Vahtera Jussi, Poikolainen Kari, Kivimäki Mika, Ala-Mursula Leena, Pentti Jaana
Finnish Institute of Occupational Health, Turku, Finland.
Am J Epidemiol. 2002 Nov 15;156(10):969-76. doi: 10.1093/aje/kwf138.
Little is known about the U-shaped relation between alcohol intake and health beyond findings related to cardiovascular disease. Medically certified sickness absence is a health indicator in which coronary heart disease is only a minor factor. To investigate the relation between alcohol intake and sickness absence, records regarding medically certified sick leaves from all causes were assessed for 4 years (1997-2000) in a cohort of 1,490 male and 4,952 female municipal employees in Finland. Hierarchical Poisson regression, adjusted for self-reported behavioral and biologic risk factors, psychosocial risk factors, and cardiovascular diseases, was used to estimate the rate ratios and their 95% confidence intervals, relating sickness absence to each level of alcohol consumption. For both men and women, a significant curvilinear trend was found between level of average weekly alcohol consumption and sickness absence. The rates of medically certified sickness absence were 1.2-fold higher (95% confidence interval: 1.1, 1.3) for never, former, and heavy drinkers compared with light drinkers. The U-shaped relation between alcohol intake and health is not likely to be explained by confounding due to psychosocial differences or inclusion of former drinkers in the nondrinkers category. Moderate alcohol consumption also may reduce health problems other than cardiovascular disease.
除了与心血管疾病相关的研究结果外，关于酒精摄入量与健康之间的U型关系，人们所知甚少。经医学认证的病假是一种健康指标，其中冠心病只是一个次要因素。为了研究酒精摄入量与病假之间的关系，对芬兰1490名男性和4952名女性市政雇员组成的队列在4年（1997 - 2000年）期间所有病因的经医学认证的病假记录进行了评估。采用分层泊松回归分析，对自我报告的行为和生物危险因素、心理社会危险因素以及心血管疾病进行了校正，以估计病假与各酒精消费水平之间的率比及其95%置信区间。对于男性和女性，平均每周酒精消费水平与病假之间均发现了显著的曲线趋势。从不饮酒者、曾经饮酒者和重度饮酒者经医学认证的病假率比轻度饮酒者高1.2倍（95%置信区间：1.1, 1.3）。酒精摄入量与健康之间的U型关系不太可能因心理社会差异导致的混杂因素或在不饮酒者类别中纳入曾经饮酒者而得到解释。适度饮酒也可能减少除心血管疾病以外的健康问题。
