Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies.
Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies.
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DOI：
10.1136/bmj.d636
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发表时间：
2011-02-22
期刊：
影响因子：
--
通讯作者：
Ghali WA
中科院分区：
文献类型：
--
作者：
Brien SE;Ronksley PE;Turner BJ;Mukamal KJ;Ghali WA
目的系统综述非已知心血管疾病成人饮酒对21种与冠心病风险相关的生物标志物的干预研究。设计系统回顾和荟萃分析。数据来源：Medline(1950年至2009年10月)和Embase(1980年至2009年10月)，无限制。研究选择两位评价者独立选择的研究检查了没有已知心血管疾病的成年人，并比较了饮酒后与不饮酒一段时间后与冠心病相关的特定生物标记物的空腹水平(对照组)。共筛选出4690篇文章，对124篇研究全文进行了综述，选择了63篇相关文章。结果在63项符合条件的研究中，44项涉及13个生物标志物的Meta分析采用固定或随机效应模型。通过对按设计分组的研究进行敏感性分析来评估质量。分析按饮料类型(葡萄酒、啤酒、烈性酒)分层。酒精显著升高高密度脂蛋白胆固醇(合并均值差0.094 mmoL/L，95%可信区间0.064~0.123)、载脂蛋白A1(0.101 g/L，0.073~0.129)和脂联素(0.56 mg/L，0.39~0.72)。酒精与高密度脂蛋白胆固醇呈剂量-反应关系(趋势检验P=0.013)。酒精降低纤维蛋白原水平(−0.20g/L，−0.29至−0.11)，但不影响甘油三酯水平。交叉研究、研究前后以及饮料类型之间的结果是相似的。结论一些心血管生物标志物(高密度脂蛋白胆固醇和脂联素水平较高，纤维蛋白原水平较低)的有利变化为适度饮酒对冠心病的保护作用提供了间接的病理生理支持。
Objective To systematically review interventional studies of the effects of alcohol consumption on 21 biological markers associated with risk of coronary heart disease in adults without known cardiovascular disease. Design Systematic review and meta-analysis. Data sources Medline (1950 to October 2009) and Embase (1980 to October 2009) without limits. Study selection Two reviewers independently selected studies that examined adults without known cardiovascular disease and that compared fasting levels of specific biological markers associated with coronary heart disease after alcohol use with those after a period of no alcohol use (controls). 4690 articles were screened for eligibility, the full texts of 124 studies reviewed, and 63 relevant articles selected. Results Of 63 eligible studies, 44 on 13 biomarkers were meta-analysed in fixed or random effects models. Quality was assessed by sensitivity analysis of studies grouped by design. Analyses were stratified by type of beverage (wine, beer, spirits). Alcohol significantly increased levels of high density lipoprotein cholesterol (pooled mean difference 0.094 mmol/L, 95% confidence interval 0.064 to 0.123), apolipoprotein A1 (0.101 g/L, 0.073 to 0.129), and adiponectin (0.56 mg/L, 0.39 to 0.72). Alcohol showed a dose-response relation with high density lipoprotein cholesterol (test for trend P=0.013). Alcohol decreased fibrinogen levels (−0.20 g/L, −0.29 to −0.11) but did not affect triglyceride levels. Results were similar for crossover and before and after studies, and across beverage types. Conclusions Favourable changes in several cardiovascular biomarkers (higher levels of high density lipoprotein cholesterol and adiponectin and lower levels of fibrinogen) provide indirect pathophysiological support for a protective effect of moderate alcohol use on coronary heart disease.
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影响因子：
8.7
作者：
CLEVIDENCE, BA;REICHMAN, ME;TAYLOR, PR
通讯作者：
TAYLOR, PR
DOI：
10.1111/j.1365-2362.1977.tb01584.x
发表时间：
1977-01-01
影响因子：
5.5
作者：
BELFRAGE, P;BERG, B;WIEBE, T
通讯作者：
WIEBE, T
影响因子：
5.3
作者：
Estruch, R;Sacanella, E;Urbano-Márquez, A
通讯作者：
Urbano-Márquez, A
DOI：
10.1016/j.numecd.2007.07.002
发表时间：
2008-10-01
影响因子：
3.9
作者：
Beulens, Joline W. J.;van den Berg, Robin;Hendriks, Henk F. J.
通讯作者：
Hendriks, Henk F. J.
影响因子：
7.1
作者：
Baer, DJ;Judd, JT;Taylor, PR
通讯作者：
Taylor, PR