Synergistic association between alcohol intake and body mass index with serum alanine and aspartate aminotransferase levels in older adults: the Rancho Bernardo Study.
Synergistic association between alcohol intake and body mass index with serum alanine and aspartate aminotransferase levels in older adults: the Rancho Bernardo Study.
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DOI：
10.1111/j.1365-2036.2009.04141.x
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发表时间：
2009-12-01
影响因子：
7.6
通讯作者：
Barrett-Connor E
中科院分区：
文献类型：
--
作者：
Loomba R;Bettencourt R;Barrett-Connor E
体重指数（BMI）和饮酒量可预测年轻人血清丙氨酸（ALT）和天冬氨酸（AST）转氨酶水平升高。目前尚不清楚酒精摄入量和BMI及其联合关联是否对老年人的ALT和AST水平有不同的影响。确定美国社区老年人中酒精、BMI及其与血清ALT和AST的联合作用之间的关系。一项在1984-87年参加研究访问的Rancho Bernardo研究（54%为女性;平均年龄：70岁，BMI：25 kg/m2，饮酒者：63%）中的老年人（n=2364）中进行的横断面、基于人群的研究。BMI由受过训练的护士记录，酒精使用情况由经过验证的问卷调查确定。使用多变量logistic回归模型，分别计算酒精和BMI及其联合暴露的血清ALT和AST升高（定义为男性≥ 30 U/L，女性≥ 19 U/L）的多重校正比值比（OR）和95%置信区间（CI），校正年龄、体重指数、总胆固醇、血清甘油三酯、空腹血糖、收缩压和糖尿病。在多变量校正的逻辑回归模型中，肥胖独立地增加了老年男性和女性ALT升高的几率，分别为3.0（95%CI，1.7-5.3）和1.8（95%CI，1.1-2.7）。每天饮用> 3杯酒精饮料和肥胖的联合作用使ALT升高的几率增加了8.9倍（95%CI，2.4-33.1），AST升高的几率增加了21倍（95%CI，2.6-170.1），证明了协同作用。肥胖者ALT升高的几率更高，即使在0 ≤ 1杯/天的情况下。在老年男性和女性中，肥胖与酒精的结合在增加肝损伤的风险方面是协同作用的。老年肥胖者应限制酒精摄入量，因为肝损伤的风险更高。
Body-mass-index (BMI) and alcohol consumption predict elevated serum alanine (ALT) and aspartate (AST) aminotransferase levels in young adults. It is unclear if alcohol intake and BMI and their joint association have a differential effect on ALT and AST levels in older adults. To determine the association between alcohol, BMI, and their combined effect with serum ALT and AST in older community-dwelling adults in the United States. A cross-sectional, population-based study in older adults (n=2364) from the Rancho Bernardo Study (54% women; mean age: 70 years, BMI: 25 kg/m2, alcohol users: 63%) who attended a research visit in 1984-87. BMI was recorded by a trained nurse and alcohol use ascertained by a validated questionnaire. Multiply adjusted odds-ratio (OR) and 95% confidence intervals (CI) of elevated serum ALT and AST (defined as ≥ 30 U/L in men and ≥ 19 U/L in women) were calculated for alcohol and BMI separately and their joint exposure using multivariate logistic regression models adjusted for age, body mass index, total cholesterol, serum triglycerides, fasting plasma glucose, systolic blood pressure, and diabetes mellitus. In multivariate-adjusted logistic regression models, obesity independently increased the odds of elevated ALT in this cohort of older men and women by 3.0 (95% CI, 1.7-5.3) and 1.8 (95%CI, 1.1-2.7), respectively. Joint effects of consuming > 3 alcoholic drinks/day and obesity raised the odds of elevated ALT by 8.9 (95%CI, 2.4-33.1) and AST by 21-fold (95%CI, 2.6-170.1), demonstrating synergism. Obese had higher odds of elevated ALT even at 0 ≤ 1 drink/day. In older men and women, combination of obesity with alcohol is synergistic in increasing the risk of liver injury. Older obese should restrict their alcohol intake as the risk of liver injury is higher.
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DOI：
10.1111/j.1530-0277.1999.tb04662.x
发表时间：
1999-09-01
影响因子：
3.2
作者：
Diehl, AM
通讯作者：
Diehl, AM
影响因子：
7.6
作者：
Angulo, P.
通讯作者：
Angulo, P.
影响因子：
158.5
作者：
FUCHS, CS;STAMPFER, MJ;WILLETT, WC
通讯作者：
WILLETT, WC
影响因子：
105.7
作者：
HOLBROOK, TL;BARRETTCONNOR, E
通讯作者：
BARRETTCONNOR, E
影响因子：
7.7
作者：
Lee, DH;Ha, MH;Christiani, DC
通讯作者：
Christiani, DC