Ding Jingzhong, Eigenbrodt Marsha L, Mosley Thomas H, Hutchinson Richard G, Folsom Aaron R, Harris Tamara B, Nieto F Javier
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Room 6009, Baltimore, Md 21205, USA.
Stroke. 2004 Jan;35(1):16-21. doi: 10.1161/01.STR.0000105929.88691.8E. Epub 2003 Dec 4.
Although the risks associated with heavy drinking for increased stroke and neurodegenerative changes are well established, the effects on the brain of low to moderate alcohol intake are unclear. Subclinical cerebral abnormalities identified on MRI have been associated with neurocognitive decline and incident stroke. We examined the associations of alcohol intake with MRI-defined cerebral abnormalities in a middle-aged, population-based cohort.
During 1993-1994, a total of 1909 middle-aged adults (40% men and 49% blacks) from 2 communities in the Atherosclerosis Risk in Communities (ARIC) Study (Forsyth County, North Carolina, and Jackson, Miss) underwent a cerebral MRI examination. Trained neuroradiologists coded the images for the presence of infarction and the extent (10-point scale) of white matter lesions, ventricular size, and sulcal size.
In logistic regression analyses, there was no association between alcohol intake and the presence of MRI infarction. In linear regression analyses, alcohol intake was not associated with white matter grade. However, intake of each additional alcoholic drink per week was associated with a 0.01 grade greater ventricular size (P=0.03) and a 0.009 grade greater sulcal size (P=0.02) after adjustment for age, sex, race, body mass index, smoking, income, sports index, and diabetes. The positive associations of alcohol intake with ventricular and sulcal size were consistent across sex and race subgroups.
A protective effect of low to moderate alcohol intake on cerebral infarction was not found; moreover, increased alcohol intake was associated with brain atrophy.
尽管大量饮酒会增加中风和神经退行性改变的风险已得到充分证实，但低至中度饮酒对大脑的影响尚不清楚。MRI检查发现的亚临床脑异常与神经认知功能下降和中风事件相关。我们在一个基于人群的中年队列中研究了饮酒与MRI定义的脑异常之间的关联。
1993年至1994年期间，社区动脉粥样硬化风险（ARIC）研究（北卡罗来纳州福赛斯县和密西西比州杰克逊市的2个社区）中的1909名中年成年人（40%为男性，49%为黑人）接受了脑部MRI检查。训练有素的神经放射科医生对图像进行编码，以确定梗死的存在以及白质病变的程度（10分制）、脑室大小和脑沟大小。
在逻辑回归分析中，饮酒与MRI梗死的存在之间没有关联。在线性回归分析中，饮酒与白质分级无关。然而，在调整年龄、性别、种族、体重指数、吸烟、收入、运动指数和糖尿病后，每周每多饮用一杯酒精饮料与脑室大小增加0.01级（P=0.03）和脑沟大小增加0.009级（P=0.02）相关。饮酒与脑室和脑沟大小的正相关在性别和种族亚组中是一致的。
未发现低至中度饮酒对脑梗死有保护作用；此外，饮酒量增加与脑萎缩有关。
