Alcohol Abuse and Alcoholism in China

Jian-Hui Liang MD, Ph.D

National Institute on Drug Dependence

Peking University, Beijing, 100083, P.R.China

China has a long history of drinking alcohol

Drinking alcohol in Chinese society acts as a “bridge” in inter-personal communication

With the rapid development of economy, the production and consumption of alcohol in China have greatly increased

Epidemiology on alcohol abuse

in China

23513 subjects in six regions of Chin

a were investigated

DSM- -R criteria and structural quⅢestionairs were used

The drinking-related subjects were divided into three groups:

Alcohol intoxication in the past six months Problem drinking subjects Alcohol dependence subjects

Prevalence of alcohol intoxication in the past six months

The total : 2.637% ( 620/23513 )

The male : 5.162% ( 618/11972 )

The female : 0.017% ( 2/11541 )

The male > the female

Problem drinking prevalence

The total : 7.03% ( 1653/23513 )

The male : 13.6% ( 1629/11972 )

The female : 0.208% ( 24/11541 )

The male > the female

Alcohol dependence prevalence

The total : 3.428% ( 806/23513 )

The male : 6.632% ( 794/11972 )

The female : 0.104% ( 12/11541 )

The male > the female

Comparison of alcohol dependence between 1982 and 1998

0

1

2

3

4

3.428%

0.018%

Pre

vale

nce

of a

lcoh

olde

pend

ence

(%

)

1982 1998

Alcohol-related damage

in alcohol dependence subjects

Physical damage

Gastrointestinal disorders 18.9% Sexual dysfunction 7.3 % Liver diseases 6.1 % Cardiovascular diseases 5.8 % Chronic pancreatitis 3.9 % Peripheral neuropathy 2.0 %

Social damage

Marital and family tension 57.8% Co-worker’s tension 49.0% Accidents 17.5% Violent behavior 16.9% Unemployment 7.3%

Alcohol-related psychiatric disorders Acute intoxication 2.637% Alcoholic withdrawal syndrome 0.434% Delirium tremens 0.043% Dementia 0.072% Amnesia 0.128% Personal disorders 0.119% Alcoholic hallucinosis 0.077%

Summary ( )Ⅰ The total prevalence of alcohol dependence

in Chinese population : 3.428% Physical damage :

gastrointestinal disorders (18.9%) Social damage:

marital and family tension (57.8%) Mental damage:

acute alcohol intoxication (2.637%)

Alcohol drinking behavior

in Chinese adolescents

Comparison of drinking alcohol over the past month in the students of different

schools

0

10

20

30

40

50

60

70

80

90

100

42.6%

63.8%

42.0%

58.5%

26.8%

39.9%

occupational school

Highschool

Middleschool

Dri

nkin

g p

rop

ort

ion

(%

) Male Female

Comparison of drinking alcohol in the past month in the students of different schools

0

10

20

30

40

50

15.8%

29.2%

12.7%

24.6%

9.1%

14.8%

occupational school

Highschool

Middleschool

Dri

nkin

g p

rop

ort

ion

(%

) Male Female

Comparison of drinking alcohol to intoxication in the past month in the students of different schools

0

2

4

6

8

10

12

4.9%

10.5%

3.1%

5.7%

2.0%

4.7%

occupational school

Highschool

Middleschool

Dri

nki

ng

pro

po

rtio

n (

%)

Male Female

Summary ( )Ⅱ

The students in occupational schools are the most important target crew to control drinking alcohol behavior.

Alcohol dependence and

gene-related polymorphism

in Chinese population

Ethanol

Acetaldehyde

Acetate

*ADH : alcohol dehydrogenase

**ALDH : acetaldehyde dehydrogenase

ADH *

ALDH **

The phenotype of ADH geneADH1ADH2 ( polymorphism )ADH3 ( polymorphism )ADH4ADH5

The phenotype of ALDH geneALDH1ALDH2 ( polymorphism )

Alcohol dependence and ADH polymorphism in Han ethnic group

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0.1150.083

0.8850.917

0.567

0.677

0.433

0.323

ADH3/2ADH3/1ADH2/2ADH2/1

Alle

le

fre

qu

en

cy

of

AD

H Normal contral Alcohol dependence

Alcohol dependence and ALDH polymorphism in Han ethnic group

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0.019

0.229

0.981

0.771

ALDH2/2ALDH2/1

Alle

le f

requ

ency

of

ALD

H Normal contral Alcohol dependence

P < 0.01

Alcohol dependence and ADH polymorphism in Mongolian ethnic group

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0.1940.160

0.806

0.900

0.403

0.6290.597

0.371

ADH3/2ADH3/1ADH2/2ADH2/1

Alle

le

fre

qu

en

cy

of

AD

H Normal contral Alcohol dependence

P < 0.01

Alcohol dependence and ALDH polymorphism in Mongolian ethnic group

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0.0320.086

0.9680.914

ALDH2/2ALDH2/1

Alle

le f

requ

ency

of

ALD

H

Normal contral Alcohol dependence

Alcohol dependence and ADH polymorphism in Korea ethnic group

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0.100.05

0.900.95

0.680.71

0.320.29

ADH3/2ADH3/1ADH2/2ADH2/1

Alle

le

fre

qu

en

cy

of

AD

H

Normal contral Alcohol dependence

Alcohol dependence and ALDH polymorphism in Korea ethnic group

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0.05

0.36

0.95

0.64

ALDH2/2ALDH2/1

Alle

le f

requ

ency

of

ALD

H

Normal contral Alcohol dependence

P < 0.01

Alcohol dependence and ADH polymorphism in Elunchun ethnic group

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0.32

0.14

0.68

0.86

0.340.38

0.660.62

ADH3/2ADH3/1ADH2/2ADH2/1

Alle

le

fre

qu

en

cy

of

AD

H

Normal contral Alcohol dependence

P < 0.01

Alcohol dependence and ALDH polymorphism in Elunchun ethnic group

-0.1

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0

0.08

1.000.92

ALDH2/2ALDH2/1

Alle

le

fre

qu

en

cy

of

AL

DH

Normal contral Alcohol dependence

P < 0.05

Correlation between alcohol dependence and ADH/ALDH genes in different ethnic population of China

Ethnic group ADH ALDH

Han _ ALDH2

Mongolian ADH2 _

Korea _ ALDH2

Elunchun ADH3 ALDH2

Conclusion

Alcohol abuse and alcoholism in

China have increasingly become a

very serious social and important

public health problem.

AcknowledgementA/Prof. Xian-xiang Lv

Ms Rong Han

Ms Yan-ping Sun

Prof. Wei Hao

Prof. Yu-cun Shen

A/Prof. Jian-hua Fang

Dr. Feng Wei

Dr. Chun-yan Luo

Thank you for your attentionThank you for your attention