Femia Romana, Natali Andrea, L'Abbate Antonio, Ferrannini Ele
Department of Internal Medicine and CNR Institute of Clinical Physiology, University of Pisa School of Medicine, Pisa, Italy.
Arterioscler Thromb Vasc Biol. 2006 Jul;26(7):1607-12. doi: 10.1161/01.ATV.0000222929.99098.1f. Epub 2006 Apr 20.
Moderate alcohol consumption is associated with reduced cardiovascular disease (CVD) risk. Whether this protection is based on a lesser degree of coronary atherosclerosis has not been established.
We studied 1676 men and 465 women consecutively undergoing coronary angiography. A score (ATS) was calculated by summing the percent lumen narrowing of all main vessels; alcohol consumption was quantitated by questionnaire. In univariate analysis, ATS was significantly (P< or = 0.001) associated with male sex, age, familial CVD, smoking, diabetes, hypertension, and serum cholesterol levels; alcohol consumption was associated with less frequent diabetes (P<0.001) and lower ATS (P = 0.02). By multivariate analysis, alcohol intake was associated with lower ATS (P<0.01) independently of the other risk factors; the estimated effect size was comparable to that associated with a 1-mmol decrement in serum cholesterol. Over a median follow-up of 93 months, 37 women and 194 men died from a cardiac cause. By Cox analysis, positive predictors for cardiac mortality were male sex (hazard ratio [HR], 1.7; 95% confidence interval [CI], 1.1 to 2.6]), age (HR, 2.1; 95% CI, 1.8 to 2.5 per decade) and diabetes (HR, 1.7; 95% CI, 1.2 to 2.4), whereas alcohol consumption was the only negative predictor (HR, 0.84; 95% CI, 0.71 to 1.00).
In a selected high-risk population, moderate alcohol consumption was independently associated with less coronary atherosclerosis and lower risk for cardiac mortality.
适度饮酒与心血管疾病（CVD）风险降低相关。这种保护作用是否基于冠状动脉粥样硬化程度较轻尚未明确。
我们对1676名男性和465名女性连续进行冠状动脉造影检查。通过将所有主要血管的管腔狭窄百分比相加计算出一个评分（ATS）；饮酒量通过问卷调查进行量化。在单因素分析中，ATS与男性性别、年龄、家族性心血管疾病、吸烟、糖尿病、高血压和血清胆固醇水平显著相关（P≤0.001）；饮酒与糖尿病发生率较低（P<0.001）和较低的ATS相关（P = 0.02）。通过多因素分析，饮酒量与较低的ATS独立于其他危险因素相关（P<0.01）；估计的效应大小与血清胆固醇降低1 mmol相当。在中位随访93个月期间，37名女性和194名男性死于心脏原因。通过Cox分析，心脏死亡的阳性预测因素为男性性别（风险比[HR]，1.7；95%置信区间[CI]，1.1至2.6）、年龄（HR，2.1；95%CI，每十年1.8至2.5）和糖尿病（HR，1.7；95%CI，1.2至2.4），而饮酒是唯一的阴性预测因素（HR，0.84；95%CI，0.71至1.00）。
在选定的高危人群中，适度饮酒与冠状动脉粥样硬化程度较轻和心脏死亡风险较低独立相关。
