Trends in Alcohol-Related Deaths by Sex in the US, 1999-2020

Karaye, Ibraheem M.; Maleki, Nasim; Hassan, Norzaihan; Yunusa, Ismaeel

doi:10.1001/jamanetworkopen.2023.26346

Cited by 17 publications

(7 citation statements)

References 29 publications

(108 reference statements)

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“…The increased drinking among female emerging adults is alarming, in part, because of sex differences in alcohol's distribution and metabolism (McCaul et al, 2019). The higher blood alcohol concentrations attained per an equivalent dose of alcohol in women compared with men contribute to more negative health outcomes (Jones, 2019;Karaye et al, 2023). Thus, heavy-drinking women with AUD are more prone to develop several alcohol-related diseases than their male counterparts including cirrhosis of the liver and cardiomyopathy (McCaul et al, 2019;White, 2020).…”

Section: Introductionmentioning

confidence: 99%

Sex differences in alcohol's effects on fronto‐amygdalar functional connectivity during processing of emotional stimuli

McKenna,

Anthenelli,

Schuckit

2024

Alcohol, Clinical and Experimental Research

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BackgroundAmygdala function underlying emotion processing has been shown to vary with an individuals' biological sex. Expanding upon functional magnetic resonance imaging (fMRI) findings reported previously where a low level of response was the focus, we examined alcohol and sex effects on functional connectivity between the amygdala and other brain regions. The central hypothesis predicted that sex would influence alcohol's effects on frontal‐limbic functional circuits underlying the processing of negative and positive facial emotions.MethodsSecondary analyses were conducted on data from a double‐blind, placebo controlled, within‐subjects, cross‐over study in 54 sex‐matched pairs (N = 108) of 18‐ to 25‐year‐old individuals without an alcohol use disorder at baseline. Participants performed an emotional faces fMRI processing task after placebo or approximately 0.7 mL/kg of ethanol. Psychophysiological interaction analyses examined functional connectivity between the amygdala with other brain regions.ResultsThere were significant alcohol‐by‐sex interactions when processing negatively valenced faces. Whereas intoxicated men exhibited decreased functional connectivity between the amygdala and ventral and dorsal anterior cingulate, angular gyrus, and middle frontal gyrus connectivity was increased in intoxicated women. There was also a main sex effect where women exhibited less functional connectivity in the middle insula than men regardless of whether they received alcohol or placebo. For happy faces, main effects of both sex and alcohol were observed. Women exhibited less amygdala functional connectivity in the right inferior frontal gyrus than men. Both men and women exhibited greater functional connectivity in the superior frontal gyrus in response to alcohol than placebo.ConclusionsAlcohol's effects on amygdala functional circuits that underlying emotional processing vary by sex. Women had higher functional connectivity than men following exposure to a moderate dose of alcohol which could indicate that women are better than men at processing affectively laden stimuli when intoxicated.

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Section: Introductionmentioning

confidence: 99%

Sex differences in alcohol's effects on fronto‐amygdalar functional connectivity during processing of emotional stimuli

McKenna,

Anthenelli,

Schuckit

2024

Alcohol, Clinical and Experimental Research

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“…Alcohol use and alcohol-related deaths increased over the past decade, with mortality rising faster among women than men . Alcohol use complications are highest between the fourth and sixth decades of life, often due to alcohol-related liver disease (ALD) development .…”

Section: Introductionmentioning

confidence: 99%

“…Alcohol use and alcohol-related deaths increased over the past decade, with mortality rising faster among women than men. 1 , 2 Alcohol use complications are highest between the fourth and sixth decades of life, often due to alcohol-related liver disease (ALD) development. 3 , 4 The COVID-19 pandemic was associated with increased alcohol consumption, particularly among women, likely due to social isolation and stress.…”

Section: Introductionmentioning

confidence: 99%

“… 3 , 4 The COVID-19 pandemic was associated with increased alcohol consumption, particularly among women, likely due to social isolation and stress. 5 While several studies have examined differences in alcohol-related hepatitis hospitalizations or alcohol-related mortality in 2020 compared with prior years, 2 , 5 , 6 , 7 , 8 a rigorous analysis of the pandemic’s effect on a broader set of high-acuity alcohol-related complications is lacking. Such analyses could provide granular information about how socially disruptive phenomena such as the COVID-19 pandemic affect alcohol use–related presentations to the health system.…”

Section: Introductionmentioning

confidence: 99%

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High-Acuity Alcohol-Related Complications During the COVID-19 Pandemic

Shuey,

Halbisen,

Lakoma

et al. 2024

JAMA Health Forum

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ImportanceResearch has demonstrated an association between the COVID-19 pandemic and increased alcohol-related liver disease hospitalizations and deaths. However, trends in alcohol-related complications more broadly are unclear, especially among subgroups disproportionately affected by alcohol use.ObjectiveTo assess trends in people with high-acuity alcohol-related complications admitted to the emergency department, observation unit, or hospital during the COVID-19 pandemic, focusing on demographic differences.Design, Setting, and ParticipantsThis longitudinal interrupted time series cohort study analyzed US national insurance claims data using Optum’s deidentified Clinformatics Data Mart database from March 2017 to September 2021, before and after the March 2020 COVID-19 pandemic onset. A rolling cohort of people 15 years and older who had at least 6 months of continuous commercial or Medicare Advantage coverage were included. Subgroups of interest included males and females stratified by age group. Data were analyzed from April 2023 to January 2024.ExposureCOVID-19 pandemic environment from March 2020 to September 2021.Main Outcomes and MeasuresDifferences between monthly rates vs predicted rates of high-acuity alcohol-related complication episodes, determined using claims-based algorithms and alcohol-specific diagnosis codes. The secondary outcome was the subset of complication episodes due to alcohol-related liver disease.ResultsRates of high-acuity alcohol-related complications were statistically higher than expected in 4 of 18 pandemic months after March 2020 (range of absolute and relative increases: 0.4-0.8 episodes per 100 000 people and 8.3%-19.4%, respectively). Women aged 40 to 64 years experienced statistically significant increases in 10 of 18 pandemic months (range of absolute and relative increases: 1.3-2.1 episodes per 100 000 people and 33.3%-56.0%, respectively). In this same population, rates of complication episodes due to alcohol-related liver disease increased above expected in 16 of 18 pandemic months (range of absolute and relative increases: 0.8-2.1 episodes per 100 000 people and 34.1%-94.7%, respectively).Conclusions and RelevanceIn this cohort study of a national, commercially insured population, high-acuity alcohol-related complication episodes increased beyond what was expected in 4 of 18 COVID-19 pandemic months. Women aged 40 to 64 years experienced 33.3% to 56.0% increases in complication episodes in 10 of 18 pandemic months, a pattern associated with large and sustained increases in high-acuity alcohol-related liver disease complications. Findings underscore the need for increased attention to alcohol use disorder risk factors, alcohol use patterns, alcohol-related health effects, and alcohol regulations and policies, especially among women aged 40 to 64 years.

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“…3,4 With recent the rise in alcohol-related liver disease, we should be prepared for a subsequent increase in metabolic bone disease and its complications. 5,6 Furthermore, alternative screening methods for osteoporosis in patients with chronic liver disease should be explored. While DEXA stands as the gold standard to screen for osteoporosis and is able to assess muscle mass, 7 it is not without limitations.…”

mentioning

confidence: 99%