Pitsavos C, Makrilakis K, Panagiotakos D B, Chrysohoou C, Ioannidis I, Dimosthenopoulos C, Stefanadis C, Katsilambros N
First Cardiology Department, School of Medicine, University of Athens, Athens, Greece.
Diabet Med. 2005 Mar;22(3):243-8. doi: 10.1111/j.1464-5491.2004.01384.x.
To identify the threshold of alcohol consumption above which the balance of risk and benefit becomes adverse in diabetic subjects.
We studied demographic, lifestyle, dietary and clinical information in 216 hospitalized diabetic patients (171 men, 63 +/- 9 years old, 45 women, 67 +/- 5 years old) with a first event of an acute coronary syndrome (ACS) and 196 frequency matched (age-sex) diabetic controls, without any clinical evidence of coronary heart disease. Alcohol consumption was quantified and a measure for the comparisons was predetermined to be a wine glass (100 ml of wine, 12 g of ethanol) and its alcohol equivalents.
Alcohol consumption was associated with an age-adjusted J-shape relationship with total cholesterol, blood pressure and smoking (all P < 0.001). A J-shape association was also found between alcohol intake and the risk of ACS (OR = 2.54-2.43 x (alcohol intake) + 0.80 x (alcohol intake)2, R2 = 0.96, P < 0.001), adjusted for several risk factors and interactions between alcohol intake and smoking status, job and familial stress, and low income. In particular, low alcohol consumption (< 12 g/day) was associated with a 47% (OR = 0.53, 95% CI 0.28-0.97) reduction of the prevalence of ACS, while a higher intake (12-24 and > 24 g/day) increased the prevalence by 2.7-fold (OR = 2.72, 95% CI 1.39-5.38) and 5.4-fold (OR = 5.44, 95% CI 1.21-24.55), respectively.
Alcohol intake is a significant predictor of coronary events. Low-to-moderate intake seems to be associated with a reduction in the prevalence of ACS in diabetes, whereas higher consumption is associated with an increase in lipids and blood pressure levels, and also the risk of developing ACS.
确定糖尿病患者饮酒量的阈值，超过该阈值风险与益处的平衡将变得不利。
我们研究了216例因急性冠状动脉综合征（ACS）首次发病而住院的糖尿病患者（171名男性，63±9岁，45名女性，67±5岁）以及196名频率匹配（年龄-性别）的糖尿病对照者的人口统计学、生活方式、饮食和临床信息，这些对照者无冠心病的任何临床证据。对饮酒量进行量化，比较的度量标准预先设定为一杯葡萄酒（100毫升葡萄酒，12克乙醇）及其酒精当量。
饮酒量与总胆固醇、血压和吸烟之间存在年龄调整后的J形关系（所有P<0.001）。在调整了几个风险因素以及饮酒量与吸烟状况、工作和家庭压力以及低收入之间的相互作用后，饮酒量与ACS风险之间也发现了J形关联（OR = 2.54 - 2.43×（饮酒量）+ 0.80×（饮酒量）²，R² = 0.96，P<0.001）。特别是，低饮酒量（<12克/天）与ACS患病率降低47%（OR = 0.53，95%CI 0.28 - 0.97）相关，而较高饮酒量（12 - 24克/天和>24克/天）分别使患病率增加2.7倍（OR = 2.72，95%CI 1.39 - 5.38）和5.4倍（OR = 5.44，95%CI 1.21 - 24.55）。
饮酒量是冠状动脉事件的重要预测指标。低至中度饮酒似乎与糖尿病患者ACS患病率降低相关，而较高饮酒量与血脂和血压水平升高以及发生ACS的风险增加相关。
