Exploring causal associations between alcohol and coronary heart disease risk factors: findings from a Mendelian randomization study in the Copenhagen General Population Study
Exploring causal associations between alcohol and coronary heart disease risk factors: findings from a Mendelian randomization study in the Copenhagen General Population Study
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DOI：
10.1093/eurheartj/eht081
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发表时间：
2013-08-01
影响因子：
39.3
通讯作者：
Davey Smith, George
中科院分区：
文献类型：
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作者：
Lawlor, Debbie A.;Nordestgaard, Borge G.;Davey Smith, George
为探讨长期饮酒对冠心病危险因素的因果影响，我们使用ADH 1B和ADH 1C基因的变异作为工具变量（IV）来估计长期饮酒对体重指数（BMI）、血压（BP）、血脂、纤维蛋白原和葡萄糖的因果影响。在54604名丹麦人（平均年龄56岁）中进行了分析。混杂因素校正的多变量和IV分析均表明，饮酒者中饮酒量越大，血压越高[饮酒者中饮酒量加倍时SBP的平均差异：0.76 mmHg（95 CI：0.63，0.90）来自多变量分析，0.94 mmHg（3.03，4.69）来自IV分析;这些结果差异的P值0.95]。在多变量分析中，酒精与HDL c呈正相关[4.9（4.7，5.1）]似乎强于IV分析[1.5（4.5，7.4）]，在多变量分析中与纤维蛋白原呈弱负相关[2.0（2.1，1.8）]在IV分析中不存在[0.6（3.8，5.0）]，但在统计学上，这两种结果无法可靠地相互区分（P值分别为0.21和0.32）。酒精与BMI [0.13 kg/m（2）]呈弱负相关（0.16，0.10）]和甘油三酯[0.4（0.7，0.4）]与酒精与BMI [1.37 kg/m（2）]的强正相关形成对比（0.59，2.15）]和与甘油三酯的强负相关性[14.9（25.6，4.3）];两者之间的差异分别为P 0.006和0.01。酒精与非高密度脂蛋白或葡萄糖无关。我们的研究结果显示长期饮酒对血压和体重指数有不良影响。我们还发现了对甘油三酯水平有潜在有益影响的新证据，这需要进一步复制。
To explore the causal effect of long-term alcohol consumption on coronary heart disease risk factors.We used variants in ADH1B and ADH1C genes as instrumental variables (IV) to estimate the causal effect of long-term alcohol consumption on body mass index (BMI), blood pressure (BP), lipids, fibrinogen, and glucose. Analyses were undertaken in 54 604 Danes (mean age 56 years). Both confounder-adjusted multivariable and IV analyses suggested that a greater alcohol consumption among those who drank any alcohol resulted in a higher BP [mean difference in SBP per doubling of alcohol consumption among drinkers: 0.76 mmHg (95 CI: 0.63, 0.90) from multivariable analyses and 0.94 mmHg (3.03, 4.69) from IV analyses; P-value for difference in these results 0.95]. The positive association of alcohol with HDLc in the multivariable analyses [4.9 (4.7, 5.1)] appeared stronger than in the IV analyses [1.5 (4.5, 7.4)], and the weak inverse association with fibrinogen in the multivariable analysis [2.0 (2.1, 1.8)] was not present in the IV analyses [0.6 (3.8, 5.0)], but statistically the results for both of these could not be reliably distinguished from each other (P-values 0.21 and 0.32, respectively). The weak inverse association of alcohol with BMI [0.13 kg/m(2) (0.16, 0.10)] and with triglycerides [0.4 (0.7, 0.4)] in multivariable analyses were in contrast to the strong positive association of alcohol with BMI [1.37 kg/m(2) (0.59, 2.15)] and the strong inverse association with triglycerides [14.9 (25.6, 4.3)] in IV analyses; P 0.006 and 0.01, respectively, for difference between the two. Alcohol was not associated with non-HDLc or glucose.Our results show adverse effects of long-term alcohol consumption on BP and BMI. We also found novel evidence for a potentially beneficial effect on triglyceride levels, which needs further replication.