Romelsjö Anders, Branting Maria, Hallqvist Johan, Alfredsson Lars, Hammar Niklas, Leifman Anders, Ahlbom Anders
Centre for Social Research on Alcohol and Drugs, Stockholm, Sweden.
Addiction. 2003 Oct;98(10):1453-62. doi: 10.1046/j.1360-0443.2003.00488.x.
Very few studies indicating that low-moderate alcohol consumption protects from myocardial infarction (MI) controlled for social support and working conditions, which could confound the findings. Therefore, a first aim was to study the risk of non-fatal and total MI in relation to volume of alcohol consumption and measures of social support and working conditions. A second aim was to analyse the impact of the volume of earlier alcohol use in abstainers.
Data came from a case-control study, the Stockholm Heart Epidemiology Program (SHEEP), including first MI among Swedish citizens 45-70 years old.
Stockholm County 1992-94.
There were 1095 cases of MI in men and 471 in women (928 and 372 were non-fatal), and 2339 living controls from the general population.
Information about alcohol use at different periods in life and job strain, social anchorage and life control besides pre-existing health problems, smoking, physical activity, socio-economic status and marital status was obtained by a questionnaire from the cases and the controls.
In multivariate logistic regression analyses, the relative risk for MI (especially non-fatal) was reduced among alcohol consumers. RR for non-fatal MI was 0.52 (95% confidence intervals 0.32, 0.85) in men with a consumption of 50-69.9 g 100% ethanol/day and 0.21 (95% confidence interval 0.06, 0.77) in women with a consumption of 30 g or more per day (reference category 0.1-5 g 100% ethanol/day). Men who were abstainers during the previous 1-10 years and with an earlier average consumption of 5-30 g 100% ethanol/day had a significantly lower relative risk compared to such abstainers with an earlier higher consumption. Earlier consumption among abstainers may also have an impact on gender differences in MI. Analyses showed positive interaction between abstention and low life-control in women, but only 4% of the female cases were due to this interaction. There were no other interactions between measures of alcohol use and social anchorage, life control and working situations.
Alcohol use had a protective impact on MI, with little impact of job strain, social anchorage and life control, giving increased support for a protective impact of low-moderate alcohol use. The level of previous alcohol consumption among male 1-10-year-long abstainers influenced the risk of MI.
极少有研究表明，适度饮酒对心肌梗死（MI）具有预防作用，这些研究对社会支持和工作条件进行了控制，而这两者可能会混淆研究结果。因此，首要目的是研究非致命性心肌梗死和总体心肌梗死的风险与饮酒量、社会支持措施及工作条件之间的关系。第二个目的是分析戒酒者既往饮酒量的影响。
数据来自一项病例对照研究，即斯德哥尔摩心脏流行病学项目（SHEEP），研究对象为45至70岁的瑞典公民首次发生的心肌梗死。
1992 - 1994年的斯德哥尔摩县。
男性心肌梗死患者1095例，女性471例（非致命性心肌梗死分别为928例和372例），以及来自普通人群的2339名在世对照者。
通过问卷调查获取了病例组和对照组关于不同时期饮酒情况、工作压力、社会支持、生活掌控状况的信息，此外还包括既往健康问题、吸烟、体育活动、社会经济地位及婚姻状况等信息。
在多因素逻辑回归分析中，饮酒者发生心肌梗死（尤其是非致命性心肌梗死）的相对风险降低。每日饮用50 - 69.9克100%乙醇的男性非致命性心肌梗死的相对风险（RR）为0.52（95%置信区间0.32, 0.85），每日饮酒量30克及以上的女性RR为0.21（95%置信区间0.06, 0.77）（参考类别为每日饮用0.1 - 5克100%乙醇）。过去1 - 10年戒酒且既往平均每日饮用5 - 30克100%乙醇的男性，与既往饮酒量较高的戒酒者相比，其相对风险显著降低。戒酒者的既往饮酒量可能也会对心肌梗死的性别差异产生影响。分析显示，女性戒酒与低生活掌控之间存在正向交互作用，但仅有4%的女性病例归因于此交互作用。饮酒措施与社会支持、生活掌控及工作状况之间不存在其他交互作用。
饮酒对心肌梗死具有保护作用，工作压力、社会支持和生活掌控的影响较小，这进一步支持了适度饮酒具有保护作用的观点。过去1 - 10年戒酒的男性，其既往饮酒量水平会影响心肌梗死的风险。
