Klatsky Arthur L, Friedman Gary D, Armstrong Mary Anne, Kipp Harald
Division of Cardiology, Department of Medicine, Kaiser Permanente Medical Center, Oakland, CA 94611, USA.
Am J Epidemiol. 2003 Sep 15;158(6):585-95. doi: 10.1093/aje/kwg184.
A substantially increased risk for heavy drinkers and a slightly reduced risk for lighter drinkers results in the J-shaped alcohol-mortality curve. Limited data suggest a more favorable mortality experience for drinkers of wine than for drinkers of liquor or beer. To examine these relations, the authors performed a cohort study of participants in a large Northern California prepaid health care program. Demographic and history data were collected from 128,934 adults undergoing health evaluations in 1978-1985, with subsequent death ascertained by an automated linkage system. Cox proportional hazards models with eight covariates were used to determine relative risk estimates according to total alcohol intake and days per week of drinking wine, wine types, beer, or liquor. The J-shaped alcohol-mortality relation was stable for 20 years. Independently, frequency of wine drinking was associated with lower mortality risk (p<0.001) largely because of lower coronary disease risk. Similar risk reductions were associated with red wine, white wine, other types of wine, and combinations of wine types. Much of the lower risk associated with light drinking was related to wine drinking. The authors conclude that drinkers of any type of wine have a lower mortality risk than do beer or liquor drinkers, but it remains unclear whether this reduced risk is due to nonalcoholic wine ingredients, drinking pattern, or associated traits.
重度饮酒者风险大幅增加，轻度饮酒者风险略有降低，由此形成了J型酒精与死亡率曲线。有限的数据表明，饮用葡萄酒者的死亡率情况比饮用烈性酒或啤酒者更为有利。为研究这些关系，作者对北加利福尼亚州一个大型预付医疗保健项目的参与者进行了一项队列研究。收集了1978年至1985年期间接受健康评估的128,934名成年人的人口统计学和病史数据，随后通过自动链接系统确定死亡情况。使用具有八个协变量的Cox比例风险模型，根据总酒精摄入量以及每周饮用葡萄酒、葡萄酒类型、啤酒或烈性酒的天数来确定相对风险估计值。J型酒精与死亡率的关系在20年中保持稳定。独立来看，饮用葡萄酒的频率与较低的死亡风险相关（p<0.001），这主要是因为冠心病风险较低。饮用红葡萄酒、白葡萄酒、其他类型葡萄酒以及多种葡萄酒组合均与类似的风险降低相关。轻度饮酒相关的较低风险很大程度上与饮用葡萄酒有关。作者得出结论，饮用任何类型葡萄酒的人比饮用啤酒或烈性酒的人死亡率风险更低，但尚不清楚这种风险降低是由于葡萄酒中的非酒精成分、饮酒模式还是相关特征所致。
