RATIONALE: Severe alcohol-associated hepatitis (SAH) is the most critical, acute, inflammatory phenotype within the alcohol-associated liver disease (ALD) spectrum, characterized by high 30- and 90-day mortality. Since several decades, corticosteroids (CS) are the only approved pharmacotherapy offering highly limited survival benefits. Contextually, there is an evident demand for 3PM innovation in the area meeting patients' needs and improving individual outcomes. Fecal microbiota transplantation (FMT) has emerged as one of the new potential therapeutic options. In this study, we aimed to address the crucial 3PM domains in order to assess (i) the impact of FMT on mortality in SAH patients beyond CS, (ii) to identify factors associated with the outcome to be improved (iii) the prediction of futility, (iv) prevention of suboptimal individual outcomes linked to increased mortality, and (v) personalized allocation of therapy. METHODS: We conducted a prospective study (NCT04758806) in adult patients with SAH who were non-responders (NR) to or non-eligible (NE) for CS between January 2018 and August 2022. The intervention consisted of five 100 ml of FMT, prepared from 30 g stool from an unrelated healthy donor and frozen at - 80 °C, administered daily to the upper gastrointestinal (GI) tract. We evaluated the impact of FMT on 30- and 90-day mortality which we compared to the control group selected by the propensity score matching and treated by the standard of care; the control group was derived from the RH7 registry of patients hospitalized at the liver unit (NCT04767945). We have also scrutinized the FMT outcome against established and potential prognostic factors for SAH - such as the model for end-stage liver disease (MELD), Maddrey Discriminant Function (MDF), acute-on-chronic liver failure (ACLF), Liver Frailty Index (LFI), hepatic venous-portal pressure gradient (HVPG) and Alcoholic Hepatitis Histologic Score (AHHS) - to see if the 3PM method assigns them a new dimension in predicting response to therapy, prevention of suboptimal individual outcomes, and personalized patient management. RESULTS: We enrolled 44 patients with SAH (NR or NE) on an intention-to-treat basis; we analyzed 33 patients per protocol for associated factors (after an additional 11 being excluded for receiving less than 5 doses of FMT), and 31 patients by propensity score matching for corresponding individual outcomes, respectively. The mean age was 49.6 years, 11 patients (33.3%) were females. The median MELD score was 29, and ACLF of any degree had 27 patients (81.8%). FMT improved 30-day mortality (p = 0.0204) and non-significantly improved 90-day mortality (p = 0.4386). Univariate analysis identified MELD ≥ 30, MDF ≥ 90, and ACLF grade > 1 as significant predictors of 30-day mortality, (p = 0.031; p = 0.014; p = 0.034). Survival was not associated with baseline LFI, HVPG, or AHHS. CONCLUSIONS AND RECOMMENDATIONS IN THE FRAMEWORK OF 3PM: In the most difficult-to-treat sub-cohort of patients with SAH (i.e., NR/NE), FMT improved 30-day mortality. Factors associated with benefit included MELD ≤ 30, MDF ≤ 90, and ACLF < 2. These results support the potential of gut microbiome as a therapeutic target in the context of 3PM research and vice versa - to use 3PM methodology as the expedient unifying template for microbiome research. The results allow for immediate impact on the innovative concepts of (i) personalized phenotyping and stratification of the disease for the clinical research and practice, (ii) multilevel predictive diagnosis related to personalized/precise treatment allocation including evidence-based (ii) prevention of futile and sub-optimally effective therapy, as well as (iii) targeted prevention of poor individual outcomes in patients with SAH. Moreover, our results add to the existing evidence with the potential to generate new research along the SAH's pathogenetic pathways such as diverse individual susceptibility to alcohol toxicity, host-specific mitochondrial function and systemic inflammation, and the role of gut dysbiosis thereof. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13167-024-00381-5.
- Publikační typ
- časopisecké články MeSH
Analýzou 996 pacientov z registra cirhózy RH7 sme zmapovali cestu pacientov počas 4,5-ročného obdobia smerom od registrácie do transplantácie pečene. Zistili sme, že u 283 pacientov (28,4 %) sa otvoril transplantačný protokol s mediánom 4 dni od registrácie, z nich 117 (11,7 %) bolo zapísaných na čakaciu listinu s mediánom 91 dní od začiatku protokolu, a 75 (7,5 %) bolo transplantovaných s mediánom 44 dní od zapísania na čakaciu listinu. Faktory, ktoré zvyšovali pravdepodobnosť začatia transplantačného protokolu, boli nižší vek, lepšia telesná konštitúcia a výkonnosť (BMI, svalová sila, krehkosť), autoimunitná etiológia, závažnosť choroby pečene a nižšia miera systémového zápalu (leukocyty, CRP). Faktory, ktoré zvyšovali pravdepodobnosť zapísania na čakaciu listinu, boli mužské pohlavie, lepšia telesná výkonnosť, a závažnosť choroby pečene. Faktory, ktoré zvyšovali pravdepodobnosť vyradenia z čakacej listiny, boli iná ako autoimunitná etiológia, závažnosť choroby pečene a systémový zápal. Prežitie 1 a 3 roky po transplantácii sme zaznamenali u 82,6 a 78,1 % pacientov. Práca poslúži ako dôležitá lekcia z fungovania nastavených procesov s cieľom ďalšieho zefektívnenia a skvalitnenia nášho transplantačného programu.
By analyzing 996 patients from the RH7 cirrhosis registry within the 4.5 years of inclusion interval, we mapped the path of patients to liver transplantation. We found that 283 patients (28.4%) opened a transplant protocol with a median of 4 days from registration, of which 117 (11.7%) were placed on a waiting list with a median of 91 days from the start of the protocol, and 75 (7.5%) were transplanted with a median of 44 days from enlisting. Factors that increased the likelihood of starting a transplant protocol were younger age, better body constitution and performance (BMI, muscle strength, lower frailty), autoimmune etiology, severity of liver disease, and lower levels of systemic inflammation (leukocytes, CRP). Factors that increased the probability of being enrolled on the waiting list were male gender, better physical performance, and severity of liver disease. Factors that increased the probability of removal from the waiting list other than autoimmune etiology, were severity of liver disease and systemic inflammation. Overall survival of one and three years after liver transplantation was 82.6 and 78.1% of patients respectively. The study will serve as an important lesson in the functioning of the set processes to further streamline and improve the quality of our transplant program.
Východisko: Pacienti s cirhózou tvoria nezanedbateľnú časť hospitalizovaných pacientov a sú častokrát opakovane hospitalizovaní. Cieľom našej práce bolo zistiť, čo sa deje s pacientami po prepustení z nemocnice do ambulantnej starostlivosti, ako často sú opakovane hospitalizovaní, akú majú prognózu a aké sú rizikové faktory týchto udalostí. Metódy: Údaje o po sebe nasledujúcich pacientoch hospitalizovaných s komplikáciou cirhózy na V. internej klinike boli zaznamenané do databázy. Sledovali sme demografické, sociálne a základné laboratórne parametre spolu s prognostickými indexami. Zaznamenávali sme mieru prvej udalosti po prepustení do 30 a 90 dní, ktorým mohla byť hospitalizácia alebo úmrtie. Následne sme vyhodnotili mortalitu do 30 a 90 dní podľa prvej udalosti a nakoniec aj rizikové faktory úmrtia a opakovanej hospitalizácie po prepustení. Výsledky: Počas sledovaného obdobia 2 rokov sme zaznamenali údaje o 110 hospitalizovaných pacientov. U všetkých pacientov prebehlo minimálne 6 mesiacov od registrácie do databázy do vyhodnotenia udalostí po prepustení, alebo cenzúry dát. Z celého súboru bolo 54 pacientov (49,1 %) opakovane hospitalizovaných, počet opakovaných hospitalizácií bol od 1 do 8. Ďalej, 27 pacientov (24,5 %) zomrelo bez opakovanej hospitalizácie a 29 pacientov (26,4 %) prežilo sledované obdobie bez opakovanej hospitalizácie. Opakovanú hospitalizáciu do 30 a 90 dní sme zaznamenali u 12 (11 %) a 32 (29,1 %) pacientov. Spomedzi 54 opakovane hospitalizovaných pacientov sme zaznamenali 30 a 90-dňovú mortalitu u 2 (3,7 %) a 9 (16,7 %). Spomedzi 27 pacientov, ktorí zomreli bez opakovanej hospitalizácie, sme zaznamenali 30 a 90-dňovú mortalitu u 16 (59,3 %) a 21 (77,8 %). V multivariantnej analýze pre konkurujúce udalosti počas sledovania (opakovaná hospitalizácia vs. úmrtie) sme zistili, že nezávislým rizikovým faktorom opakovanej hospitalizácie boli akútna alkoholová hepatitída (HR = 0,0), INR (HR = 0,42), počet ľudí žijúcich v domácnosti s pacientom (HR = 1,36), trombocyty (HR = 0,99) a cholelitiáza (HR = 2,51). Nezávislými rizikovými faktormi úmrtia boli MELD-Na skóre (HR = 1,09), CLIF-ACLF skóre (HR = 1,99) a status bezdomovca (HR = 2,99). Záver: Opakovaná hospitalizácia do 1 a 3 mesiacov od prepustenia bola častá, avšak takmer štvrtina pacientov zomrela bez rehospitalizácie. Rizikovými faktormi opakovanej hospitalizácie boli INR, počet ľudí žijúcich v domácnosti s pacientom, trombocyty a cholelitiáza. Pacienti s akútnou alkoholovou hepatitídou boli opakovane hospitalizovaní len raritne.
Background: Patients with cirrhosis make up a non-negligible part of hospitalized patients and are often hospitalized repeatedly. The aim of our work was to find out what happens to patients after being discharged from the hospital to outpatient care, how often they are re-hospitalized, what their prognosis is, and what are the risk factors for these events. Methods: Data on consecutive patients hospitalized with complications of cirrhosis at the V. internal clinic were recorded in the database. We monitored demographic, social and basic laboratory parameters along with prognostic indices. We recorded the rate of the first event after discharge within 30 and 90 days, which could be hospitalization or death. Subsequently, we evaluated mortality within 30 and 90 days according to the first event, and finally also the risk factors of death and repeated hospitalization after discharge. Results: During the monitored period of 2 years, we recorded data on 110 hospitalized patients. For all patients, a minimum of 6 months passed from registration in the database to the evaluation of events after discharge or data censoring. From the whole set, 54 patients (49.1%) were repeatedly hospitalized, the number of repeated hospitalizations was from 1 to 8. Furthermore, 27 patients (24.5%) died without repeated hospitalization and 29 patients (26.4%) survived the observed period without repeated hospitalization. We recorded repeated hospitalization within 30 and 90 days in 12 (11%) and 32 (29.1%) patients. Among 54 repeatedly hospitalized patients, we recorded 30- and 90-day mortality in 2 (3.7%) and 9 (16.7%). Among 27 patients who died without re-hospitalization, we recorded 30- and 90-day mortality in 16 (59.3%) and 21 (77.8%). In multivariate analysis for competing events during follow-up (rehospitalization vs. death), we found that acute alcoholic hepatitis (HR=0.0), INR (HR=0.42), number of people living in the patient's household (HR=1.36), platelets (HR=0.99), and cholelithiasis (HR=2.51) were independent risk factors for rehospitalization. Independent risk factors for death were MELD-Na score (HR=1.09), CLIF-ACLF score (HR=1.99), and homeless status (HR=2.99). Conclusion: Rehospitalization within 1 and 3 months of discharge was common, but nearly a quarter of patients died without rehospitalization. Risk factors for repeated hospitalization were INR, number of people living in the patient's household, platelets and cholelithiasis. Patients with acute alcoholic hepatitis were repeatedly hospitalized only rarely.
Úvod a ciele: Slovensko patrí na popredné priečky v počte odvrátiteľných úmrtí, avšak systematická analýza podielu úmrtí na zhubné nádory (ZN) tráviacej sústavy v posledných rokoch chýbala. V našej práci sme analyzovali údaje o mortalite na ZN tráviacej sústavy za jednu dekádu s dôrazom na predčasné úmrtia, rozdiely medzi pohlaviami a časové trendy pre jednotlivé lokalizácie. Materiál a metódy: Analyzovali sme revidované údaje z rokov 2011–2020 z Národného centra zdravotníckych informácií (NCZI) na kódy diagnóz MKCH-10 C15–C26 agregované podľa vekových podskupín (<50 rokov, <65 rokov, <75 rokov), pohlavia a jednotlivých lokalizácií. Hrubá úmrtnosť bola prepočítaná na 100 tis. obyvateľov, trendy sme analyzovali pomocou lineárnej regresie ako priemernú ročnú percentuálnu zmenu. Výsledky: Spolu sme analyzovali úmrtia u 46 508 prípadov, z toho 27 146 mužov a 19 362 žien v priemernom veku 70,5 ± 11,6 roka. Podiel úmrtí do 50, 65 a 75 rokov zo všetkých úmrtí na ZN tráviacej sústavy tvoril 4,1; 29,8 a 60,4 %. Zo všetkých úmrtí na ZN do 65 rokov života tvorili úmrtia na ZN tráviacej sústavy u mužov jednu tretinu a u žien jednu štvrtinu. V podskupine do 75 rokov dominoval v roku 2020 kolorektálny karcinóm (41 %), nádory pankreasu (21 %), nádory žalúdka (12,8 %) a pečene (10 %). Priemerný vek úmrtia bol u mužov významne nižší ako u žien, a medzi rokmi 2011 a 2020 sa tento vek zvýšil pre všetky lokalizácie. U žien bol trend rovnaký, s výnimkou pečene, IH žlčovodov (pokles o 1 rok), ostatných žlčových ciest a žalúdka (bez zmeny). V podskupine do 65 rokov sme pre všetky lokalizácie spolu zistili priemerný ročný pokles mortality o 1,7 %. U mužov bol pokles v lokalizácii pažerák, žalúdok, kolorektum (–1,8 %/rok), pečeň a žlčník, u žien v lokalizácii kolorektum (–1,8 %/rok) a žlčník (–6 %/rok). Naopak, v celej populácii došlo u oboch pohlaví ku vzostupu úmrtnosti na lokalizáciu pankreas (+2,3 až 2,8 %/rok) a žlčové cesty (+4,4 až 7,3 %/rok). Záver: ZN tráviacej sústavy sú významným bremenom spôsobujúcim úmrtia, ktoré sú odvrátiteľné (a to najmä, ak sa týkajú predčasných úmrtí). Niektoré priaznivé trendy (žalúdok, žlčník) sú súčasne sledované nepriaznivými (žlčové cesty, pankreas). Starnutie populácie a čoraz dlhšia expozícia rizikovým faktorom by mali byť vyvážené zavedením účinných preventívnych opatrení a flexibilnou adaptáciou systémov zdravotnej starostlivosti.
Introduction and objectives: Slovakia ranks among the leaders in preventable deaths, but a systematic analysis of the share of digestive system cancers (DSCs) and their trends has been lacking. We analyzed data on mortality from DSCs in Slovakia in the years 2011–2020 with an emphasis on premature deaths, sex differences, and trends for individual locations. Material and methods: Data in the years 2011–2020 by ICD-10 codes C15–C26 aggregated by age subgroups (<50 years, <65 years, <75 years), sex, and individual locations were available. The crude death rate was calculated per 100,000 inhabitants and linear regression was used for the annual percentage change in mortality. Results: We recorded 46,508 deaths; 27,146 were men and 19,362 women with an average age of 70,5 ±11,6. Deaths under the age of 50, 65, and 75 made up 4.1%, 29.8%, and 60.4% of all deaths from DSCs. Among all deaths due to cancer under the age of 65, deaths from DSCs accounted for one-third in men and one-quarter in women. Under the age of 75, colorectal (41%), pancreatic (21%), stomach (12.8%), and liver (10%) cancers dominated the proportions of locations. The average age of death was significantly lower in men and increased over the decade for all locations. In women, the trend was identical, except for the liver, intrahepatic bile ducts (decrease by 1 year), bile ducts, and stomach (no change). Under the age of 65 in all cases, the average annual mortality rate decreased by 1.7%. In men, it decreased for locations in the esophagus, stomach, colorectum (–1.8%/year), liver, and gallbladder. In women, for colorectum (–1.8%/year) and gallbladder (–6%/year). In contrast, in the entire population mortality increased for locations in the pancreas (+2.3 to 2.8%/year) and bile ducts (+4.4 to 7.3%/year). Conclusion: DSCs are significant burden causing preventable deaths. Some favorable trends (stomach, gall bladder) are simultaneously followed by unfavorable ones (biliary tract, pancreas). In the global context of an aging population and increasingly longer exposure to risk factors, we need to introduce effective societal preventive measures as well as flexible adaptation of our healthcare systems.
- MeSH
- gastrointestinální nádory * mortalita MeSH
- lidé MeSH
- mortalita trendy MeSH
- nádory jater mortalita MeSH
- nádory jícnu mortalita MeSH
- nádory slinivky břišní mortalita MeSH
- nádory žaludku mortalita MeSH
- nádory žlučového ústrojí mortalita MeSH
- střevní nádory mortalita MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Slovenská republika MeSH
Ultra-spracované potraviny (UPF) sa často vyznačujú nízkou nutričnou kvalitou, vysokou energetickou hustotou a prítomnosťou prídavných látok, látok z obalov a zlúčenín, ktoré vznikajú počas výroby, spracovania a skladovania. UPF zahŕňa priemyselné receptúry a zvyčajne obsahuje mnoho zložiek. UPF obsahuje cukor, oleje, tuky, soľ, antioxidanty, stabilizátory a konzervačné látky, potravinárske prísady a emulgátory. Okrem nízkej výživovej hodnoty spracovanie potravín podporuje tvorbu škodlivých zlúčenín v potravinách. Potravinové prísady v rámci UPF, podporujú zápaly, poruchy funkcie pečene a metabolický syndróm, ktoré sú založené na zmenách mikrobiómu. Obezogény sú látky z prostredia, ktoré menia rovnováhu medzi príjmom a výdajom energie. Obezogény sú podskupinou environmentálnych chemických látok, ktoré pôsobia ako endokrinné disruptory ovplyvňujúce koncové metabolické ukazovatele. V posledných desaťročiach sa na celom svete dramaticky zvýšila spotreba ultra-spracovaných výrobkov. UPF sa na priemernom energetickom príjme podieľali viac ako 60 %. Priemerný obsah bielkovín, vlákniny, vitamínov a vápnika v strave výrazne klesá. Energetický príspevok UPF, zatiaľ čo obsah sacharidov, pridaného cukru a nasýtených tukov sa zvyšuje. Ultra-spracované potraviny sa podieľajú na väčšine pridaných cukrov v západnej strave. Fruktóza – najčastejší obezogén, sa spája so zvýšeným rizikom fibrózy pečene. V posledných rokoch pribúdajú dôkazy o škodlivom vplyve UPF. Konzumácia UPF sa spája s metabolickými zmenami, výskytom chronických ochorení a nadmernou úmrtnosťou. Existujú aj dôkazy o súvislosti s NAFLD, NASH a fibrózou. Vysoká spotreba UPF súvisí so škodlivými metabolickými a hepatálnymi parametrami v populácii NAFLD. Okrem toho kombinácia fajčenia a vysokého príjmu UPF môže zosilniť poškodenie pečene. Na základe dôkazov zo štúdií by sa vo výživových usmerneniach malo zvážiť odporúčanie znížiť príjem ultra- -spracovaných potravín na minimum a implementovať opatrenia v oblasti verejného zdravotníctva.
Ultra-processed foods (UPF) are often characterized by low nutritional quality, high energy density, and the presence of additives, substances from packaging, and compounds formed during production, processing, and storage. UPF includes industrial formulations, and usually contains many ingredients. UPF includes sugar, oils, fats, salt, antioxidants, stabilizers and preservatives, food additives, and emulsifiers. Beyond the poor nutritional value, food processing promotes the creation of harmful compounds in the food. Food additives within UPF, promote inflammation, liver dysfunction, and metabolic syndrome, which are based on changes in the microbiome. Obesogens are environmental substances that alter the balance between energy intake and energy expenditure. Obesogens are a subset of environmental chemicals that act as endocrine disruptors affecting metabolic endpoints. The consumption of ultra-processed products has increased dramatically worldwide in the last decades. UPF contributed more than 60% of the mean energy intake. The average content of protein, fiber, vitamins, and calcium in the diet decreases significantly. The roducy contribution of UPFs, while carbohydrate, added sugar, and saturated fat contents increase. Ultra-processed foods contribute most of the added sugars in the western diet. Fructose – the most frequent obesogen, is associated with an increased risk of liver fibrosis. In recent years, there has been growing evidence about the harmful effect of UPF. UPF consumption is associated with metabolic alterations, the incidence of chronic diseases, and excess mortality. There is also evidence for an association with NAFLD, NASH, and fibrosis. High UPF consumption is related to harmful metabolic and hepatic parameters in NAFLD population. Furthermore, the combination of smoking and high UPF intake may amplify liver damage. The evidence from studies, a recommendation to reduce ultra-processed food intake to a minimum should be considered in nutritional guidelines and implemented by public health policy measures.
- MeSH
- lidé MeSH
- metabolický syndrom etiologie MeSH
- nealkoholová steatóza jater * etiologie MeSH
- průmyslově zpracované potraviny * škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Séria dvoch kazuistík rozoberá diferenciálnu diagnostiku nebolestivého ikteru u starších ľudí a poukazuje na autoimunitnú pankreatitídu ako jednu z jeho zriedkavejších príčin. V rámci pátrania po príčine je prvým krokom vylúčenie malígneho pôvodu obštrukcie pomocou klinického obrazu, zobrazovacích vyšetrení, a EUS navigovanou biopsiou. Na možnosť diagnózy autoimunitnej pankreatitídy môže spočiatku upozorniť zobrazovacie vyšetrenie, ale pri fokálnom postihnutí je odlíšenie od nádoru nespoľahlivé. Vyšetrenie protilátok IgG4 môže priblížiť diagnostiku IgG4 asociovanej chronickej pankreatitídy 1. typu. Histologické vyšetrenie pankreasu pomôže odhaliť typické črty autoimunitnej pankreatitídy, ako sú lymfoplazmocytárny infiltrát, storiformná fibróza, obliterujúca flebitída a zvýšený počet IgG4 pozitívnych plazmocytov. Na základe týchto kritérií je možné začať liečbu steroidmi, pričom typickou je rýchla odpoveď v zmysle poklesu cholestatických markerov a bilirubínu. Pacienti s autoimunitnou pankreatitídou vyžadujú dlhodobé sledovanie jednak za účelom úpravy liečby v prípade recidív, pre riziko vývoja exokrinnej a endokrinnej insuficiencie, a v prípade IgG4 asociovanej pankreatitídy aj pre riziko systémového orgánového postihnutia. Zvýšené riziko nádoru pankreasu je stále predmetom diskusií.
A series of two case reports discusses the differential diagnosis of painless jaundice in the elderly and points to autoimmune pancreatitis as one of its rarer causes. In search for the cause, the first step is to rule out the malignant origin of the obstruction using the clinical picture, imaging examinations, and EUS-guided biopsy. An imaging examination can initially point to the possibility of autoimmune pancreatitis, but in the case of focal pancreatic involvement the distinction from cancer is unreliable. Elevated concentration of IgG4 antibodies can further increase the probability of IgG4-associated pancreatitis. Histological examination of the pancreas will help reveal typical features of autoimmune pancreatitis such as lymphoplasmacytic infiltrate, storiform fibrosis, obliterating phlebitis and increased number of IgG4 positive plasma cells. Once the diagnosis is probable, it is advisable to start a treatment with steroids. A quick decrease in cholestatic markers and bilirubin is typical. Patients with autoimmune pancreatitis require long-term follow-up, to adjust the treatment in case of relapses, the risk of developing exocrine or endocrine insufficiency, and in case of IgG4 associated disease due to the risk of other organ systems involvement. The risk of pancreatic cancer is still a matter of discussion.
- MeSH
- autoimunitní pankreatitida diagnóza farmakoterapie MeSH
- biopsie MeSH
- diferenciální diagnóza MeSH
- imunoglobulin G analýza MeSH
- lidé MeSH
- obstrukční žloutenka * diagnóza etiologie farmakoterapie MeSH
- pankreas anatomie a histologie diagnostické zobrazování patologie MeSH
- prednison aplikace a dávkování terapeutické užití MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
BACKGROUND: Alcohol consumption is an important issue. Adverse childhood experiences (ACEs) can affect alcohol consumption later in life. Therefore, the main objective of this study was to test the association between ACE and the alcohol consumption in college students. MATERIALS AND METHODS: A cross-sectional study on college students was conducted during December 2021 and January 2022, Through the school web system, students received a standard questionnaire on alcohol consumption (AUDIT) and ACEs. The study involved 4,044 participants from three universities in Slovakia. RESULT: Compared to men, the incidence of emotional abuse by a parent, physical abuse by a parent, and sexual abuse was significantly higher in women (p < 0.001). Furthermore, women reported greater emotional and physical neglect (p < 0.001). The incidence of a high or very high AUDIT score in college students with ACE-0, ACE-1, ACE-2, ACE-3, and ACE-4+ was 3.8, 4.7, 4.1, 6.4, and 9.3%, respectively. CONCLUSION: More adverse childhood experiences were associated with increased alcohol consumption in both male and female university students. Baseline drinking was higher in male students, but increased drinking in relation to an increase in ACEs was higher in female students. These results point to gender-specific driving forces and targets for intervention.
- Publikační typ
- časopisecké články MeSH
