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KMID : 1154920220170010089
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Korean Journal of Insurance Medicine
2022 Volume.17 No. 1 p.89 ~ p.108
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Binge Drinking, Obesity and Markers of Liver Function: using the 2009∼2015 Korean National Health Insurance Service Data
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Kityo Anthony
Lee Sang-Ah
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Abstract
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Background: The combined association of Binge drinking (BD) intensity and obesity are less known. This study aimed to examine the combined influence of binge drinking intensity and obesity on liver function enzymes.
Methods: Data was collected between 2009∼2015 from subscribers of the Korean National Health Insurance Service (KNHIS). The BD intensity was categorized into non-binge drinking, BD level I and high intensity BD (HIBD), and obesity was defined based on body mass index (BMI) and waist circumference. Logistic regression models were fitted to examine the independent and joint association of BD and obesity with elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamate aminotransferase (GGT). The relative excess risk (RERI), the attributable proportion (AP) and synergy index (SI) for the interaction of BD and obesity were computed.
Results: A total of 285,600 Korean citizens was analyzed. The mean age (mean±standard error) was 42.1±0.03, and 50.2% were women. The prevalence of elevated ALT, AST and GGT were 7.9%, 15.3% and 12.5% respectively, and the prevalence of BDI and HIBD was 15.1% and 4.3% respectively. The odds ratios (ORs) and 95% confidence intervals of elevated ALT (OR 1.50, 95% CI 1.40∼1.60), AST (OR 1.54, 95% CI 1.47∼1.61), and GGT (OR 2.34, 95% CI 1.23∼2.48) were observed among HIBD compared to non-BD. In addition, the odds of elevated ALT (OR 3.57, 95% CI 3.43∼3.71), AST (OR 3.47, 95% CI 3.37∼3.58) and GGT (OR 2.10, 95% CI 1.98∼2.12) were observed among individuals with obesity. Individuals with abdominal obesity aslo had higher odds of elevated AST (OR 2.70, 95% CI 2.62∼ 2.78), AST (OR 2.64, 95% CI 2.58∼2.71) and GGT (OR 1.83, 95% CI 1.78∼1.89). The RERI, AP and SI, respectively, for the interaction effect of HIBD and obesity were 23%, 7% and 13% for elevated ALT and 67%, 24% and 8% for elevated GGT. Similar findings were replicated with abdominal obesity. The RERI, AP and SI, respectively, for the interaction effect of HIBD and abdominal obesity were 25%, 10% and 13% for elevated ALT and 79%, 24% and 56% for elevated GGT.
Conclusion: Obesity aggravated the odds of elevated liver AST and GGT among high intensity binge drinkers in Korea. The effects of obesity and high risk drinking on hepatic disease morbidity and mortality require further investigation in order to inform guidelines for liver disease prevention.
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KEYWORD
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obesity, binge drinking, liver enzymes, logistic regression, interaction
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