consumption is a major health and social issue in our society. Pharmacologic administration of the endocrine hormone fibroblast growth factor 21 (FGF21) suppresses alcohol consumption through actions in the brain in rodents, and genome-wide association studies have identified single nucleotide polymorphisms in genes involved with FGF21 signaling as being associated with increased alcohol consumption in humans. However, the neural circuit(s) through which FGF21 signals to suppress alcohol consumption are unknown, as are its effects on alcohol consumption in higher organisms. Here, we demonstrate that administration of an FGF21 analog to alcohol-preferring non-human primates reduces alcohol intake by 50%. Further, we reveal that FGF21 suppresses alcohol consumption through a projection-specific subpopulation of KLB-expressing neurons in the basolateral amygdala. Our results illustrate how FGF21 suppresses alcohol consumption through a specific population of neurons in the brain and demonstrate its therapeutic potential in non-human primate models of excessive alcohol consumption.

Alcohol Drinking

The Tokelau Island migrant study: alcohol consumption in two environments.

The prevalence of alcohol consumption, the choice of beverages and the quantity of drinks used by a Polynesian society are described, both in the Tokelau atolls and among Tokelauan migrants in New Zealand. Current drinking was uncommon but increasing among women. Among men, it was more common, but both prevalence and quantity were modest compared with national alcohol consumption in New Zealand. Description of alcohol consumption in such migrant populations may provide a basis for encouraging continuing prudence regarding alcohol and ready acceptance and provision for the non-drinker of alcohol.

Adolescent

Prediction of alcohol consumption: The role of genetics, impulsivity, and sensation seeking from adolescence to adulthood.

BACKGROUND: There are well-known phenotypic and genetic associations among impulsivity, sensation seeking (SS), and alcohol consumption, but whether they vary between adolescence and early adulthood remains unclear. PURPOSE/HYPOTHESES: We hypothesized that adolescent alcohol consumption would be better predicted by polygenic indices (PGIs) of impulsivity and SS than PGIs of adult alcohol consumption (drinks per week; DPW), but that the reverse would be observed in young adulthood (i.e., stronger associations for DPW PGIs). METHODS: N = 733-754 twins of European genetic ancestry from the Colorado Longitudinal Twin Study were assessed at age 17 and/or 23 years using structural equation modeling. RESULTS: The SS PGIs were associated with alcohol consumption in adolescence (β=0.16), whereas DPW PGIs were associated with alcohol consumption in early adulthood (β=0.15). Additionally, phenotypic measures of impulsivity and SS are associated with alcohol consumption at both ages (β=.13-.21) and mediated some PGI-alcohol associations. DISCUSSION: These findings suggest that genetic influences on alcohol consumption change from adolescence to early adulthood, with genetic influences on sensation seeking most relevant to alcohol consumption in adolescence.

Humans