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ALCOHOL as RISK FACTOR for DUPUYTREN & LEDDERHOSE DISEASE ?!
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08/04/19 18:54
Prof.Seegenschmiedt 
08/04/19 18:54
Prof.Seegenschmiedt 

ALCOHOL as RISK FACTOR for DUPUYTREN & LEDDERHOSE DISEASE ?!

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What do we really know ?

Before the 1950s only a single case was reported in the literature in which the excessive use of alcohol was considered as an aetiological factor for DD. In another study a higher incidence of DD was found among patients of a liver unit for chronic alcoholic patients with cirrhosis of the liver; the had a prevalence of 66% for DD while alcoholic patients without liver cirrhosis had only 27% DD. As other studies in the 1960s confirmed this finding, the belief that alcohol was an aetiological factor became established in the medical community.

Later the knowledge became more diverse: Liver disease was considered as an aetiological factor for DD in patients with epilepsy and long term phenobarbital treatment, which can impair the liver function. In the late 1980s a clinical study examined over 400 patients and found a prevalence between alcoholic patients with and without liver disease. This lead to the conclusion that alcohol rather than liver disease was associated with DD. However, it was noted that in those patients with chronic cirrhotic liver disease, the presence of DD strongly suggested an alcoholic cause, with a 90% positive predictive value.

Thus, it appears nowadays that alcohol has a role in the aetiology of DD, although it is not clear if this relation is only true in alcoholic patients (i.e. with alcohol addiction), or if those who drink more alcohol have a higher incidence of the disease. This hypothesis was examined in a group of Chelsea pensioners during the early 1990s, and it was found that DD was not more common in those persons who drank more alcohol.

In summary, it seems that alcoholic patients (i.e. those with alcohol addiction) have an increased prevalence of DD. However, it should be always remembered that most of those with DD are not alcoholic patients per se. As some recent studies have supported the role for smoking in the aetiology of DD, it has been speculated that heavy smoking - which is more common in alcoholic patients - may explain the high prevalence of DD in this group.

The mechanism whereby alcohol intake is associated with DD is still unclear. Suggestions include negative effects on the local perfusion or circulation in the palm, damage to the subcutaneous fatty tissues which may induce a fibrotic response, and eventually changes in the prostaglandin synthesis, but none of these mechanisms have been clearly established.

Enclosed are a few published clinical studies which address the topic of alcohol consumption ....

(1) A Danish study concluded that alcohol intake and tobacco smoking are independently associated with increased risk of DD and the combination of the two conveys a very large risk.

https://www.ncbi.nlm.nih.gov/pubmed/15485739 - 2004

(2) The outcome of a very large UK study with 97,537 miners seeking compensation for Hand-Arm Vibration Syndrome. The prime determinant of DD prevalence was age; thus, all other factors investigated were corrected for age. There was no statistically significant correlation between years of exposure to vibration and prevalence of DD, but there was a statistically significant association with smoking, alcohol consumption and diabetes mellitus, with the heaviest smokers having an increased odds ratio (OR) of 1.31, the heaviest drinkers (> 22 units a week) an increased OR of 1.59, and patients with diabetes mellitus an increased OR of 1.52 (95% CI 1.30, 1.77).

https://www.ncbi.nlm.nih.gov/pubmed/17950195

(3) The results of a Dutch study showed a high prevalence of the nodular form of DD in The Netherlands. The prevalence increased with age, from 4.9 percent in participants aged 50 to 55 years to 52.6 percent among those aged 76 to 80 years. Men were more often affected (26.4 percent) than women (18.6 percent). Other significant risk factors were previous hand injury, excessive alcohol consumption, familial occurrence of Dupuytren disease, and presence of Ledderhose disease.

https://www.ncbi.nlm.nih.gov/pubmed/23897337

(4) In a large French cohort study, DD in men was associated with high levels of alcohol consumption and exposure to hand-transmitted vibration. It is likely that the same applied to women.

https://www.ncbi.nlm.nih.gov/pubmed/24477316 - 2014

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For all those who enjoy a glass of wine in the evening and don´t want to consider radiation of their hand in the early stage I might have an interesting suggestion .... try to irradiate the bottle or glas of wine before drinking

Cheers, Prof. Seegenschmiedt

Edited 08/04/19 18:57

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08/04/19 20:38
wach 

Administrator

08/04/19 20:38
wach 

Administrator

Re: ALCOHOL as RISK FACTOR for DUPUYTREN & LEDDERHOSE DISEASE ?!

Thank you very much for this detailed overview of the effect of alcohol consumption!

May I add two more literature references:

5) French Researchers (Attali et al.) in 1987 found a strong relation between heavy alcohol consumption and the prevalence of Dupuytren disease https://www.ncbi.nlm.nih.gov/pubmed/3592873

6) a large patient survey of the International Dupuytren Society conducted in 2014/2015 with more than 2,000 patients participating found no influence of moderate alcohol consumption on the Age of Onset of Dupuytren's (prevalence could not be analyzed this being a patient survey). Yet it showed that, on average, for smokers the disease starts 7 years earlier. https://link.springer.com/chapter/10.100...3-319-32199-8_5 .

Lanting et al. (your ref 3) observed a clear influence of relatively moderate alcohol consumption (more than 2 glases of beer or wine per day) on the prevalence of Dupuytren Disease It might be that regular alcohol comsumption makes it more likely to develop Dupuytren's but it might not affect the Age of Onset. But that's speculative needing further investigation.

Wolfgang

08/04/19 21:49
Stefan_K. 
08/04/19 21:49
Stefan_K. 

Re: ALCOHOL as RISK FACTOR for DUPUYTREN & LEDDERHOSE DISEASE ?!

I see a difference between on one side the statistical correlation between more or less heavy drinking and the occurrence of DD, or the age of onset, and on the other side the direct, immediate (yet reversible) effect on nodules and cords described in this discussion. It would be interesting to know after how many glasses of wine this is observed.

08/04/19 21:56
Stefan_K. 
08/04/19 21:56
Stefan_K. 

Re: ALCOHOL as RISK FACTOR for DUPUYTREN & LEDDERHOSE DISEASE ?!

Stefan_K.:
I see a difference between on one side the statistical correlation between more or less heavy drinking and the occurrence of DD, or the age of onset, and on the other side the direct, immediate (yet reversible) effect on nodules and cords described in this discussion. It would be interesting to know after how many glasses of wine this is observed.

For background, I just made the above post in the belief it was in the recent discussion about this topic, to which the OP hinted: https://www.dupuytren-online.info/Forum_...835030_1.html#3
Sorry for any confusion.

Stef

[57, Dupuytren diagnosis 2006, RH contracture and PNF/NA 2014, radiotherapy RH 2015, LH 2017 & 2018, night splint glove RH since 2015]

08/06/19 01:30
Carolynrivers 
08/06/19 01:30
Carolynrivers 
Re: ALCOHOL as RISK FACTOR for DUPUYTREN & LEDDERHOSE DISEASE ?!

I have a question while we’re on the topic of correlations. I do not have a seizure disorder but have been on topamax (topiramate) for about 10 years because of sever migraines. I take 50 mg a day. Could that be impacting my Dupuytren? My contractors are getting extremely bad. I’m not sure I can get off the medication. I also get Botox every 3 months.
I seriously don’t know where to go in the Chicago area for my hand. I’m watching it cramp up before my eyes. I think I’m going to a referral from this forum who recommended a doctor in Peoria. Hard to believe that Chicago wouldn’t have someone. The two doctors I saw were disappointing.

Thank you for your help. Carolyn

08/06/19 09:12
spanishbuddha 

Administrator

08/06/19 09:12
spanishbuddha 

Administrator

Re: ALCOHOL as RISK FACTOR for DUPUYTREN & LEDDERHOSE DISEASE ?!

Carolynrivers:
I have a question while we’re on the topic of correlations. I do not have a seizure disorder but have been on topamax (topiramate) for about 10 years because of sever migraines. I take 50 mg a day. Could that be impacting my Dupuytren? My contractors are getting extremely bad. I’m not sure I can get off the medication. I also get Botox every 3 months.
I seriously don’t know where to go in the Chicago area for my hand. I’m watching it cramp up before my eyes. I think I’m going to a referral from this forum who recommended a doctor in Peoria. Hard to believe that Chicago wouldn’t have someone. The two doctors I saw were disappointing.

Thank you for your help. Carolyn
In Chicago Dr Mathew Scott at the hand center clinic https://www.dupuytrenscenterchicago.com/...-6g0bA-prhVKKbI comes up on the Facebook groups as does Dr Bednar in the Loyola Hospital https://www.loyolamedicine.org/locations...-medical-center. I hope they are not the doctors you have already seen. I’m not aware of a link with topamax, and a quick search didn’t throw anything up. There is a new drug, Erenumab, approved for migraine and you could discuss a trial for that with your GP?

Edited 08/06/19 09:29

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correlation   hand-transmitted   increased   dupuytrenscenterchicago   DUPUYTREN   DISEASE   consumption   Seegenschmiedt   Carolynrivers   disappointing   prostaglandin   aetiological   alcoholic   LEDDERHOSE   statistically   prevalence   ALCOHOL   loyolamedicine   patients   dupuytren-online