Risérus Ulf, Ingelsson Erik
Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism/Geriatrics, Uppsala Science Park, 751 85 Uppsala, Sweden.
Obesity (Silver Spring). 2007 Jul;15(7):1766-73. doi: 10.1038/oby.2007.210.
Moderate and high alcohol intake have been associated with decreased and increased risk of type 2 diabetes, respectively. Insulin resistance, insulin secretion, and abdominal obesity are major predictors of diabetes, but the links with alcohol intake remain contradictory because of limited data.
In a population-based cohort of 807 men (age, 70 years), we studied whether alcohol intake was related to insulin sensitivity, measured with the gold standard technique (euglycemic clamp), insulin secretion (early insulin response), or adiposity [BMI, waist circumference (WC), waist-to-hip ratio]. Alcohol intake was self-reported (questionnaire) and was assessed from a validated 7-day dietary record. The cross-sectional associations were evaluated using multivariable linear regression, adjusting for smoking, education level, physical activity, dietary total energy intake, hypertension, diabetes, triglycerides, and cholesterol.
In multivariable models, self-estimated alcohol intake was not related to insulin sensitivity, early insulin response, or BMI, but was positively related to WC (beta-coefficient, 0.77; 95% confidence interval, 0.15 to 1.39; p=0.02) and waist-to-hip ratio (0.006 [0.002-0.009], p=0.003). The association with WC and waist-to-hip ratio was most pronounced in men in the lowest tertile of BMI. The results using dietary records were similar.
Evaluated in a large sample in elderly men, neither insulin sensitivity measured by clamp technique nor insulin secretion was significantly associated with alcohol intake. However, high alcohol intake was associated with abdominal obesity, which might explain the higher diabetes risk previously observed in high alcohol consumers.
中度和大量饮酒分别与2型糖尿病风险降低和升高相关。胰岛素抵抗、胰岛素分泌和腹部肥胖是糖尿病的主要预测因素，但由于数据有限，它们与饮酒之间的联系仍存在矛盾。
在一个基于人群的队列研究中，纳入807名70岁男性，我们研究了饮酒是否与胰岛素敏感性（采用金标准技术——正常血糖钳夹法测量）、胰岛素分泌（早期胰岛素反应）或肥胖程度[体重指数（BMI）、腰围（WC）、腰臀比]有关。饮酒情况通过自我报告（问卷）并根据经过验证的7天饮食记录进行评估。使用多变量线性回归评估横断面关联，并对吸烟、教育水平、身体活动、饮食总能量摄入、高血压、糖尿病、甘油三酯和胆固醇进行校正。
在多变量模型中，自我估计的饮酒量与胰岛素敏感性、早期胰岛素反应或BMI无关，但与腰围呈正相关（β系数为0.77；95%置信区间为0.15至1.39；p = 0.02），与腰臀比也呈正相关（0.006 [0.002 - 0.009]，p = 0.003）。与腰围和腰臀比的关联在BMI最低三分位数的男性中最为明显。使用饮食记录得出的结果相似。
在大量老年男性样本中评估发现，通过钳夹技术测量的胰岛素敏感性和胰岛素分泌均与饮酒量无显著关联。然而，大量饮酒与腹部肥胖有关，这可能解释了之前在大量饮酒者中观察到的较高糖尿病风险。
