Association of High-Intensity Binge Drinking With Lipid and Liver Function Enzyme Levels
Association of High-Intensity Binge Drinking With Lipid and Liver Function Enzyme Levels
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DOI：
10.1001/jamanetworkopen.2019.5844
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发表时间：
2019-06-01
影响因子：
13.8
通讯作者：
Lohoff, Falk W.
中科院分区：
文献类型：
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作者：
Rosoff, Daniel B.;Charlet, Katrin;Lohoff, Falk W.
在美国，高强度酗酒（HIBD）的流行率正在迅速增加，HIBD的定义是消费2倍或2倍以上的酗酒阈值，由国家酒精滥用和酒精中毒研究所（NIAAA）定义。虽然酒精消耗和脂质和肝功能酶（LFT）生物标志物之间的关系以前已经研究过，但HIBD与这些生物标志物的关联仍然未知。目的在一个富含参与HIBD的参与者的横断面样本中研究HIBD与脂质和LFT水平的关联。2005年，至2017年8月21日，参与者招募了NIAAA筛查方案或住院酒精治疗计划。在这项研究中，参与者根据自我报告的饮酒量分为4个性别特定的狂欢水平：非狂欢和狂欢阈值的1倍，2倍和3倍或更多倍（I级，II级和III级）。多变量分析检查了临床上高水平的脂质和LFT在狂欢水平上的几率。分析时间为2018年12月3日至2019年1月30日。主要结果和指标血清高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇、总胆固醇、甘油三酯、丙氨酸转氨酶、天冬氨酸转氨酶和.结果：共有2065名参与者接受了方案筛选; 1519名具有关于酒精消耗、体重指数、脂质水平和LFT水平的可用数据的参与者被包括在最终分析中。平均（SD）年龄为39.7岁12.1岁;平均（SD）体重指数为26.6（5.1）; 978（64.4%）为男性;（47.3%）为白色; 578人（31.1%）在非狂欢水平饮酒，321人（21.2%）在I级，239人（15.7%）在II级，318人（25.1%）在III级。高强度酗酒与临床高水平HDL-C、总胆固醇、甘油三酯和所有LFT的几率增加2至8倍相关（例如，HDL-C：III级比值比[OR]，8.65; 95%CI，4.75-15.77;谷氨酰转移酶：水平III OR，8.21; 95% CI，5.90-11.43）。HIBD频率增加（在II级和III级消耗的天数）与临床高水平HDL-C、总胆固醇和所有LFT的几率增加相关（在相应的暴饮暴食水平下，每单位消耗天数的增加）（例如，HDL-C：II级OR，1.025; 95% CI，1.014-1.036和III级OR，1.033; 95%CI，1.019-1.047，谷氨酰转移酶：II级OR，1.028; 95%CI，1.019-1.037和III级OR，1.033; 95%CI，1.019-1.047）。结论和相关性高冲击性狂饮与临床高水平脂质和LFT的几率增加显著相关。鉴于HIBD在美国成年人中越来越普遍，旨在减少HIBD的有针对性的干预措施可能具有重要的健康益处。
IMPORTANCE The prevalence of high-intensity binge drinking (HIBD), defined as consuming 2 or more times the binge threshold defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), is rapidly increasing in the United States. While the relationship between alcohol consumption and lipid and liver function enzyme (LFT) biomarkers has been previously examined, the associations of HIBD with those biomarkers remain unknown.OBJECTIVE To examine associations of HIBD with lipid and LFT levels in a cross-sectional sample enriched with participants who engage in HIBD.DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study using data from the NIAAA clinical sample collected from March 3, 2005, to August 21, 2017, with participants recruited for either the NIAAA screening protocols or inpatient alcohol treatment program. For this study, participants were stratified by self-reported alcohol consumption into 4 sex-specific binge levels: nonbinge and 1, 2, and 3 or more times the binge threshold (levels I, II, and III). Multivariable analyses examined the odds of clinically high levels of lipids and LFTs across binge levels. Analyses were performed from December 3, 2018, to January 30, 2019.MAIN OUTCOMES AND MEASURES Serum levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, total cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, and.-glutamyltransferase.RESULTS A total of 2065 participants underwent protocol screening; 1519 with data available on alcohol consumption, body mass index, lipid levels, and LFT levels were included in the final analyses. Mean (SD) age was 39.7 (12.1) years; mean (SD) body mass index was 26.6 (5.1); 978 (64.4%) were male; 718 (47.3%) were white; and 578 (31.1%) consumed alcohol at the nonbinge level, 321 (21.2%) at level I, 239 (15.7%) at level II, and 318 (25.1%) at level III. High-intensity binge drinking was associated with 2-to 8-fold increased odds for clinically high levels of HDL-C, total cholesterol, triglycerides, and all LFTs (eg, for HDL-C: level III odds ratio [OR], 8.65; 95% CI, 4.75-15.77 and for.-glutamyltransferase: level III OR, 8.21; 95% CI, 5.90-11.43). Increased HIBD frequency (days consuming at levels II and III) was associated with increased odds for clinically high levels of HDL-C, total cholesterol, and all LFTs (per unit increase in days consuming at the respective binge level) (eg, for HDL-C: level II OR, 1.025; 95% CI, 1.014-1.036 and level III OR, 1.033; 95% CI, 1.019-1.047 and for.-glutamyltransferase: level II OR, 1.028; 95% CI, 1.019-1.037 and level III OR, 1.033; 95% CI, 1.019-1.047).CONCLUSIONS AND RELEVANCE High-impact binge drinking was significantly associated with increased odds for clinically high levels of lipids and LFTs. Given that HIBD is increasingly common among US adults, targeted interventions aimed at reducing HIBD may have important health benefits.