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Interaction of alcohol intake and cofactors on the risk of cirrhosis

Authors

  • Tommaso Stroffolini,

    1. Department of Infectious and Tropical Diseases, Policlinico Umberto I, Rome, Italy
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  • Gaetano Cotticelli,

    1. Division of Gastroenterology and Hepatology, Department of Clinical and Experimental Internal Medicine ‘F. Magrassi & A. Lanzara- Interuniversity Centre on Foods, Nutrition and Gastrointestinal Tract (CIRANAD) Second University of Naples, Naples, Italy
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  • Emanuela Medda,

    1. National Institute of Health, Rome, Italy
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  • Marco Niosi,

    1. Division of Gastroenterology and Hepatology, Department of Clinical and Experimental Internal Medicine ‘F. Magrassi & A. Lanzara- Interuniversity Centre on Foods, Nutrition and Gastrointestinal Tract (CIRANAD) Second University of Naples, Naples, Italy
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  • Camillo Del Vecchio-Blanco,

    1. Division of Gastroenterology and Hepatology, Department of Clinical and Experimental Internal Medicine ‘F. Magrassi & A. Lanzara- Interuniversity Centre on Foods, Nutrition and Gastrointestinal Tract (CIRANAD) Second University of Naples, Naples, Italy
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  • Giovanni Addolorato,

    1. AISF-SIA National Group:Vonghia L (Rome), Volpe M (Pesaro), Lomazzo D (Bari), D'Avola D (Rome), Caputo F (Bologna), Cottone C (Palermo), Scaglioni F (Modena), Pontoriero L (Lamezia Terme)
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  • Enzo Petrelli,

    1. AISF-SIA National Group:Vonghia L (Rome), Volpe M (Pesaro), Lomazzo D (Bari), D'Avola D (Rome), Caputo F (Bologna), Cottone C (Palermo), Scaglioni F (Modena), Pontoriero L (Lamezia Terme)
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  • Maria T. Salerno,

    1. AISF-SIA National Group:Vonghia L (Rome), Volpe M (Pesaro), Lomazzo D (Bari), D'Avola D (Rome), Caputo F (Bologna), Cottone C (Palermo), Scaglioni F (Modena), Pontoriero L (Lamezia Terme)
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  • Antonio Picardi,

    1. AISF-SIA National Group:Vonghia L (Rome), Volpe M (Pesaro), Lomazzo D (Bari), D'Avola D (Rome), Caputo F (Bologna), Cottone C (Palermo), Scaglioni F (Modena), Pontoriero L (Lamezia Terme)
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  • Mauro Bernardi,

    1. AISF-SIA National Group:Vonghia L (Rome), Volpe M (Pesaro), Lomazzo D (Bari), D'Avola D (Rome), Caputo F (Bologna), Cottone C (Palermo), Scaglioni F (Modena), Pontoriero L (Lamezia Terme)
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  • Piero Almasio,

    1. AISF-SIA National Group:Vonghia L (Rome), Volpe M (Pesaro), Lomazzo D (Bari), D'Avola D (Rome), Caputo F (Bologna), Cottone C (Palermo), Scaglioni F (Modena), Pontoriero L (Lamezia Terme)
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  • Stefano Bellentani,

    1. AISF-SIA National Group:Vonghia L (Rome), Volpe M (Pesaro), Lomazzo D (Bari), D'Avola D (Rome), Caputo F (Bologna), Cottone C (Palermo), Scaglioni F (Modena), Pontoriero L (Lamezia Terme)
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  • Lorenzo A. Surace,

    1. AISF-SIA National Group:Vonghia L (Rome), Volpe M (Pesaro), Lomazzo D (Bari), D'Avola D (Rome), Caputo F (Bologna), Cottone C (Palermo), Scaglioni F (Modena), Pontoriero L (Lamezia Terme)
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  • Carmela Loguercio

    1. Division of Gastroenterology and Hepatology, Department of Clinical and Experimental Internal Medicine ‘F. Magrassi & A. Lanzara- Interuniversity Centre on Foods, Nutrition and Gastrointestinal Tract (CIRANAD) Second University of Naples, Naples, Italy
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Correspondence
C. Loguercio, Department of Clinical and Experimental Medicine ‘F. Magrassi & A. Lanzara’, Interuniversity Centre for Foods, Nutrition and Gastrointestinal Tract (CIRANAD), Second University of Naples, via Pansini 5, Building 3, 80100 Naples, Italy
Tel: +390815666708
Fax: +390815666837
e-mail: gaetano.cotticelli@unina2.it

Abstract

Objective: Evaluation of the interaction between alcohol intake and cofactors [hepatitis B virus (HBV), hepatitis C virus (HCV), body mass index] and coffee consumption on the risk of cirrhosis.

Design: Seven hundred and forty-nine consecutive patients with chronic liver disease referring to units for liver or alcohol diseases in Italy during a 6-months period. Teetotalers were excluded. The odds ratios (OR) for cirrhosis were evaluated using chronic hepatitis cases as the control group.

Results: An alcohol intake of more than 3 units/day resulted associated with the likelihood of cirrhosis both in males (OR 4.3; 95% CI=2.5–7.3) and in females (OR 5.7; 95% CI=2.3–14.5). A multiplicative interaction on the risk of cirrhosis between risky alcohol intake and HBsAg or HCV-Ab/HCV-RNA positivity was observed. A reduction of cirrhosis risk was observed in subjects consuming more than 3 alcohol units/day with increasing coffee intake. The OR for the association with cirrhosis decreased from 2.3 (95% CI=1.2–4.4) in subjects drinking 0–2 cups of coffee/day to 1.4 (95% CI=0.6–3.6) in those drinking more than 2 cups/day.

Conclusions: In subjects with an alcohol intake >3 units/day the coexistence of HBV or HCV multiplies the risk of cirrhosis. Coffee represents a modulator of alcoholic cirrhosis risk.

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