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

ABSTRACT: To determine if associations of alcohol consumption with all-cause mortality replicate in discordant monozygotic twin comparisons that control for familial and genetic confounds.A 30-year prospective follow-up.Population-based older Finnish twin cohort.Same-sex twins, aged 24-60?years at the end of 1981, without overt comorbidities, completed questionnaires in 1975 and 1981 with response rates of 89 and 84%. A total of 15,607 twins were available for mortality follow-up from the date of returned 1981 questionnaires to 31?December 2011; 14,787 twins with complete information were analysed.Self-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.Among twins as individuals, high levels of monthly alcohol consumption (??259?g/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.The 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.

SUBMITTER: Sipila P 

PROVIDER: S-EPMC4835818 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature