Light-to-moderate alcohol consumption and mortality in the physicians' health study enrollment cohort
Light-to-moderate alcohol consumption and mortality in the physicians' health study enrollment cohort
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DOI：
10.1016/s0735-1097(99)00531-8
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发表时间：
2000-01-01
影响因子：
24
通讯作者：
Buring, JE
中科院分区：
文献类型：
--
作者：
Gaziano, JM;Gaziano, TA;Buring, JE
目的：本研究探讨轻度至中度饮酒与死因特异性死亡率之间的关系。背景先前的研究表明酒精与男性总死亡率之间呈j型关系。心血管疾病（CVD）死亡率的下降而没有其他死亡原因的显著增加，可能解释了总体风险在轻度至中度水平上的降低。方法：我们对89,299名美国男性进行了一项前瞻性队列研究，这些男性来自1982年医师健康研究的入组队列，年龄在40至84岁之间，基线时无已知的心肌梗死、中风、癌症或肝脏疾病。通常的饮酒量是通过有限的食物频率问卷来估计的。结果在5.5年的随访中有3216人死亡。我们观察到饮酒与总死亡率之间呈u型关系，与很少或从不饮酒的人相比，每周饮酒1次、2至4次、5至6次以及每天饮酒1次的人死亡风险显著降低（多变量相对风险[RRs]分别为0.74、0.77、0.78和0.82），在每次饮酒超过或等于2次时，没有发现总体的益处或危害（RR = 0.95； 95%可信区间（CI）， 0.79至1.14）。与心血管疾病死亡率呈负相关或l型关系，即使在每天超过或等于2杯的最高类别中，风险也明显降低（RR = 0.76; 95% CI， 0.57至1.01）。我们没有发现对所有或常见的特异性癌症有明显的危害或益处。对于其他癌症来说，每天饮酒超过或等于两杯的人患癌症的风险增加了28%。结论：这些数据支持酒精与轻度至中度饮酒男性总死亡率之间呈u型关系。u型曲线可能反映心血管疾病死亡率呈负相关，与常见部位特异性癌症无关联，与不常见癌症可能呈正相关。(C) 1999年由美国心脏病学会出版。
OBJECTIVES This study examined the relationship between light-to-moderate alcohol consumption and cause-specific mortality.BACKGROUND Previous studies suggest a J-shaped relation between alcohol and total mortality in men. A decrease in cardiovascular disease (CVD) mortality without a significant increase in other causes of mortality may explain the overall risk reduction at light-to-moderate levels.METHODS We conducted a prospective cohort study of 89,299 U.S. men from the Physicians' Health Study enrollment cohort who were 40 to 84 years old in 1982 and free of known myocardial infarction, stroke, cancer or liver disease at baseline. Usual alcohol consumption was estimated by a limited food frequency questionnaire.RESULTS There were 3,216 deaths over 5.5 years of follow-up. We observed a U-shaped relationship between alcohol consumption and total mortality, Compared with rarely/never drinkers, consumers of 1, 2 to 4 and 5 to 6 drinks per week and 1 drink per day had significant reductions in risk of death (multivariate relative risks [RRs] of 0.74, 0.77, 0.78 and 0.82, respectively) with no overall benefit or harm detected at the greater than or equal to 2 drinks per clay level (RR = 0.95; 95% confidence interval (CI), 0.79 to 1.14). The relationship with CVD mortality was inverse or L-shaped with apparent risk reductions even in the highest category of greater than or equal to 2 drinks per day (RR = 0.76; 95% CI, 0.57 to 1.01). We found no clear harm or benefit for total or common sire-specific cancers. For remaining other cancers, there was a nonsignificant 28%, increased risk for those consuming greater than or equal to 2 drinks per day.CONCLUSIONS These data support a U-shaped relation between alcohol and total mortality among light-to-moderate drinking men. The U-shaped curve may reflect an inverse association for CVD mortality, no association for common site-specific cancers and a possible positive association for less common cancers. (C) 1999 by the American College of Cardiology.