ALCOHOL AND MORTALITY
ALCOHOL AND MORTALITY
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DOI：
10.7326/0003-4819-117-8-646
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发表时间：
1992-10-15
影响因子：
39.2
通讯作者：
FRIEDMAN, GD
中科院分区：
文献类型：
--
作者：
KLATSKY, AL;ARMSTRONG, MA;FRIEDMAN, GD
目的：在一个大型流动人群中研究酒精摄入量与死亡率之间的关系，关注死亡原因以及与年龄、性别、种族和基线风险相关的差异。设计：前瞻性队列研究。设置：在奥克兰和弗朗西斯科，加州的预付综合保健计划设施。参与者：成年人（n = 128934）谁提供的数据在1978年和1985年之间的健康评估。测量：人口统计学数据和健康史提供了问卷调查。通过自动化连接系统确定死亡，并进行单独验证。通过考克斯比例风险模型计算了不同饮酒水平下的死亡相对风险，使用终身不饮酒者作为参考，并控制了8个协变量。重度饮酒者死于非心血管原因的风险更大（与不饮酒相比，每天饮酒超过或等于6次的相对风险= 1.6，95% CI，1.3至2.0）尤其是肝硬化，非自然死亡，和烟草相关的癌症。这种与酒精相关的风险在女性（每天饮酒超过或等于6杯时，所有原因导致的死亡相对风险= 2.2; CI，1.4至3.8）和年轻人（对于<50岁的人，每天饮酒超过或等于6杯时，所有原因导致的死亡相对风险= 1.9; CI，1.3至2.9）中更高。轻度饮酒者死于心血管疾病的风险较低，尤其是冠心病（每天饮酒1至2次的相对风险= 0.7; CI，0.6至0.9），与基线风险无关，老年人的风险降低最大。60岁以上的轻度饮酒者非心血管死亡的风险也略低，但这一发现并不独立于基线冠心病risk.Conclusions：女性和年轻人似乎更容易受到大量饮酒的死亡风险增加。少量饮酒者心血管风险的降低在老年人中更为明显。较低的冠状动脉疾病患病率可能会降低轻度饮酒者的非心血管死亡风险。
Objective: To study the relation between alcohol intake and mortality in a large ambulatory population with attention to causes of death and differences related to age, sex, race, and baseline risk.Design: Prospective cohort study.Setting: Prepaid comprehensive health care program facilities in Oakland and San Francisco, California.Participants: Adults (n = 128 934) who supplied data at health evaluations between 1978 and 1985.Measurements: Demographic data and health history were supplied using questionnaires. Death was ascertained by an automated linkage system and was individually validated. Relative risk for death at various levels of drinking was calculated by Cox proportional hazards models using lifelong nondrinkers as the reference and controlling for eight covariables.Results: Heavier drinkers were at greater risk for death from noncardiovascular causes (relative risk at greater-than-or-equal-to 6 drinks per day compared with no alcohol = 1.6, 95% Cl, 1.3 to 2.0) especially cirrhosis, unnatural death, and tobacco-related cancers. This alcohol-associated risk was higher in women (relative risk for death from all causes at greater-than-or-equal-to 6 drinks per day = 2.2; Cl, 1.4 to 3.8) and younger persons (for persons < 50 years of age, relative risk for death from all causes at greater-than-or-equal-to 6 drinks per day = 1.9; Cl, 1.3 to 2.9). Lighter drinkers were at lower risk for death from cardiovascular disease, especially coronary heart disease (relative risk at 1 to 2 drinks per day = 0.7; Cl, 0.6 to 0.9), independent of baseline risk, with the greatest reduction of risk in older persons. Lighter drinkers over 60 years of age also had a slightly lower risk for noncardiovascular death, but this finding was not independent of baseline coronary heart disease risk.Conclusions: Women and younger persons appear more susceptible to the increased mortality risk of heavy drinking. The reduced cardiovascular risk of lighter drinkers is more pronounced in older persons. Lower coronary disease prevalence may reduce the noncardiovascular mortality risk of lighter drinkers.