Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

作     者：Bryazka, Dana Reitsma, Marissa B. Griswold, Max G. Abate, Kalkidan Hassen Abbafati, Cristiana Abbasi-Kangevari, Mohsen Abbasi-Kangevari, Zeinab Abdoli, Amir Abdollahi, Mohammad Abdullah, Abu Yousuf Md Abhilash, E. S. Abu-Gharbieh, Eman Acuna, Juan Manuel Addolorato, Giovanni Adebayo, Oladimeji M. Adekanmbi, Victor Adhikari, Kishor Adhikari, Sangeet Adnani, Qorinah Estiningtyas Sakilah Afzal, Saira Agegnehu, Wubetu Yimam Aggarwal, Manik Ahinkorah, Bright Opoku Ahmad, Araz Ramazan Ahmad, Sajjad Ahmad, Tauseef Ahmadi, Ali Ahmadi, Sepideh Ahmed, Haroon Rashid, Tarik Ahmed Akunna, Chisom Joyqueenet Al Hamad, Hanadi Alam, Md Zakiul Alem, Dejene Tsegaye Alene, Kefyalew Addis Alimohamadi, Yousef Alizadeh, Atiyeh Allel, Kasim Alonso, Jordi Alvand, Saba Alvis-Guzman, Nelson Amare, Firehiwot Ameyaw, Edward Kwabena Amiri, Sohrab Ancuceanu, Robert Anderson, Jason A. Andrei, Catalina Liliana Andrei, Tudorel Arabloo, Jalal Arshad, Muhammad Artamonov, Anton A. Aryan, Zahra Asaad, Malke Asemahagn, Mulusew A. Astell-Burt, Thomas Athari, Seyyed Shamsadin Atnafu, Desta Debalkie Atorkey, Prince Atreya, Alok Ausloos, Floriane Ausloos, Marcel Ayano, Getinet Ayanore, Martin Amogre Ayinde, Olatunde O. Ayuso-Mateos, Jose L. Azadnajafabad, Sina Azanaw, Melkalem Mamuye Azangou-Khyavy, Mohammadreza Jafari, Amirhossein Azari Azzam, Ahmed Y. Badiye, Ashish D. Bagheri, Nasser Bagherieh, Sara Bairwa, Mohan Bakkannavar, Shankar M. Bakshi, Ravleen Kaur Balchut-Bilchut, Awraris Hailu Barra, Fabio Barrow, Amadou Baskaran, Pritish Belo, Luis Bennett, Derrick A. Bensenor, Isabela M. Bhagavathula, Akshaya Srikanth Bhala, Neeraj Bhalla, Ashish Bhardwaj, Nikha Bhardwaj, Pankaj Bhaskar, Sonu Bhattacharyya, Krittika Bhojaraja, Vijayalakshmi S. Bintoro, Bagas Suryo Blokhina, Elena A. Elena Bodicha, Belay Boda Abule Boloor, Archith Bosetti, Cristina Braithwaite, Dejana Brenner, Hermann Briko, Nikolay Ivanovich Brunoni, Andre R. Butt, Zahid A. Cao, Chao Cao, Yin Cardenas, Rosario Carvalho, Andre F. Carvalho, Marcia Castaldelli-Maia, Joao Mauricio Castelpietra, Giulio Castro-de-Araujo, Luis F. S. Cattaruzza, Maria Sofia Chakraborty, Promit Ananyo Charan, Jaykaran Chattu, Vijay Kumar Chaurasia, Akhilanand Cherbuin, Nicolas Chu, Dinh-Toi Chudal, Nandita Chung, Sheng-Chia Churko, Chuchu Ciobanu, Liliana G. Cirillo, Massimo Claro, Rafael M. Costanzo, Simona Cowden, Richard G. Criqui, Michael H. Cruz-Martins, Natalia Culbreth, Garland T. Dachew, Berihun Assefa Dadras, Omid Dai, Xiaochen Damiani, Giovanni Dandona, Lalit Dandona, Rakhi Daniel, Beniam Darge Danielewicz, Anna Gela, Jiregna Darega Davletov, Kairat Paiva de Araujo, Jacyra Azevedo De Sa-Junior, Antonio Reis Debela, Sisay Abebe Dehghan, Azizallah Demetriades, Andreas K. Molla, Meseret Derbew Desai, Rupak Desta, Abebaw Alemayehu da Silva, Diana Dias Diaz, Daniel Digesa, Lankamo Ena Diress, Mengistie Dodangeh, Milad Dongarwar, Deepa Dorostkar, Fariba Dsouza, Haneil Larson Duko, Bereket Duncan, Bruce B. Edvardsson, Kristina Ekholuenetale, Michael Elgar, Frank J. Elhadi, Muhammed Elmonem, Mohamed A. Endries, Aman Yesuf Eskandarieh, Sharareh Etemadimanesh, Azin Fagbamigbe, Adeniyi Francis Fakhradiyev, Ildar Ravisovich Farahmand, Fatemeh Farinha, Carla Sofia e Sa Faro, Andre Farzadfar, Farshad Fatehizadeh, Ali Fauk, Nelsensius Klau Feigin, Valery L. Feldman, Rachel Feng, Xiaoqi Fentaw, Zinabu Ferrero, Simone Desideri, Lorenzo Ferro Filip, Irina Fischer, Florian Francis, Joel Msafiri Franklin, Richard Charles Gaal, Peter Andras Gad, Mohamed M. Gallus, Silvano Galvano, Fabio Ganesan, Balasankar Garg, Tushar Gebrehiwot, Mesfin Gebrehiwot Damtew Gebremeskel, Teferi Gebru Gebremichael, Mathewos Alemu Gemechu, Tadele Regasa Getacher, Lemma Getachew, Motuma Erena Obsa, Abera Getachew Getie, Asmare Ghaderi, Amir Ghafourifard, Mansour Ghajar, Alireza Ghamari, Seyyed-Hadi Ghandour, Lilian A. Nour, Mohammad Ghasemi Ghashghaee, Ahmad Ghozy, Sherief Glozah, Franklin N. Glushkova, Ekaterina Vladimirovna Godos, Justyna Goel, Amit Goharinezhad, Salime Golechha, Mahaveer Goleij, Pouya Golitaleb, Mohamad Greaves, Felix Grivna, Michal Grosso, Giuseppe Gudayu, Temesgen Worku Gupta, Bhawna Gupta, Rajeev Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Hafezi-Nejad, Nima Haj-Mirzaian, Arvin Hall, Brian J. Halwani, Rabih Handiso, Tiilahun Beyene Hankey, Graeme J. Hariri, Sanam Haro, Josep Maria Hasaballah, Ahmed I. Hassanian-Moghaddam, Hossein Hay, Simon I. Hayat, Khezar Heidari, Golnaz Heidari, Mohammad Hendrie, Delia Herteliu, Claudiu Heyi, Demisu Zenbaba Hezam, Kamal Hlongwa, Mbuzeleni Mbuzeleni Holla, Ramesh Hossain, Md Mahbub Hossain, Sahadat Hosseini, Seyed Kianoosh Hosseinzadeh, Mehdi Hostiuc, Mihaela Hostiuc, Sorin Hu, Guoqing Huang, Junjie Hussain, Salman Ibitoye, Segun Emmanuel Ilic, Irena M. Ilic, Milena D. Immurana, Mustapha Irham, Lalu Muhammad Islam, M. Mofizul Islam, Rakibul M. Islam, Sheikh Mohammed Shariful Iso, Hiroyasu Itumalla, Ramaiah Iwagami, Masao Jabbarinejad, Roxana Jacob, Louis Jakovljevic, Mihajlo Jamalpoor, Zahra Jamshidi, Elham Jayapal, Sathish Kumar Jayarajah, Umesh Umesh Jayawardena, Ranil Jebai, Rime Jeddi, Seyed Ali Jema, Alelign Tasew Jha, Ravi Prakash Jindal, Har Ashish Jonas, Jost B. Joo, Tamas Joseph, Nitin Joukar, Farahnaz Jozwiak, Jacek Jerzy Jurisson, Mikk Kabir, Ali Kabthymer, Robel Hussen Kamble, Bhushan Dattatray Kandel, Himal Kanno, Girum Gebremeskel Kapoor, Neeti Karaye, Ibraheem M. Karimi, Salah Eddin Kassa, Bekalu Getnet Kaur, Rimple Jeet Kayode, Gbenga A. Keykhaei, Mohammad Khajuria, Himanshu Khalilov, Rovshan Khan, Imteyaz A. Khan, Moien A. B. Kim, Hanna Kim, Jihee Kim, Min Seo Kimokoti, Ruth W. Kivimaki, Mika Klymchuk, Vitalii Knudsen, Ann Kristin Skrindo Kolahi, Ali-Asghar Korshunov, Vladimir Andreevich Koyanagi, Ai Krishan, Kewal Krishnamoorthy, Yuvaraj Kumar, G. Anil Kumar, Narinder Kumar, Nithin Ben Lacey Lallukka, Tea Lasrado, Savita Lau, Jerrald Lee, Sang-woong Lee, Wei-Chen Lee, Yo Han Lim, Lee-Ling Lim, Stephen S. Lobo, Stany W. Lopukhov, Platon D. Lorkowski, Stefan Lozano, Rafael Lucchetti, Giancarlo Madadizadeh, Farzan Madureira-Carvalho, Aurea M. Mahjoub, Soleiman Mahmoodpoor, Ata Mahumud, Rashidul Alam Makki, Alaa Malekpour, Mohammad-Reza Manjunatha, Narayana Mansouri, Borhan Mansournia, Mohammad Ali Martinez-Raga, Jose Martinez-Villa, Francisco A. Matzopoulos, Richard Maulik, Pallab K. Mayeli, Mahsa McGrath, John J. Meena, Jitendra Kumar Nasab, Entezar Mehrabi Menezes, Ritesh G. Mensink, Gert B. M. Mentis, Alexios-Fotios A. Meretoja, Atte Merga, Bedasa Taye Mestrovic, Tomislav Jonasson, Junmei Miao Miazgowski, Bartosz de Sa, Ana Carolina Micheletti Gomide Nogueira Miller, Ted R. Mini, G. K. Mirica, Andreea Mirijello, Antonio Mirmoeeni, Seyyedmohammadsadeq Mirrakhimov, Erkin M. Misra, Sanjeev Moazen, Babak Mobarakabadi, Maryam Moccia, Marcello Mohammad, Yousef Mohammadi, Esmaeil Mohammadian-Hafshejani, Abdollah Mohammed, Teroj Abdulrahman Moka, Nagabhishek Mokdad, Ali H. Momtazmanesh, Sara Moradi, Yousef Mostafavi, Ebrahim Mubarik, Sumaira Mullany, Erin C. Mulugeta, Beemnet Tekabe Murillo-Zamora, Efren Murray, Christopher J. L. Mwita, Julius C. Naghavi, Mohsen Naimzada, Mukhammad David Nangia, Vinay Nayak, Biswa Prakash Negoi, Ionut Negoi, Ruxandra Irina Nejadghaderi, Seyed Aria Nepal, Samata Neupane, Sudan Prasad Prasad Kandel, Sandhya Neupane Nigatu, Yeshambel T. Nowroozi, Ali Nuruzzaman, Khan M. Nzoputam, Chimezie Igwegbe Obamiro, Kehinde O. Ogbo, Felix Akpojene Oguntade, Ayodipupo Sikiru Okati-Aliabad, Hassan Olakunde, Babayemi Oluwaseun Oliveira, Glaucia Maria Moraes Bali, Ahmed Omar Omer, Emad Ortega-Altamirano, Doris V. Otoiu, Adrian Otstavnov, Stanislav S. Oumer, Bilcha Mahesh, P. A. Padron-Monedero, Alicia Palladino, Raffaele Pana, Adrian Panda-Jonas, Songhomitra Pandey, Anamika Pandey, Ashok Pardhan, Shahina Parekh, Tarang Park, Eun-Kee Parry, Charles D. H. Kan, Fatemeh Pashazadeh Patel, Jay Pati, Siddhartha Patton, George C. Paudel, Uttam Pawar, Shrikant Peden, Amy E. Petcu, Ionela-Roxana Phillips, Michael R. Pinheiro, Marina Plotnikov, Evgenii Pradhan, Pranil Man Singh Prashant, Akila Quan, Jianchao Radfar, Amir Rafiei, Alireza Raghav, Pankaja Raghav Rahimi-Movaghar, Vafa Rahman, Azizur Rahman, Md Mosfequr Rahman, Mosiur Rahmani, Amir Masoud Rahmani, Shayan Ranabhat, Chhabi Lal Ranasinghe, Priyanga Rao, Chythra R. Rasali, Drona Prakash Rashidi, Mohammad-Mahdi Ratan, Zubair Ahmed Rawaf, David Laith Rawaf, Salman Rawal, Lal Renzaho, Andre M. N. Rezaei, Negar Rezaei, Saeid Rezaeian, Mohsen Riahi, Seyed Mohammad Romero-Rodriguez, Esperanza Roth, Gregory A. Rwegerera, Godfrey M. Saddik, Basema Sadeghi, Erfan Sadeghian, Reihaneh Saeed, Umar Saeedi, Farhad Sagar, Rajesh Sahebkar, Amirhossein Sahoo, Harihar Sahraian, Mohammad Ali Saif-Ur-Rahman, K. M. Salahi, Sarvenaz Salimzadeh, Hamideh Samy, Abdallah M. Sanmarchi, Francesco Santric-Milicevic, Milena M. Sarikhani, Yaser Sathian, Brijesh Saya, Ganesh Kumar Sayyah, Mehdi Schmidt, Maria Ines Schutte, Aletta Elisabeth Schwarzinger, Michael Schwebel, David C. Seidu, Abdul-Aziz Kumar, Nachimuthu Senthil SeyedAlinaghi, SeyedAhmad Seylani, Allen Sha, Feng Shahin, Sarvenaz Shahraki-Sanavi, Fariba Shahrokhi, Shayan Shaikh, Masood Ali Shaker, Elaheh Shakhmardanov, Murad Ziyaudinovich Shams-Beyranvand, Mehran Sheikhbahaei, Sara Sheikhi, Rahim Ali Shetty, Adithi Shetty, Jeevan K. Shiferaw, Damtew Solomon Shigematsu, Mika Shiri, Rahman Shirkoohi, Reza Shivakumar, K. M. Shivarov, Velizar Shobeiri, Parnian Shrestha, Roman Sidemo, Negussie Boti Sigfusdottir, Inga Dora Santos Silva, Diego Augusto da Silva, Natacha Torres Singh, Jasvinder A. Singh, Surjit Skryabin, Valentin Yurievich Skryabina, Anna Aleksandrovna Sleet, David A. Solmi, Marco Solomon, Yonatan Song, Suhang Song, Yimeng Sorensen, Reed J. D. Soshnikov, Sergey Soyiri, Ireneous N. Stein, Dan J. Subba, Sonu Hangma Szocska, Miklos Tabares-Seisdedos, Rafael Tabuchi, Takahiro Taheri, Majid Tan, Ker-Kan Tareke, Minale Tarkang, Elvis Enowbeyang Temesgen, Gebremaryam Temesgen, Worku Animaw Temsah, Mohamad-Hani Thankappan, Kavumpurathu Raman Thapar, Rekha Thomas, Nikhil Kenny Tiruneh, Chalachew Todorovic, Jovana Torrado, Marco Touvier, Mathilde Tovani-Palone, Marcos Roberto Mai Thi Ngoc Tran Trias-Llimos, Sergi Tripathy, Jaya Prasad Vakilian, Alireza Valizadeh, Rohollah Varmaghani, Mehdi Varthya, Shoban Babu Vasankari, Tommi Juhani Vos, Theo Wagaye, Birhanu Waheed, Yasir Walde, Mandaras Tariku Wang, Cong Wang, Yanzhong Wang, Yuan-Pang Westerman, Ronny Wickramasinghe, Nuwan Darshana Wubetu, Abate Dargie Xu, Suowen Yamagishi, Kazumasa Yang, Lin Yesera, Gesila Endashaw E. Yigit, Arzu Yigit, Vahit Yimaw, Ayenew Engida Ayenew Engida Yon, Dong Keon Yonemoto, Naohiro Yu, Chuanhua Zadey, Siddhesh Zahir, Mazyar Zare, Iman Zastrozhin, Mikhail Sergeevich Zastrozhina, Anasthasia Zhang, Zhi-Jiang Zhong, Chenwen Zmaili, Mohammad Zuniga, Yves Miel H. Gakidou, Emmanuela 

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Arabia 

出 版 物：《LANCET》 (柳叶刀)

年 卷 期：2022年第400卷第10347期

页      面：185-235页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：Bill & Melinda Gates Foundation 

摘      要：Background The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0.603 (0.400-1.00) standard drinks per day, and the NDE varied between 0.002 (0-0) and 1.75 (0.698-4.30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0.114 (0-0.403) to 1.87 (0.500-3.30) standard drinks per day and an NDE that ranged between 0.193 (0-0.900) and 6.94 (3.40-8.30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59.1% (54.3-65.4) were aged 15-39 years and 76.9% (7.0-81.3) were male. Interpretation There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable