Alcohol consumption, binge drinking, and early coronary calcification: Findings from the coronary artery risk development in young adults (CARDIA) study
Alcohol consumption, binge drinking, and early coronary calcification: Findings from the coronary artery risk development in young adults (CARDIA) study
复制标题
DOI：
10.1093/aje/kwi062
复制
发表时间：
2005-03-01
影响因子：
5
通讯作者：
Hulley, SB
中科院分区：
文献类型：
--
作者：
Pletcher, MJ;Varosy, P;Hulley, SB
目前尚不清楚适度饮酒对心血管的明显有益影响在多大程度上是通过保护动脉粥样硬化来实现的。在青年冠状动脉风险发展研究(CARDIA)研究(1985-2001)中，对饮酒量、冠心病危险因素和冠状动脉钙化(动脉粥样硬化的一个标志)进行了15年的跟踪调查。在3,037名年龄在33-45岁的受试者中(55%为女性，45%为黑人)，冠状动脉钙化的患病率为每周饮用0杯饮料的8%(n=1,435)，每周饮用1-6杯饮料的9%(n=1,023)，每周饮用7-13杯饮料的13%(n=341)，每周饮酒大于或等于14杯的19%(n=238)(p<；趋势为0.001)。钙化在酗酒者中也更常见(优势比=2.1，95%可信区间：1.6，2.7)。在对潜在混杂因素(年龄、性别/种族、收入、体力活动、家族史、体重指数、吸烟)和中介因素(血脂、血压、血糖、C反应蛋白和纤维蛋白原)进行调整后，这些关联仍然存在。分层在黑人男性中显示出最明显的剂量-反应关系；在其他种族/性别亚组中，只有重度饮酒(大于或等于每周14杯)与冠状动脉钙化相关。这些令人惊讶的发现表明，酒精在年轻人中存在致动脉粥样硬化的作用，特别是黑人男性，这可能抵消高密度脂蛋白胆固醇升高和酒精消费的其他可能好处。
It is unclear to what extent the apparently beneficial cardiovascular effects of moderate alcohol consumption are mediated by protection against atherosclerosis. Alcohol consumption, coronary heart disease risk factors, and coronary calcification (a marker of atherosclerosis) were measured during 15 years of follow-up in the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985-2001). Among 3,037 participants aged 33-45 years after follow-up (55% women, 45% Black), the prevalence of coronary calcification was 8% for consumption of 0 drinks/week (n = 1,435), 9% for 1-6 drinks/week (n = 1,023), 13% for 7-13 drinks/week (n = 341), and 19% for greater than or equal to14 drinks/week (n = 238) (p < 0.001 for trend). Calcification was also more common among binge drinkers (odds ratio = 2.1, 95% confidence interval: 1.6, 2.7). These associations persisted after adjustment for potential confounders (age, gender/ethnicity, income, physical activity, family history, body mass index, smoking) and intermediary factors (lipids, blood pressure, glucose, C-reactive protein, and fibrinogen). Stratification showed the dose-response relation most clearly in Black men; only heavier alcohol consumption (greater than or equal to14 drinks/week) was associated with coronary calcification in other race/sex subgroups. These surprising findings suggest the presence of proatherogenic effects of alcohol in young adults, especially Black men, which may counterbalance high density lipoprotein cholesterol elevation and other possible benefits of alcohol consumption.