Gaziano J M, Hennekens C H, Godfried S L, Sesso H D, Glynn R J, Breslow J L, Buring J E
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02215-1204, USA.
Am J Cardiol. 1999 Jan 1;83(1):52-7. doi: 10.1016/s0002-9149(98)00782-6.
We examined the relation of alcoholic beverage type and risk of myocardial infarction (MI) in a case-control study among 340 cases of MI and an equal number of age-, sex-, and community-matched controls. Alcohol consumption was estimated using a food frequency questionnaire, with alcohol drinkers defined as those consuming > or = 1/2 drink/day on average of any alcoholic beverage. Beer, wine, and liquor drinkers had at least half of their consumption from 1 beverage type. Fasting venous blood samples were obtained and analyzed for lipid profiles. Compared with nondrinkers, after adjustment for age and sex, reductions in risk of MI were similar for regular drinkers of any type of alcoholic beverage (relative risk [RR] 0.54; 95% confidence interval [CI] 0.37 to 0.79; p = 0.001), beer (RR 0.55; 95% CI 0.31 to 0.97; p <0.05), wine (RR 0.48; 95% CI 0.27 to 0.87; p <0.05), and liquor (RR 0.59; 95% CI 0.38 to 0.91; p <0.05) drinkers. Comparable benefits remained apparent even after multivariate adjustment for a wide range of nonlipid coronary risk factors. High-density lipoprotein (HDL) levels were significantly higher in all 4 beverage categories when compared with levels in nondrinkers, and as expected, adjustment for total HDL, a major direct effect of alcohol, substantially attenuated the protective effect in all 4 beverage categories. Relative risks were 0.94 for any beverage, 1.09 for beer, 0.97 for wine, and 0.83 for liquor after further adjustment. This strongly suggests that the protective effect of each beverage type is, in large part, mediated by increased HDL. These data indicate that regular consumption of small to moderate amounts of alcoholic beverages, regardless of the type, reduces the risk of MI, and further suggest that there is benefit, in large part, from increases in HDL levels.
在一项病例对照研究中，我们调查了酒精饮料类型与心肌梗死（MI）风险之间的关系。该研究纳入了340例心肌梗死患者，并选取了数量相等的年龄、性别和社区匹配的对照。使用食物频率问卷评估酒精摄入量，将平均每天饮用任何酒精饮料≥1/2杯的人定义为饮酒者。啤酒、葡萄酒和烈酒饮用者至少一半的饮酒量来自一种饮料类型。采集空腹静脉血样本并分析血脂谱。与不饮酒者相比，在调整年龄和性别后，任何类型酒精饮料的经常饮用者发生心肌梗死的风险降低程度相似（相对风险[RR]0.54；95%置信区间[CI]0.37至0.79；p = 0.001），啤酒饮用者（RR 0.55；95% CI 0.31至0.97；p <0.05）、葡萄酒饮用者（RR 0.48；95% CI 0.27至0.87；p <0.05）和烈酒饮用者（RR 0.59；95% CI 0.38至0.91；p <0.05）。即使在对广泛的非脂质冠状动脉危险因素进行多变量调整后，类似的益处仍然明显。与不饮酒者相比，所有4种饮料类别中的高密度脂蛋白（HDL）水平均显著更高，正如预期的那样，对总HDL进行调整（酒精的主要直接作用）后，所有4种饮料类别中的保护作用均大幅减弱。进一步调整后，任何饮料的相对风险为0.94，啤酒为1.09，葡萄酒为0.97，烈酒为0.83。这有力地表明，每种饮料类型的保护作用在很大程度上是由HDL升高介导的。这些数据表明，无论饮料类型如何，定期饮用少量至适量的酒精饮料均可降低心肌梗死风险，并进一步表明，大部分益处来自HDL水平的升高。
