老年人饮酒与脑部磁共振成像的亚临床发现：心血管健康研究

Alcohol consumption and subclinical findings on magnetic resonance imaging of the brain in older adults: the cardiovascular health study.

作者信息

Mukamal K J, Longstreth W T, Mittleman M A, Crum R M, Siscovick D S

机构信息

Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

出版信息

Stroke. 2001 Sep;32(9):1939-46. doi: 10.1161/hs0901.095723.

DOI:10.1161/hs0901.095723

PMID:11546878

Abstract

BACKGROUND AND PURPOSE

Subclinical findings on MRI of the brain are associated with poorer cognitive and neurological function among older adults. We sought to determine how alcohol consumption is related to these findings.

METHODS

As part of the Cardiovascular Health Study, 3660 adults aged 65 years and older underwent MRI of the brain from 1992 to 1994. We excluded 284 participants with a confirmed history of cerebrovascular disease. We assessed self-reported intake of beer, wine, and liquor at the annual clinic visit closest to the date of the MRI and grouped participants into 6 categories: abstainers, former drinkers, <1 drink weekly, 1 to <7 drinks weekly, 7 to <15 drinks weekly, and >/=15 drinks weekly. Neuroradiologists assessed white matter grade, infarcts, ventricular size, and sulcal size in a standardized and blinded manner. We used multivariate regression to control for sociodemographic and clinical characteristics.

RESULTS

We found a U-shaped relationship between alcohol consumption and white matter abnormalities. Compared with abstainers, individuals consuming 1 to <7 drinks had an OR of 0.68, and those consuming >/=15 drinks weekly had an OR of 0.95 (p for quadratic term=0.01). Heavier alcohol consumption was associated with a lower prevalence of infarcts (OR for >/=15 drinks weekly relative to abstainers 0.59; P for trend=0.004), but larger ventricular size (OR for >/=15 drinks weekly relative to abstainers 1.32; P for trend=0.006) and sulcal size (OR for >/=15 drinks weekly relative to abstainers 1.53; P for trend=0.007).

CONCLUSIONS

Moderate alcohol consumption is associated with a lower prevalence of white matter abnormalities and infarcts, thought to be of vascular origin, but with a dose-dependent higher prevalence of brain atrophy on MRI among older adults. The extent to which these competing associations influence overall brain function will require further study.

摘要

背景与目的

老年人脑部MRI的亚临床检查结果与较差的认知和神经功能相关。我们试图确定饮酒与这些检查结果之间的关系。

方法

作为心血管健康研究的一部分，1992年至1994年期间，3660名65岁及以上的成年人接受了脑部MRI检查。我们排除了284名有确诊脑血管疾病史的参与者。我们在最接近MRI检查日期的年度门诊就诊时评估了自我报告的啤酒、葡萄酒和烈酒摄入量，并将参与者分为6类：戒酒者、既往饮酒者、每周饮酒少于1杯、每周饮酒1至少于7杯、每周饮酒7至少于15杯以及每周饮酒≥15杯。神经放射科医生以标准化且盲法的方式评估白质等级、梗死灶、脑室大小和脑沟大小。我们使用多变量回归来控制社会人口统计学和临床特征。

结果

我们发现饮酒与白质异常之间呈U形关系。与戒酒者相比，每周饮酒1至少于7杯的个体的比值比为0.68，每周饮酒≥15杯的个体的比值比为0.95（二次项p值=0.01）。饮酒量越大，梗死灶的患病率越低（每周饮酒≥15杯相对于戒酒者的比值比为0.59；趋势p值=0.004），但脑室越大（每周饮酒≥15杯相对于戒酒者的比值比为1.32；趋势p值=0.006），脑沟也越大（每周饮酒≥15杯相对于戒酒者的比值比为1.53；趋势p值=0.007）。