Effect of body mass index and alcohol consumption on liver disease: analysis of data from two prospective cohort studies.
Effect of body mass index and alcohol consumption on liver disease: analysis of data from two prospective cohort studies.
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DOI：
10.1136/bmj.c1240
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发表时间：
2010-03-11
期刊：
影响因子：
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通讯作者：
Davey Smith G
中科院分区：
文献类型：
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作者：
Hart CL;Morrison DS;Batty GD;Mitchell RJ;Davey Smith G
目的探讨饮酒和体重指数(BMI)升高是否会增加患肝病的风险。前瞻性队列研究数据的设计分析。背景是苏格兰。参与者数据来自两项中跨前瞻性队列研究(9559名男性)：1965年至2008年的主要研究，参与者来自苏格兰中部地带的工作场所、蒂里岛居民和大陆亲属，以及来自格拉斯哥、克莱德班克和格兰茅斯27个工作场所的参与者，1970年至2003年。随访至2007年12月31日(中位数29年，范围0.13-42)。我们根据体重指数(体重指数)(体重不足/正常体重25，超重25至30，肥胖≥30)和饮酒量(无，1-14，每周≥15单位)将参与者分为九组。主要指标肝病发病率和死亡率。结果主要死因为肝病80例(0.8%)，各种死因146例(1.5%)。在这项合作研究中，196名男性(3.3%)患有由死亡、入院或癌症登记定义的肝病。在调整了其他混杂因素的分析中，体重指数和饮酒与肝病死亡率密切相关(分别为P=0.001和P<；0.0001)。与体重过轻/体重正常的非饮酒者相比，在任何BMI类别中每周饮酒15个单位或更多的饮酒者和肥胖饮酒者的所有肝病定义的相对率都有所提高。每周饮酒15单位或以上的饮酒者调整后的肝病死亡率相对比率，体重不足/正常体重男性为3.16(95%可信区间1.28至7.8)，超重男性为7.01(3.02至16.3)，肥胖男性为18.9(6.84至52.4)。每周摄入1-14个单位的肥胖男性的相对比率为5.3(1.36至20.7)。体重指数与饮酒交互作用的相对超额风险为5.58(1.09~10.1)；协同指数=2.89(1.29~6.47)。结论体重指数升高和饮酒都与肝病有关，有证据表明两者之间存在超加性相互作用。这两个因素在同一人群中的出现应该为健康促进和公共卫生政策提供信息。
Objective To investigate whether alcohol consumption and raised body mass index (BMI) act together to increase risk of liver disease. Design Analysis of data from prospective cohort studies. Setting Scotland. Participants Data were from two of the Midspan prospective cohort studies (9559 men): “Main” study 1965-8, participants from workplaces across central belt of Scotland, population of island of Tiree, and mainland relatives, and “Collaborative” study, 1970-3, participants from 27 workplaces in Glasgow, Clydebank, and Grangemouth. Follow-up was to 31 December 2007 (median 29 years, range 0.13-42). We divided participants into nine groups based on measures of body mass index (BMI) (underweight/normal weight <25, overweight 25 to <30, and obese ≥30) and alcohol consumption (none, 1-14, and ≥15 units per week). Main outcome measures Liver disease morbidity and mortality. Results 80 (0.8%) men died with liver disease as the main cause and 146 (1.5%) with liver disease as any cause. In the Collaborative study, 196 men (3.3%) had liver disease defined by a death, admission, or cancer registration. BMI and alcohol consumption were strongly associated with liver disease mortality in analyses adjusted for other confounders (P=0.001 and P<0.0001 respectively). Drinkers of 15 or more units per week in any BMI category and obese drinkers had raised relative rates for all definitions of liver disease, compared with underweight/normal weight non-drinkers. Drinkers of 15 or more units per week had adjusted relative rates for liver disease mortality of 3.16 (95% confidence interval 1.28 to 7.8) for underweight/normal weight men, 7.01 (3.02 to 16.3) for overweight, and 18.9 (6.84 to 52.4) for obese men. The relative rate for obese men who consumed 1-14 units per week was 5.3 (1.36 to 20.7). The relative excess risk due to interaction between BMI and alcohol consumption was 5.58 (1.09 to 10.1); synergy index=2.89 (1.29 to 6.47). Conclusions Raised BMI and alcohol consumption are both related to liver disease, with evidence of a supra-additive interaction between the two. The occurrence of both factors in the same populations should inform health promotion and public health policies.