Drinking and mortality : long-term follow-up of drinking-discordant twin pairs

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http://hdl.handle.net/10138/323307

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Sipila , P , Rose , R J & Kaprio , J 2016 , ' Drinking and mortality : long-term follow-up of drinking-discordant twin pairs ' , Addiction , vol. 111 , no. 2 , pp. 245-254 . https://doi.org/10.1111/add.13152

Title: Drinking and mortality : long-term follow-up of drinking-discordant twin pairs
Author: Sipila, Pyry; Rose, Richard J.; Kaprio, Jaakko
Contributor: University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2016-02
Language: eng
Number of pages: 10
Belongs to series: Addiction
ISSN: 0965-2140
URI: http://hdl.handle.net/10138/323307
Abstract: AimsTo determine if associations of alcohol consumption with all-cause mortality replicate in discordant monozygotic twin comparisons that control for familial and genetic confounds. DesignA 30-year prospective follow-up. SettingPopulation-based older Finnish twin cohort. ParticipantsSame-sex twins, aged 24-60years at the end of 1981, without overt comorbidities, completed questionnaires in 1975 and 1981 with response rates of 89 and 84%. A total of 15607 twins were available for mortality follow-up from the date of returned 1981 questionnaires to 31December 2011; 14787 twins with complete information were analysed. MeasurementsSelf-reported monthly alcohol consumption, heavy drinking occasions (HDO) and alcohol-induced blackouts. Adjustments for age, gender, marital and smoking status, physical activity, obesity, education and social class. FindingsAmong twins as individuals, high levels of monthly alcohol consumption (259g/month) associated with earlier mortality [hazard ratio (HR)=1.63, 95% confidence interval (CI)=1.47-1.81]. That association was replicated in comparisons of all informatively drinking-discordant twin pairs (HR=1.91, 95% CI=1.49-2.45) and within discordant monozygotic (MZ) twin pairs (HR=2.24, 95% CI=1.31-3.85), with comparable effect size. Smaller samples of MZ twins discordant for HDO and blackouts limited power; a significant association with mortality was found for multiple blackouts (HR=2.82, 95% CI=1.30-6.08), but not for HDO. ConclusionsThe associations of high levels of monthly alcohol consumption and alcohol-induced blackouts with increased all-cause mortality among Finnish twins cannot be explained by familial or genetic confounds; the explanation appears to be causal.
Subject: Alcohol drinking
alcoholic intoxication
binge drinking
causality
confounding factors
follow-up studies
mortality
twins
ALCOHOL-USE DISORDERS
ALL-CAUSE MORTALITY
CAUSAL INFERENCE
RISK-FACTORS
CONSUMPTION
DISEASE
METAANALYSIS
BURDEN
ENVIRONMENT
PATTERN
3142 Public health care science, environmental and occupational health
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