{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:43:01Z","timestamp":1787013781724,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH\u2010B\u2010110011"],"award-info":[{"award-number":["TSGH\u2010B\u2010110011"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH\u2010B\u2010111017"],"award-info":[{"award-number":["TSGH\u2010B\u2010111017"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH\u2010C103\u2010085"],"award-info":[{"award-number":["TSGH\u2010C103\u2010085"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH\u2010D\u2010110049"],"award-info":[{"award-number":["TSGH\u2010D\u2010110049"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001869","name":"Academia Sinica","doi-asserted-by":"publisher","award":["40\u201005\u2010GMM"],"award-info":[{"award-number":["40\u201005\u2010GMM"]}],"id":[{"id":"10.13039\/501100001869","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001869","name":"Academia Sinica","doi-asserted-by":"publisher","award":["AS\u2010GC\u2010110\u2010MD02"],"award-info":[{"award-number":["AS\u2010GC\u2010110\u2010MD02"]}],"id":[{"id":"10.13039\/501100001869","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","award":["VHCT\u2010RD\u20102016\u20108"],"award-info":[{"award-number":["VHCT\u2010RD\u20102016\u20108"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007225","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST 103\u20102314\u2010B\u2010016\u2010012"],"award-info":[{"award-number":["MOST 103\u20102314\u2010B\u2010016\u2010012"]}],"id":[{"id":"10.13039\/100007225","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007225","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST 104\u20102314\u2010B\u2010016\u2010013"],"award-info":[{"award-number":["MOST 104\u20102314\u2010B\u2010016\u2010013"]}],"id":[{"id":"10.13039\/100007225","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcohol, Clinical and Experimental Research"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>ALDH2*2<\/jats:italic>\n                      allele, common in East Asians, impairs aldehyde metabolism and leads to acetaldehyde accumulation during alcohol consumption. Whether this variant interacts with alcohol use to influence the age at ischemic stroke onset remains unclear. We evaluated the associations between\n                      <jats:italic>ALDH2*2<\/jats:italic>\n                      and alcohol consumption with age at stroke onset.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We enrolled 930 patients (598 men and 332 women) with first\u2010ever ischemic stroke. Alcohol consumption was dichotomized as heavy (&gt;45\u2009g\/day or &gt;300\u2009g\/week of ethanol) versus nonheavy (abstinent or \u226445\u2009g\/day and \u2264300\u2009g\/week). Because heavy drinking was rare in women, primary analyses focused on men. Participants were grouped by the\n                      <jats:italic>ALDH2<\/jats:italic>\n                      genotype (\n                      <jats:italic>*1\/*1<\/jats:italic>\n                      vs.\n                      <jats:italic>*1\/*2<\/jats:italic>\n                      or\n                      <jats:italic>*2\/*2<\/jats:italic>\n                      ) and drinking category. Clinical variables were compared using analysis of variance and chi\u2010squared tests. Multivariable linear regression, adjusted for smoking, assessed associations with age at stroke onset.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among men, mean age at stroke onset differed significantly across genotype\u2013drinking groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                      <jats:italic>ALDH2*2<\/jats:italic>\n                      carriers with heavy drinking had the earliest onset (56.1\u2009\u00b1\u20099.6\u2009years), whereas\n                      <jats:italic>ALDH2*2<\/jats:italic>\n                      carriers with nonheavy drinking had the latest onset (63.6\u2009\u00b1\u200912.3\u2009years). Relative to\n                      <jats:italic>*1\/*1<\/jats:italic>\n                      with nonheavy drinking,\n                      <jats:italic>ALDH2*2<\/jats:italic>\n                      carriers with nonheavy drinking had later onset (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20092.67\u2009years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023), while those with heavy drinking had earlier onset (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22124.61\u2009years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). In the overall cohort, male sex, smoking, and heavy drinking were independently associated with younger onset (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22123.20, \u22122.57, and\u2009\u2212\u20093.40\u2009years;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001, 0.006, and 0.002, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In East Asian men, heavy alcohol consumption among\n                      <jats:italic>ALDH2*2<\/jats:italic>\n                      carriers is associated with earlier ischemic stroke onset, suggesting a gene\u2013environment interaction. These findings support genotype\u2010informed lifestyle counseling for stroke prevention.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70217","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T13:35:46Z","timestamp":1764596146000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of\n                    <scp>ALDH2<\/scp>\n                    genotypes and alcohol consumption on age at first\u2010ever ischemic stroke: A cohort study in Taiwan"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5984-9277","authenticated-orcid":false,"given":"Yueh\u2010Feng","family":"Sung","sequence":"first","affiliation":[{"name":"Department of Neurology, Tri\u2010Service General Hospital National Defense Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiunn\u2010Tay","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tri\u2010Service General Hospital National Defense Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaur\u2010Jong","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurology Taipei Medical University Hospital and Shuang Ho Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiann\u2010Shing","family":"Jeng","sequence":"additional","affiliation":[{"name":"Stroke Center and Department of Neurology National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung\u2010Yi","family":"Chiou","sequence":"additional","affiliation":[{"name":"School of Public Health, College of Public Health Taipei Medical University  Taipei Taiwan"},{"name":"Institute of Population Health Sciences National Health Research Institutes  Miaoli Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giia\u2010Sheun","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tri\u2010Service General Hospital National Defense Medical University  Taipei Taiwan"},{"name":"Division of Neurology, Department of Internal Medicine Taipei Veterans General Hospital, Taoyuan Branch  Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.540781"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21194"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12929-017-0327-y"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1158554"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00017.2013"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvq192"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gene.2018.08.002"},{"key":"e_1_2_10_9_1","first-page":"22","article-title":"ALDH2, ADH1B, and ADH1C genotypes in Asians: a literature review","volume":"30","author":"Eng M.Y.","year":"2007","journal-title":"Alcohol Research & Health"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00369-7"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/cr.2013.69"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10528-020-09950-5"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.936526"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.006724"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocpiqo.2021.01.015"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-5-155"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27036"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008459"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.109.213645"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12215"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1333595"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/FPC.0b013e3282609e67"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/FPC.0000000000000096"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1479-7364-3-2-121"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70193-5"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1586\/erc.10.56"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.025245"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.21803"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.013204"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xgen.2023.100345"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2011.184"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41525-021-00178-9"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.38962"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/1479-7364-5-6-569"},{"key":"e_1_2_10_35_1","first-page":"198","article-title":"Acetaldehyde, polymorphisms and the cardiovascular system","volume":"285","author":"Yin S.J.","year":"2007","journal-title":"Novartis Foundation Symposium"}],"container-title":["Alcohol, Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acer.70217","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acer.70217","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acer.70217","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:23:30Z","timestamp":1772987010000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acer.70217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/acer.70217"],"URL":"https:\/\/doi.org\/10.1111\/acer.70217","archive":["Portico"],"relation":{},"ISSN":["2993-7175","2993-7175"],"issn-type":[{"value":"2993-7175","type":"print"},{"value":"2993-7175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]},"assertion":[{"value":"2025-09-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70217"}}