(ALDH2 polymorphism檢測潛力) 酒精不耐症全球5.6億人 (台灣~50%/日本40%/大陸35%/南韓25%)

5成國人酒精不耐症 當心酒害 2018-03-18 00:01聯合報 記者陳雨鑫／台北報導 研究顯示，台灣有45％到49％的人有酒精不耐症，罹病比率為全球最高，患者一周內最多只能攝取純酒精20毫升，等於500毫升啤酒或一杯紅酒，飲用超量，身體無法代謝，增加罹癌風險。美國史丹佛大學醫學院高級研究員陳哲宏呼籲，政府應該建立「酒害防制法」，保護國人健康。陳哲宏表示，酒精不耐症是指體內缺乏幫助酒精代謝的「ALDH2 酵素」。調查顯示，除台灣，日本有40％民眾有酒精不耐症、大陸35％、南韓25％，全球罹患此症者約5億6000多萬人，幾乎都是華人，為東南亞地區特殊疾病。研究顯示，酒精不耐症患者喝酒一旦過量，體內就會累積酒精而無法代謝，未來罹患口腔癌、食道癌風險是一般人的100倍，女性罹患乳癌機率也比一般人高，也增加大腸直腸癌機率。世界衛生組織於2007年將酒精轉化的乙醛列為一級致癌物，近期也有報告顯示，酒精是失智症危險因子之一。陳哲宏表示，國人對「不耐症」會迷思，誤以為不斷喝，對抗它、就可以戰勝它，這是錯誤觀念，酒精不耐症與體內缺乏ALDH2酵素有關，並非多喝酒就可以克服。陳哲宏說，若飲酒後臉紅，有70％的機率是酒精不耐症，民眾也能將OK蹦塗上濃度70％酒精，貼在皮膚上約10到15分鐘，若皮膚變紅，就是酒精不耐症的患者；若想精確知道是否為患者，有醫院可提供相關基因檢查，每次要價約2000元。陳哲宏呼籲政府正視相關酒精防治，台灣已經有菸害防制法，卻沒有酒害防制法，希望政府能正視此事。

ALDH2 polymorphism and alcohol-related cancers in Asians: a public health perspective Journal of Biomedical Science201724:19 The occurrence of more than 200 diseases, including cancer, can be attributed to alcohol drinking. The global cancer deaths attributed to alcohol-consumption rose from 243,000 in 1990 to 337,400 in 2010. In 2010, cancer deaths due to alcohol consumption accounted for 4.2% of all cancer deaths. Strong epidemiological evidence has established the causal role of alcohol in the development of various cancers, including esophageal cancer, head and neck cancer, liver cancer, breast cancer, and colorectal cancer. The evidence for the association between alcohol and other cancers is inconclusive. Because of the high prevalence of ALDH2*2 allele among East Asian populations, East Asians may be more susceptible to the carcinogenic effect of alcohol, with most evidence coming from studies of esophageal cancer and head and neck cancer, while data for other cancers are more limited. The high prevalence of ALDH2*2 allele in East Asian populations may have important public health implications and may be utilized to reduce the occurrence of alcohol-related cancers among East Asians, including: 1) Identification of individuals at high risk of developing alcohol-related cancers by screening for ALDH2 polymorphism; 2) Incorporation of ALDH2 polymorphism screening into behavioral intervention program for promoting alcohol abstinence or reducing alcohol consumption; 3) Using ALDH2 polymorphism as a prognostic indicator for alcohol-related cancers; 4) Targeting ALDH2 for chemoprevention; and 5) Setting guidelines for alcohol consumption among ALDH2 deficient individuals. Future studies should evaluate whether these strategies are effective for preventing the occurrence of alcohol-related cancers.