Alcohol (Hanover, York County, Pa.)最新文献_第8页

Prenatal alcohol exposure and health at midlife: Self-reported health outcomes in two cohorts 产前酒精暴露与中年健康：两个队列中自我报告的健康结果。

IF 3 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2024-10-29 DOI: 10.1111/acer.15441

C. D. Coles, Z. R. Shapiro, J. A. Kable, S. A. Stoner, G. J. Ritfeld, T. M. Grant

Background

The Developmental Origins of Health and Disease Hypothesis (DOHaD) suggests prenatal alcohol exposure (PAE) should have implications for adult physical and mental health. Since the health profile of older adults with PAE and diagnoses of fetal alcohol spectrum disorder (FASD) is unknown, the current study evaluates self-reported health problems of midlife adults with and without a history of PAE to describe these outcomes.

Methods

Participants (N = 357) recruited from longitudinal cohorts in Atlanta, GA and Seattle, WA completed a health survey assessing a range of physical conditions. Initial analysis compared the frequency of conditions between alcohol-exposed and nonexposed groups. To identify patterns within groups, 10 problem areas were subjected to latent class analysis (LCA). Finally, the direct effect of PAE on health outcomes was evaluated using multilevel modeling, controlling for effects of other factors.

Results

Compared with unexposed controls, individuals with PAE reported significantly higher frequencies of problems with hearing, dentition, heart, cancer, gastritis, kidney stones, bladder, diabetes, thyroid, skin, and seizures. LCA found that controls yielded two classes, with 45% reporting sleep and vision problems and 55% reporting sleep, vision, cardiovascular, endocrine, immune, and dental problems. The PAE group yielded three classes, with 13% endorsing few health problems, 43% reporting sleep, vision, immune, and dental problems, and 43% reporting sleep, vision, cardiovascular, urinary, endocrine, skin, immune, dental, and gastrointestinal problems. With multivariate analysis, controlling for other influences, PAE was associated directly with hearing, urinary, dental, and gastrointestinal problems. A similar pattern was found for alcohol-exposed individuals who did and did not meet criteria for fetal alcohol syndrome (FAS).

Discussion

Patients affected by alcohol may report greater frequency and range of health adversity. That PAE was only uniquely associated with a limited set of problems suggests that many health outcomes in midlife result from an initial vulnerability potentiated by postnatal stress resulting from other associated factors.

背景：健康与疾病的发展起源假说（DOHaD）认为，产前酒精暴露（PAE）会对成人的身心健康产生影响。由于患有产前酒精暴露和胎儿酒精谱系障碍（FASD）诊断的老年人的健康状况尚不清楚，本研究评估了有和没有产前酒精暴露史的中年人自我报告的健康问题，以描述这些结果：从佐治亚州亚特兰大市和华盛顿州西雅图市的纵向队列中招募的参与者（N = 357）完成了一项健康调查，评估了一系列身体状况。初步分析比较了接触酒精组和未接触酒精组的身体状况发生频率。为了确定组内的模式，对 10 个问题领域进行了潜类分析（LCA）。最后，使用多层次模型评估了 PAE 对健康结果的直接影响，并控制了其他因素的影响：结果：与未接触 PAE 的对照组相比，报告 PAE 患者在听力、牙齿、心脏、癌症、胃炎、肾结石、膀胱、糖尿病、甲状腺、皮肤和癫痫发作方面出现问题的频率明显更高。LCA 发现，对照组产生了两类问题，其中 45% 报告了睡眠和视力问题，55% 报告了睡眠、视力、心血管、内分泌、免疫和牙科问题。PAE 组有三个类别，13% 的人很少有健康问题，43% 的人有睡眠、视力、免疫和牙科问题，43% 的人有睡眠、视力、心血管、泌尿、内分泌、皮肤、免疫、牙科和肠胃问题。通过多变量分析，在控制了其他影响因素后，PAE 与听力、泌尿、牙科和胃肠道问题直接相关。讨论：受酒精影响的患者可能会报告更频繁地出现听力、泌尿、牙科和胃肠道问题：讨论：受酒精影响的患者可能会报告更多频率和范围的健康问题。PAE仅与有限的一组问题有独特的关联，这表明中年时期的许多健康结果都是由其他相关因素导致的产后压力所增强的最初脆弱性造成的。

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引用次数: 0

Insomnia treatment effects on negative emotionality among veterans in treatment for alcohol use disorder 失眠治疗对接受酒精使用障碍治疗的退伍军人负面情绪的影响。

IF 3 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2024-10-28 DOI: 10.1111/acer.15436

Mary Beth Miller, Ryan W. Carpenter, Melissa Nance, Lindsey K. Freeman, Jane Metrik, Brian Borsari, Christina S. McCrae, Jennifer E. Merrill, Kate B. Carey, John E. McGeary

Background

Insomnia symptoms are pervasive and persistent in alcohol use disorder (AUD), though little is known about the mechanisms that underlie this association. We previously found that cognitive behavioral therapy for insomnia (CBT-I) reduced alcohol-related problems among veterans by improving insomnia severity (NCT03806491). In this planned secondary analysis of the same clinical trial data, we tested negative emotionality as one potential mechanism to explain this effect. Specifically, we tested the change in negative emotionality as a mediator of the association between change in insomnia symptoms and alcohol-related outcomes (craving, heavy drinking frequency, and alcohol-related problems).

Methods

Participants were 67 veterans in treatment for AUD who also met the criteria for insomnia disorder (91% male, 84% White, average age = 46.3 years). Participants were randomized to five sessions of CBT-I or a single-session sleep hygiene control. Assessments occurred at baseline, immediately posttreatment (~6 weeks after baseline), and at 6-week follow-up. Measures included the Insomnia Severity Index, Penn Alcohol Craving Scale, Timeline Followback, and Short Inventory of Problems. We created a latent negative emotionality indicator based on five validated and reliable measures of negative emotionality.

Results

Contrary to hypotheses, CBT-I did not improve negative emotionality relative to sleep hygiene control. However, across both treatment conditions, decreases in insomnia symptoms from baseline to posttreatment were associated with concurrent decreases in negative emotionality, which in turn predicted reductions in alcohol craving and heavy drinking.

Conclusion

Negative emotionality may help explain links between insomnia symptoms and alcohol-related outcomes.

背景：失眠症状在酒精使用障碍（AUD）患者中普遍存在且持续存在，但人们对这种关联的机制知之甚少。我们之前发现，失眠认知行为疗法（CBT-I）通过改善失眠严重程度，减少了退伍军人中与酒精相关的问题（NCT03806491）。在计划对同一临床试验数据进行的二次分析中，我们测试了负性情绪作为解释这种效应的一种潜在机制。具体来说，我们测试了负性情绪变化作为失眠症状变化与酒精相关结果（渴求、大量饮酒频率和酒精相关问题）之间关联的中介因素的作用：参与者为 67 名正在接受 AUD 治疗的退伍军人，他们也符合失眠症的标准（91% 为男性，84% 为白人，平均年龄为 46.3 岁）。参与者被随机分配到五个疗程的 CBT-I 或一个疗程的睡眠卫生对照组。分别在基线、治疗后（基线后约 6 周）和 6 周随访时进行评估。评估项目包括失眠严重程度指数、宾州酒精渴求量表、时间轴回溯和问题简表。我们根据五种经过验证的可靠负性情绪测量方法创建了一个潜在负性情绪指标：与假设相反，与睡眠卫生控制相比，CBT-I 并未改善负性情绪。然而，在两种治疗条件下，失眠症状从基线到治疗后的减少与负性情绪性的同时减少有关，而负性情绪性的减少又预示着酒精渴求和大量饮酒的减少：结论：负性情绪可能有助于解释失眠症状与酒精相关结果之间的联系。

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引用次数: 0

Links between adolescent binge drinking and midlife alcohol use behaviors by age, sex, and race/ethnicity 按年龄、性别和种族/民族分列的青少年暴饮与中年酒精使用行为之间的联系。

IF 3 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2024-10-27 DOI: 10.1111/acer.15435

Megan E. Patrick, Sarah J. Peterson, Yuk C. Pang, Yvonne M. Terry-McElrath

Background

Alcohol use is increasing among adults in midlife (i.e., ages 35–60), but few studies examine specific alcohol use behaviors in this age group. We examined measures of typical drinks, maximum drinks, binge drinking, and high-intensity drinking by age, sex, and race/ethnicity among midlife adults, as well as the prospective association between age 18 binge drinking and midlife behaviors.

Methods

Data from 5180 respondents participating in the national Monitoring the Future Panel study who were aged 35–60 in 2022 (followed since they were in 12th grade in 1980–2005) were used to estimate past 30-day midlife drinking behaviors (i.e., typical drinks, maximum drinks, binge, and high-intensity drinking) by age group, sex, and race/ethnicity. Associations between age 18 binge drinking status and midlife drinking outcomes were examined, as well as moderation by sociodemographic characteristics.

Results

Across ages 35–60, the mean typical number of drinks on drinking days within the past month ranged from 1.4 to 1.8; the mean maximum drinks ranged from 2.3 to 3.2. Past-month binge and high-intensity drinking prevalence ranged from 19.1% to 31.2% and 3.6% to 8.1%, respectively. Estimates of drinking behaviors were generally higher among respondents aged 35–40 (vs. older age groups), males (vs. females), those identifying as White (vs. other racial/ethnic groups), and those who reported age 18 binge drinking (vs. not). Adolescent binge drinking was a stronger predictor of high-intensity drinking among females than males and of typical and maximum drinks among older (age 60) than younger (age 35) respondents.

Conclusion

Binge and high-intensity drinking were reported by a meaningful percentage of the US midlife adults. Binge drinking in adolescence was a predictor of subsequent alcohol-related risks. These long-term connections were especially strong among females. Age 18 binge drinking was a stronger predictor of high-intensity drinking at age 60 than earlier in midlife, underscoring that adolescent binge drinking is a key indicator of risk across the lifespan.

背景：中年成年人（即 35-60 岁）的饮酒量正在增加，但很少有研究对这一年龄组的具体饮酒行为进行调查。我们研究了中年成年人中按年龄、性别和种族/民族划分的典型饮酒量、最高饮酒量、暴饮暴食量和高强度饮酒量，以及 18 岁暴饮暴食与中年行为之间的前瞻性关联：方法：利用参与全国 "监测未来小组 "研究的 5180 名 2022 年 35-60 岁受访者的数据（自 1980-2005 年 12 年级开始跟踪），按年龄组、性别和种族/民族对过去 30 天的中年饮酒行为（即典型饮酒、最多饮酒、酗酒和高强度饮酒）进行估计。研究了18岁暴饮状态与中年饮酒结果之间的关系，以及社会人口特征的调节作用：结果：在 35-60 岁的人群中，过去一个月内饮酒日的平均典型饮酒量在 1.4-1.8 之间；平均最高饮酒量在 2.3-3.2 之间。过去一个月的暴饮和高强度饮酒率分别为 19.1%至 31.2%和 3.6%至 8.1%。饮酒行为的估计值在以下人群中普遍较高：35-40 岁（相对于更大年龄组）、男性（相对于女性）、白人（相对于其他种族/民族）以及报告 18 岁暴饮（相对于未报告）的人群。青春期暴饮对女性高强度饮酒的预测作用强于男性，对年龄较大（60 岁）的受访者典型饮酒量和最高饮酒量的预测作用强于年龄较小（35 岁）的受访者：结论：在美国的中年人中，有相当比例的人报告了暴饮和高强度饮酒。青少年时期的酗酒是日后酒精相关风险的预测因素。这些长期联系在女性中尤为明显。与中年早期相比，18 岁时的酗酒更能预测 60 岁时的高强度饮酒，这表明青少年时期的酗酒是整个生命周期中风险的关键指标。

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引用次数: 0

From detection to intervention, optimizing care for patients with alcohol use disorder and advanced hepatic fibrosis 从检测到干预，优化对酒精使用障碍和晚期肝纤维化患者的护理。

IF 3 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2024-10-27 DOI: 10.1111/acer.15473

Paola Zuluaga, Suthat Liangpunsakul

<p>Nearly half of the world's population consumes alcohol, with approximately 20% engaging in binge drinking and 5%–10% drinking excessively over the long term (Manthey et al., <span>2019</span>). Alcohol consumption is a leading cause of liver disease and mortality in both the United States and Europe, contributing to a significant public health burden (Karlsen et al., <span>2022</span>). The risk of developing alcohol-associated liver disease (ALD) varies widely among individuals, influenced by factors such as genetics (Schwantes-An et al., <span>2024</span>; Yuan et al., <span>2024</span>), socioeconomic status (Askgaard et al., <span>2021</span>), and specific drinking patterns (Aberg et al., <span>2017</span>). Additionally, the stigma surrounding heavy drinking complicates accurate tracking of alcohol intake, leading to underreporting and misdiagnosis (Schomerus et al., <span>2022</span>). Unlike many other liver diseases, ALD is often diagnosed late, typically after serious complications from portal hypertension or advanced fibrosis have developed (Shah et al., <span>2019</span>).</p><p>The progression of liver disease in heavy drinkers is heterogeneous; while some individuals develop severe liver problems rapidly, others may experience a slower progression or remain relatively unaffected for years (Israelsen et al., <span>2024</span>). Noninvasive tests (NITs) play a crucial role in identifying high-risk patients who require intervention, distinguishing them from those at lower risk (Israelsen et al., <span>2024</span>). Early detection through NITs focuses on two critical scenarios: screening at-risk individuals for significant liver fibrosis and diagnosing or predicting outcomes for patients with advanced liver disease (Israelsen et al., <span>2024</span>). Liver fibrosis, a key predictor of liver failure and mortality in asymptomatic ALD patients, can be assessed using various methods (Israelsen et al., <span>2024</span>). These include elastography-based tools such as liver stiffness measurement (LSM) and blood-based markers such as the fibrosis-4 test (FIB-4) (Israelsen et al., <span>2024</span>). While LSM provides valuable insights into liver stiffness, its availability is limited, particularly in nonspecialist settings, which restricts its use for routine screening and early detection of fibrosis (Israelsen et al., <span>2024</span>). In contrast, blood-based biomarkers such as the FIB-4 test may offer a more convenient and accessible option for screening, allowing for easier implementation in various healthcare settings (Israelsen et al., <span>2024</span>).</p><p>Patients with excessive alcohol use (EAU) or alcohol use disorder (AUD) represent a critical population for screening for advanced fibrosis and ALD, primarily due to their significantly elevated risk of liver damage. Prolonged heavy drinking can lead to the development of liver fibrosis, rendering AUD patients particularly susceptible to more severe liver diseases. Our

世界上近一半的人口饮酒，其中约20%的人酗酒，5%-10%的人长期过度饮酒（Manthey et al., 2019）。在美国和欧洲，饮酒是肝脏疾病和死亡的主要原因，造成了重大的公共卫生负担（Karlsen et al., 2022）。发生酒精相关性肝病（ALD）的风险在个体之间差异很大，受遗传等因素的影响(Schwantes-An et al., 2024；Yuan et al., 2024)、社会经济地位（Askgaard et al., 2021）和特定饮酒模式（Aberg et al., 2017）。此外，酗酒带来的耻辱感使准确追踪酒精摄入量变得复杂，导致漏报和误诊（Schomerus et al., 2022）。与许多其他肝脏疾病不同，ALD通常诊断较晚，通常在门静脉高压或晚期纤维化引起的严重并发症发生后（Shah et al., 2019）。重度饮酒者肝病的进展具有异质性；虽然有些人会迅速发展为严重的肝脏问题，但其他人可能会经历较慢的进展或多年来相对不受影响（Israelsen等人，2024）。非侵入性检查（nit）在识别需要干预的高危患者，将其与低风险患者区分开来方面发挥着至关重要的作用（Israelsen等人，2024）。通过NITs进行的早期检测侧重于两个关键场景：筛查有肝纤维化风险的个体，诊断或预测晚期肝病患者的预后（Israelsen et al., 2024）。肝纤维化是无症状ALD患者肝衰竭和死亡率的关键预测指标，可通过多种方法进行评估（Israelsen et al., 2024）。其中包括基于弹性成像的工具，如肝脏硬度测量（LSM）和基于血液的标志物，如纤维化-4测试（FIB-4）（Israelsen等人，2024）。虽然LSM提供了对肝脏硬度的宝贵见解，但其可用性有限，特别是在非专业环境中，这限制了其用于常规筛查和早期检测纤维化（Israelsen et al, 2024）。相比之下，基于血液的生物标志物，如FIB-4测试，可能为筛查提供更方便和可访问的选择，允许更容易地在各种医疗保健环境中实施（Israelsen等人，2024）。过度饮酒（EAU）或酒精使用障碍（AUD）患者是晚期纤维化和ALD筛查的关键人群，主要是因为他们的肝损伤风险显著升高。长期大量饮酒可导致肝纤维化的发展，使AUD患者特别容易发生更严重的肝脏疾病。我们最近的研究强调了这一问题的紧迫性，表明大约五分之一接受AUD治疗的患者显示FIB-4值，表明晚期肝纤维化（Zuluaga et al., 2024）。肝纤维化筛查至关重要，因为它能够在纤维化的初始阶段识别纤维化，从而及时干预并显著降低严重并发症的风险。在2024年10月的ACER杂志上，Houston等人（2024）研究了EAU和高FIB-4评分的患者是否被适当地转介到肝病学。他们分析了2013年至2023年间大型公共卫生系统中1131名患者的记录，发现在316名EAU活动性和FIB-4评分较高的患者中，只有37%的患者转诊到肝病学（Houston et al., 2024）。有酒精相关精神健康问题的患者和因创伤入院的患者接受转诊的可能性较小，而有酒精相关肝脏住院治疗且合并症评分较高的患者更有可能被转诊（Houston et al., 2024）。令人震惊的是，近63%有晚期肝病风险的患者没有得到他们需要的治疗（Houston et al., 2024）。对EAU或AUD患者进行晚期纤维化筛查是有价值的，但其有效性取决于筛查结果后采取的措施。识别有晚期纤维化风险的患者只是第一步；医疗保健提供者必须实施适当的后续行动，以有效地解决这些发现。筛查举措的成功依赖于一种协调一致的方法，这种方法不仅强调发现有风险的个体，而且强调及时和适当的临床反应的重要性。这包括及时转诊给肝病专家，制定全面的管理计划，并根据每位患者的具体需求实施有针对性的干预措施。如果没有这些后续行动，筛查工作可能无法转化为患者预后的有意义的改善。根据Houston等人的研究。（2024），尽管人们意识到EAU和FIB-4评分高的患者发生晚期肝病的风险很大，但转诊到适当的肝病学服务的比例仍然低得惊人。这一趋势在与酒精有关的精神健康问题和因创伤入院的个人中尤为明显，他们经常错过必要的评估和转诊（Houston et al., 2024）。有几个因素可能导致这个令人担忧的问题。首先，医疗保健提供者通常优先考虑直接的精神健康需求或创伤管理，而不是潜在的肝脏问题，特别是在急诊或住院环境中。这种对精神或身体危机的极度关注可能会掩盖评估潜在肝纤维化的重要性（Johnson et al, 2022）。因此，对肝纤维化进行全面评估的迫切需要可能被忽视，导致错过及时转诊的机会。其次，心理健康和初级保健提供者可能不熟悉非侵入性筛查工具，如FIB-4评分和与饮酒相关的特定肝脏相关风险（Johnson et al, 2022）。这种知识差距可能导致低估肝病的严重程度，并未能认识到专业护理的必要性。第三，围绕精神健康状况的耻辱感可能会给临床护理带来偏见（Ahad et al., 2023）。提供者可能会无意识地认为与酒精相关的精神健康问题患者没有那么紧急的医疗问题，这削弱了对肝脏疾病进行必要筛查的重视。相比之下，酒精相关肝脏住院的患者通常会出现明显的急性肝脏并发症，这使得医疗保健提供者更有可能认识到转诊的必要性。最后，诸如支离破碎的护理模式和初级保健、精神卫生和肝病服务之间沟通不足等系统性问题进一步加剧了促进及时转诊的挑战(McGinty &amp；Daumit, 2020;Zuchowski et al., 2015)。为了在初级保健和精神病学机构中加强对EAU或AUD患者的晚期纤维化筛查，必须采取多方面的方法。首先要加强对提供者的肝脏健康教育和培训，强调ALD的病理生理学以及使用FIB-4评分等nit进行早期检测的重要性。实施综合护理模式，促进初级保健或精神卫生提供者与肝病服务之间的合作，对于全面管理至关重要（Winder等，2022）。这种模式促进了定期沟通和协调护理计划的制定，确保精神健康和潜在的晚期纤维化得到优先考虑（Winder等人，2022）。此外，在初级保健或精神科就诊期间，为常规肝脏评估制定标准化的筛查方案，可以简化对高危个体的识别。利用电子健康记录来标记需要及时进行肝脏评估的患者将进一步加强筛查过程（Khan等人，2017）。通过教育让患者了解肝病的重要性和与EAU相关的风险是至关重要的。赋予病人权利，让他们为自己的福祉进行宣传，可以使他们更多地参与到自己的保健工作中，并鼓励他们寻求定期检查。建立一个强大的系统，及时跟进筛查结果并转诊到专科护理，对于改善患者预后至关重要（Seyed-Nezhad等，2021）。这包括制定跟踪筛查结果的协议，促进医疗保健提供者之间的沟通，确保患者得到适当的护理，而不会出现不必要的延误（Sheehan等人，2021年）。此外，实施持续的质量改进框架可以监测筛查和转诊过程的有效性（Hill等人，2020）。通过收集和分析关于筛查率、转诊模式和患者结果的数据，医疗保健提供者可以确定需要改进的领域，并为正在进行的培训和政策调整提供信息（Hill等

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引用次数: 0

Drinking firsts at home and with parental knowledge: Racial/ethnic differences in associations with later alcohol outcomes among underage youth 在父母知情的情况下，在家中第一次饮酒：与未成年青少年日后酗酒结果相关的种族/民族差异。

IF 3 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2024-10-25 DOI: 10.1111/acer.15471

Sharon Lipperman-Kreda, Kristina Wharton, Tammy Chung, Carolyn E. Sartor, Kristina M. Jackson, Tim Slade

Background

Prior research has shown that early alcohol experiences, such as age of initiation and speed of progression between drinking milestones, vary across racial/ethnic groups. To inform culturally tailored prevention efforts, this longitudinal study examined racial/ethnic differences in the associations of drinking firsts at home and with parental knowledge with alcohol use outcomes among underage youth.

Methods

The study included baseline and five follow-up surveys, collected every 6 months, from California adolescents (ages 12–16 years at baseline). The analytic sample was composed of the 689 adolescents who reported lifetime alcohol use at baseline or a follow-up survey (5% Black, 37% Latinx, 46% White, and 12% other/mixed racial/ethnic group; 54% female). Participants who reported consumption of a full drink, intoxication, or heavy episodic drinking (HED) were asked ages and contexts of these drinking firsts, including whether the initiation was at their own home and whether their parents/guardians knew about this drinking event. Outcomes included past-6-month alcohol frequency, alcohol quantity, and number of alcohol-related problems. Multilevel negative binomial regression analyses were conducted, controlling for demographics and age of initiation by type of drinking behavior. Moderation analyses examined racial/ethnic differences.

Results

For consumption of the first full drink, both drinking at home and parental knowledge were negatively associated with all outcomes; associations did not vary by race/ethnicity. First intoxication at own home was negatively associated with the number of drinks for Latinx youth and with the number of problems for Black youth. For first HED, drinking at own home was positively associated with drinking frequency across groups, and for Black youth specifically, parental knowledge of their first HED experience was significantly associated with greater later alcohol frequency and quantity.

Conclusions

Results suggest that the association of family contexts of drinking first with later alcohol outcomes among underage youth varied by stage of alcohol use and race/ethnicity.

背景：先前的研究表明，不同种族/民族群体的早期饮酒经历（如开始饮酒的年龄和饮酒里程碑之间的进展速度）各不相同。为了给针对不同文化背景的预防工作提供信息，本纵向研究考察了不同种族/民族在家中首次饮酒以及父母对饮酒的了解程度与未成年青少年饮酒结果之间的关联：研究包括每 6 个月一次的基线调查和五次跟踪调查，调查对象为加州青少年（基线调查时年龄为 12-16 岁）。分析样本由在基线调查或后续调查中报告终生饮酒的 689 名青少年组成（5% 为黑人，37% 为拉丁裔，46% 为白人，12% 为其他/混合种族/人种；54% 为女性）。调查询问了报告饮酒过量、醉酒或大量偶发性饮酒（HED）的参与者的年龄及其首次饮酒的背景，包括是否在自己家中开始饮酒以及其父母/监护人是否知道这一饮酒事件。结果包括过去 6 个月的饮酒频率、饮酒量和与酒精有关的问题数量。通过控制人口统计学和饮酒行为类型的开始年龄，进行了多层次负二项式回归分析。调节分析研究了种族/民族差异：结果：就第一次完全饮酒而言，在家中饮酒和父母对饮酒的了解程度与所有结果均呈负相关；相关性不因种族/人种而异。对于拉丁裔青少年来说，在自己家中首次醉酒与饮酒数量呈负相关，而对于黑人青少年来说，则与问题数量呈负相关。对于首次酗酒的青少年来说，在自己家中酗酒与各群体的饮酒频率呈正相关，特别是对于黑人青少年来说，父母对其首次酗酒经历的了解程度与日后饮酒频率和饮酒量的增加呈显著相关：结论：研究结果表明，未成年青少年首次饮酒的家庭环境与日后饮酒结果的关系因饮酒阶段和种族/民族而异。

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引用次数: 0

Discovering what young adults want in electronic interventions aimed at reducing alcohol-related consequences 在旨在减少酒精相关后果的电子干预措施中发现年轻人的需求。

IF 3 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2024-10-25 DOI: 10.1111/acer.15439

Chelsea D. Mackey, Gage L. Sibik, Victoria Szydlowski, Jessica A. Blayney, Christine M. Lee, Mary E. Larimer, Brittney A. Hultgren

Background

Despite intervention efforts, negative alcohol-related consequences continue to impact young adults. Most alcohol interventions focus on reducing alcohol consumption; however, previous research indicates that focusing solely on alcohol use may not decrease consequences. Additionally, many alcohol interventions have diminishing engagement, and few are designed with young adults involved in the development process. Drawing on user-centered design, this study sought to understand young adult perceptions, preferences, and needs for electronic interventions specifically aimed at reducing alcohol consequences.

Methods

Using semi-structured qualitative interviews, 21 young adult drinkers (ages 18–24; 57.1% female) shared their opinions regarding the need for electronic interventions (i.e., mobile or web-delivered) to reduce alcohol consequences as well as their preferences for content, features, and ways to increase engagement. Interviews were coded and analyzed using a multi-step thematic analysis approach.

Results

As part of our discovery phase of intervention development, content coding revealed four main themes. Participants perceived several benefits of interventions focused on alcohol consequences, such as promoting mindful alcohol use and reducing alcohol-related harms. Participants also discussed perceived limitations of such programs, including believing consequences from drinking are unavoidable, necessary for learning, and associated with peer pressure. Preferences for features included real-time tracking, personalized feedback, and psychoeducation along with preferences for design including non-judgmental framing, interactive content, and a user-friendly platform.

Conclusions

Engaging end users early in the development process is a valuable approach to increase intervention relevancy with the target population. This can also inform intervention content and design to maximize engagement and satisfaction (e.g., framing, features, and interactivity) while also reducing barriers identified early on (e.g., peer pressure).

背景：尽管采取了干预措施，但与酒精相关的不良后果仍在影响着青少年。大多数酒精干预措施的重点是减少酒精消费；然而，以往的研究表明，仅仅关注酒精使用可能不会减少后果。此外，许多酒精干预措施的参与度越来越低，而且很少有干预措施是由青少年参与设计的。本研究借鉴以用户为中心的设计理念，试图了解年轻人对旨在减少酒精后果的电子干预措施的看法、偏好和需求：通过半结构式定性访谈，21 名年轻的成年饮酒者（18-24 岁；57.1% 为女性）分享了他们对减少酒精后果的电子干预措施（即手机或网络提供的干预措施）的需求，以及他们对内容、功能和提高参与度的方式的偏好。我们采用多步骤主题分析方法对访谈进行了编码和分析：作为干预开发探索阶段的一部分，内容编码揭示了四大主题。参与者认为以酒精后果为重点的干预措施有多种益处，如促进谨慎饮酒和减少与酒精相关的危害。参与者还讨论了此类项目的局限性，包括认为饮酒的后果是不可避免的、对学习是必要的，以及与同伴压力有关。对功能的偏好包括实时跟踪、个性化反馈和心理教育，对设计的偏好包括非评判性框架、互动内容和用户友好型平台：结论：在开发过程的早期让最终用户参与进来是提高干预措施与目标人群相关性的重要方法。这还可以为干预内容和设计提供信息，以最大限度地提高参与度和满意度（如框架、功能和互动性），同时减少早期发现的障碍（如同伴压力）。

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引用次数: 0

Delay discounting of rewards and losses, alcohol use, and the influence of socioeconomic factors: A cross-sectional online study in frequent drinkers 奖励和损失的延迟贴现、饮酒以及社会经济因素的影响：一项针对经常饮酒者的横断面在线研究。

IF 3 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2024-10-22 DOI: 10.1111/acer.15469

Mathieu Pinger, Malin Skirke, Janine Thome, Wolfgang H. Sommer, Georgia Koppe, Peter Kirsch

Background

Delay discounting describes the devaluation of future outcomes over time and is a popular behavioral construct in addiction research. Prior studies show modest yet consistent associations between problematic alcohol use and delayed reward discounting (DRD). However, the potential confounding influence of socioeconomic status (SES, e.g., income and education) is rarely addressed. In this study, we aimed to investigate the robustness of DRD as a predictor of alcohol use after controlling for socioeconomic and demographic variables. Additionally, we aimed to test the association between delayed loss discounting (DLD) and alcohol use in a sufficiently large sample.

Methods

We collected data from 341 moderate-to-heavy-drinking participants (27.92 ± 21.12 g alcohol/day, 43.48 ± 11.90 years old, 49.9% female, UK residents) in a cross-sectional online study. DRD and DLD were measured using an intertemporal choice task. Questionnaires encompassed alcohol use (AUDIT, weekly alcohol consumption), education and income, subjective measures of past and present socioeconomic status, and impulsivity.

Results

DRD, but not DLD, was significantly associated with AUDIT scores (r = 0.15) and weekly alcohol consumption (r = 0.12). DRD remained a significant yet weak predictor of AUDIT scores when controlling for education and income, but not when controlling for education and age.

Conclusions

We replicated a small but robust association between alcohol use and DRD, but not DLD. This association appeared to be confounded by education and age, but not by income. We conclude that socioeconomic and demographic variables should systematically be accounted for in future studies investigating DRD and alcohol use.

背景：延迟折现描述的是随着时间的推移对未来结果的贬值，是成瘾研究中一个流行的行为结构。先前的研究表明，问题性饮酒与延迟奖赏折扣（DRD）之间存在适度但一致的关联。然而，社会经济地位（SES，如收入和教育）的潜在混杂影响却很少被提及。在本研究中，我们旨在研究在控制社会经济和人口统计学变量后，DRD 作为酒精使用预测指标的稳健性。此外，我们还希望在足够大的样本中测试延迟损失贴现（DLD）与饮酒之间的关联：我们在一项横断面在线研究中收集了 341 名中度至重度饮酒者（27.92 ± 21.12 克酒精/天，43.48 ± 11.90 岁，49.9% 女性，英国居民）的数据。DRD 和 DLD 采用跨时空选择任务进行测量。问卷内容包括饮酒情况（AUDIT，每周饮酒量）、教育程度和收入、过去和现在社会经济地位的主观测量以及冲动性：DRD与AUDIT得分（r = 0.15）和每周饮酒量（r = 0.12）显著相关，而DLD与AUDIT得分（r = 0.15）和每周饮酒量（r = 0.12）无关。在控制教育程度和收入的情况下，DRD 对 AUDIT 分数的预测作用仍然明显，但不明显；在控制教育程度和年龄的情况下，DRD 对 AUDIT 分数的预测作用则不明显：我们重复了饮酒与 DRD（但不是 DLD）之间微小但稳健的关联。这种关联似乎与教育和年龄有关，但与收入无关。我们的结论是，在今后调查 DRD 和饮酒的研究中，应系统地考虑社会经济和人口变量。

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引用次数: 0

Association of circulating adipokines with metabolic measures among people with HIV: Moderating effects of alcohol use 循环脂肪因子与艾滋病病毒感染者代谢指标的关系：饮酒的调节作用

IF 3 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2024-10-18 DOI: 10.1111/acer.15464

Liz Simon, Hui-Yi Lin, Jonquil Poret, Curtis Vande Stouwe, Tekeda F. Ferguson, David A. Welsh, Patricia E. Molina

Background

People with HIV (PWH) are at increased risk for cardiometabolic comorbidities. We have reported that lifetime alcohol use among people with HIV (PWH) is associated with increased risk for metabolic syndrome. Dysfunctional adipose tissue and altered circulating adipokines mediate metabolic dysregulation. The objective of this study was to determine the associations of circulating adipokine concentration with metabolic measures, and the moderating effects of lifetime and recent alcohol use in PWH.

Methods

This is a cross-sectional analysis of data from 357 PWH at their baseline visit of the longitudinal New Orleans Alcohol and HIV (NOAH) study. The concentrations of four circulating adipokines (adiponectin, leptin, resistin, and fatty acid-binding protein 4 [FABP4]) and their associations with five metabolic measures (triglycerides, cholesterol, Hemoglobin A1c, Homeostatic Model Assessment for Insulin Resistance, and metabolic syndrome) were examined.

Results

Higher circulating adiponectin was associated with increased odds of normal triglyceride, cholesterol, and Hemoglobin A1c levels. Increased leptin and FABP4 concentrations were associated with decreased odds of normal triglyceride and cholesterol levels. Increased leptin and FABP4 concentrations were associated with increased odds of insulin resistance and meeting criteria for metabolic syndrome. Increased circulating resistin concentration was associated with decreased odds of normal triglyceride levels and increased odds of meeting criteria for metabolic syndrome. Additionally, among PWH with increased lifetime alcohol use, higher adiponectin concentration was associated with decreased odds of meeting criteria for metabolic syndrome.

Conclusions

These data suggest the interplay between adiponectin, leptin, FABP4, and resistin may contribute to metabolic stability among PWH. Moreover, lifetime, but not recent, alcohol use moderates the relationship between adipokines and metabolic measures. These data highlight the relevance of functional adipose tissue mass and associated circulating adipokine levels in maintaining metabolic homeostasis, and its moderation by lifetime alcohol consumption.

背景：艾滋病病毒感染者（PWH）罹患心脏代谢合并症的风险增加。我们曾报道，HIV 感染者终生饮酒与代谢综合征风险增加有关。功能失调的脂肪组织和循环脂肪因子的改变介导了代谢失调。本研究旨在确定循环脂肪因子浓度与代谢指标之间的关系，以及终生饮酒和近期饮酒对 PWH 的调节作用：本研究对新奥尔良酒精与艾滋病（NOAH）纵向研究中 357 名艾滋病感染者的基线访问数据进行了横断面分析。研究人员检测了四种循环脂肪因子（脂肪连通素、瘦素、抵抗素和脂肪酸结合蛋白 4 [FABP4]）的浓度及其与五种代谢指标（甘油三酯、胆固醇、血红蛋白 A1c、胰岛素抵抗稳态模型评估和代谢综合征）之间的关系：结果：循环脂肪连通素越高，甘油三酯、胆固醇和血红蛋白 A1c 水平正常的几率越大。瘦素和 FABP4 浓度的增加与甘油三酯和胆固醇水平正常几率的降低有关。瘦素和 FABP4 浓度的增加与胰岛素抵抗和符合代谢综合征标准的几率增加有关。循环抵抗素浓度的增加与甘油三酯水平正常的几率降低和符合代谢综合征标准的几率增加有关。此外，在终生酗酒的残疾人中，较高的脂肪连通素浓度与代谢综合征达标几率的降低有关：这些数据表明，脂肪连接蛋白、瘦素、FABP4 和抵抗素之间的相互作用可能有助于促进 PWH 代谢的稳定。此外，终生饮酒（而非近期饮酒）会缓和脂肪因子与代谢指标之间的关系。这些数据强调了功能性脂肪组织质量和相关循环脂肪因子水平在维持代谢平衡中的重要性，以及终生饮酒对其影响的调节作用。

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引用次数: 0

Lipid droplet-associated proteins in alcohol-associated fatty liver disease: A proteomic approach 酒精相关性脂肪肝中的脂滴相关蛋白：蛋白质组学方法

IF 3 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2024-10-16 DOI: 10.1111/acer.15446

Sathish Kumar Perumal, Le Z. Day, Madan Kumar Arumugam, Srinivas Chava, Vikas Kumar, Natalia A. Osna, Jon Jacobs, Karuna Rasineni, Kusum K. Kharbanda

Background

The earliest manifestation of alcohol-associated liver disease (ALD) is steatosis characterized by deposition of fat in specialized organelles called lipid droplets (LDs). While alcohol administration causes a rise in LD numbers in the hepatocytes, little is known regarding their characteristics that allow their accumulation and size to increase. The aim of the present study is to gain insights into underlying pathophysiological mechanisms by investigating the ethanol-induced changes in hepatic LD proteome as a function of LD size.

Methods

Adult male Wistar rats (180–200 g BW) were fed with ethanol liquid diet for 6 weeks. At sacrifice, large-, medium-, and small-sized hepatic LD subpopulations (LD1, LD2, and LD3, respectively) were isolated and subjected to morphological and proteomic analyses.

Results

Morphological analysis of LD1-LD3 fractions of ethanol-fed rats clearly demonstrated that LD1 contained larger LDs compared with LD2 and LD3 fractions. Our preliminary results from principal component analysis showed that the proteome of different-sized hepatic LD fractions was distinctly different. Proteomic data analysis identified over 2000 proteins in each LD fraction with significant alterations in protein abundance among the three LD fractions. Among the altered proteins, several were related to fat metabolism, including synthesis, incorporation of fatty acid, and lipolysis. Ingenuity pathway analysis revealed increased fatty acid synthesis, fatty acid incorporation, LD fusion, and reduced lipolysis in LD1 compared to LD3. Overall, the proteomic findings indicate that the increased level of protein that facilitates fusion of LDs combined with an increased association of negative regulators of lipolysis dictates the generation of large-sized LDs during the development of alcohol-associated hepatic steatosis.

Conclusion

Several significantly altered proteins were identified in different-sized LDs isolated from livers of ethanol-fed rats. Ethanol-induced increases in specific proteins that hinder LD lipid metabolism led to the accumulation and persistence of large-sized LDs in the liver.

背景：酒精相关性肝病（ALD）的最早表现是脂肪变性，其特征是脂肪沉积在称为脂滴（LDs）的特殊细胞器中。虽然饮酒会导致肝细胞中的脂滴数量增加，但人们对其积累和体积增大的特征却知之甚少。本研究的目的是通过研究乙醇诱导的肝脏 LD 蛋白质组变化与 LD 大小的关系，深入了解潜在的病理生理机制：方法：成年雄性 Wistar 大鼠（体重 180-200 g）用乙醇液态食物喂养 6 周。牺牲时，分离大、中、小尺寸肝脏 LD 亚群（分别为 LD1、LD2 和 LD3）并进行形态学和蛋白质组分析：结果：对乙醇喂养大鼠的 LD1-LD3 组群进行的形态学分析清楚地表明，与 LD2 和 LD3 组群相比，LD1 组群含有较大的 LD。主成分分析的初步结果显示，不同大小的肝脏 LD 部分的蛋白质组明显不同。蛋白质组数据分析在每个 LD 组份中发现了 2000 多个蛋白质，三个 LD 组份的蛋白质丰度发生了显著变化。在改变的蛋白质中，有几种与脂肪代谢有关，包括合成、脂肪酸结合和脂肪分解。Ingenuity pathway 分析显示，与 LD3 相比，LD1 中的脂肪酸合成、脂肪酸掺入、LD 融合增加，而脂肪分解减少。总之，蛋白质组学研究结果表明，在酒精相关性肝脂肪变性的发展过程中，促进 LD 融合的蛋白质水平增加，加上脂肪分解负调控因子的关联增加，决定了大尺寸 LD 的产生：结论：从喂食乙醇的大鼠肝脏中分离出的不同大小的LDs中发现了几种明显改变的蛋白质。乙醇引起的阻碍LD脂质代谢的特定蛋白质的增加导致了大尺寸LD在肝脏中的积累和持续存在。

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引用次数: 0

Phosphatidylethanol testing and return to alcohol use after liver transplantation: Implications for candidate selection and care 磷脂酰乙醇检测与肝移植后恢复饮酒：对候选者选择和护理的影响。

IF 3 Q2 SUBSTANCE ABUSE

Alcohol (Hanover, York County, Pa.)

Pub Date : 2024-10-16 DOI: 10.1111/acer.15467

Hanna Blaney, Suthat Liangpunsakul

引用次数: 0