title: The association between obesity and lethal blood alcohol concentrations: a nationwide register-based study of medicolegal autopsy cases in Sweden.
abstract: Obesity is a global problem and in aspects of lethal ethanol intoxications virtually unexplored. The cause of death in ethanol intoxication is generally considered to be suppression of the respiratory function. Previous research indicates that respiratory function is more vulnerable in obese subjects than in those of normal weight. We hypothesized that lethal blood alcohol concentration (BAC) is lower in obese subjects compared to those of normal weight. We used the Swedish medicolegal autopsy register and identified all medicolegal autopsy cases in Sweden during the period from 1999 to 2013 (N=79,060), and identified 1545 cases with ethanol intoxication identified as the primary cause of death. We studied the association between body mass index and lethal BAC using logistic regression models that we adjusted using several potential confounders such as age, sex, drugs, and extent of decomposition. We observed an association between obesity and lower lethal BACs. The estimated adjusted odds ratio of the association between obesity and a lethal BAC >3‰, using subjects of normal weight as reference, was 0.54, 95% confidence interval: 0.39-0.74. The result indicates that in obese subjects the lethal BAC is lower than in those of normal weight.
authors.affiliation: Department of Forensic Medicine in Lund, The National Board of Forensic Medicine, Sölvegatan 25, SE-223 62 Lund, Sweden; Unit for Forensic Medicine, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden. Electronic address: carl_johan.wingren@med.lu.se.
authors.forename: Carl Johan
authors.initials: CJ
authors.lastname: Wingren
authors.affiliation: Department of Forensic Medicine in Lund, The National Board of Forensic Medicine, Sölvegatan 25, SE-223 62 Lund, Sweden; Unit for Forensic Medicine, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Ottosson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000435:Alcoholic Intoxication / Q000097:blood* / Q000401:mortality*; D015992:Body Mass Index; D002492:Central Nervous System Depressants / Q000097:blood*; D000431:Ethanol / Q000097:blood*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D012042:Registries; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol
keywords: Epidemiology; Forensic medicine; Lethal ethanol intoxication; Obesity; Risk factor