Fan Amy Z, Russell Marcia, Stranges Saverio, Dorn Joan, Trevisan Maurizio
Pacific Institute for Research and Evaluation, Prevention Research Center, 1995 University Avenue, Suite 450, Berkeley, California 94704, USA.
J Clin Endocrinol Metab. 2008 Jan;93(1):154-61. doi: 10.1210/jc.2007-1395. Epub 2007 Nov 20.
Alcohol intakes may vary considerably over a drinker's lifetime. This study was designed to examine whether lifetime drinking trajectories are associated with cardiovascular risk factors that are used to define the metabolic syndrome (MetS). DESIGN, SETTING, PARTICIPANTS, AND OUTCOMES: This is a population-based cross-sectional study. Participants were ever-regular drinkers (n = 2818) selected from healthy controls for the Western New York Health Study (1996-2001) in which lifetime lifestyle was ascertained retrospectively. Prevalence of the MetS and its individual components, including obesity, high triglycerides, low high-density lipoprotein cholesterol, elevated blood pressure, and high fasting glucose, were the main outcomes.
Trajectory analyses were based on estimates of total kilograms of ethanol for each age decade between 10 and 59 yr. Two groups of drinkers with distinct lifetime drinking trajectories were obtained, an early peak and a stable trajectory group. Compared with stable trajectory drinkers, early-peak drinkers were 10 yr younger on average, had earlier onset of regular drinking, drank heavily in late adolescence and early adulthood tapering off in middle age, averaged more drinks per drinking day in lifetime, and were more likely to abstain when interviewed. After controlling for age, sex, and other potential confounders, early-peak trajectories were modestly associated with high odds of the MetS [1.31; 95% confidence interval (CI) 1.00, 1.71] overall, low high-density lipoprotein cholesterol (1.62; 95% CI 1.27, 2.08), abdominal obesity (1.48; 95% CI 1.23, 1.78), and overweight (1.32; 95% CI 1.10, 1.60).
Early initiation of alcohol drinking and heavy drinking in adolescence and early adulthood may be associated with an adverse cardiometabolic profile.
饮酒者一生中的酒精摄入量可能有很大差异。本研究旨在探讨终生饮酒轨迹是否与用于定义代谢综合征（MetS）的心血管危险因素相关。
设计、地点、参与者与结果：这是一项基于人群的横断面研究。参与者为从西纽约健康研究（1996 - 2001年）的健康对照中选取的曾经规律饮酒者（n = 2818），该研究通过回顾性确定终生生活方式。主要结果是MetS及其各个组成部分的患病率，包括肥胖、高甘油三酯、低高密度脂蛋白胆固醇、血压升高和空腹血糖升高。
轨迹分析基于10至59岁每个十年的乙醇总千克数估计值。获得了两组具有不同终生饮酒轨迹的饮酒者，即早期高峰组和稳定轨迹组。与稳定轨迹饮酒者相比，早期高峰饮酒者平均年轻10岁，开始规律饮酒的时间更早，在青春期后期和成年早期大量饮酒，中年时饮酒量逐渐减少，终生平均每天饮酒量更多，并且在接受访谈时更有可能戒酒。在控制年龄、性别和其他潜在混杂因素后，早期高峰轨迹总体上与MetS的高患病率[1.31；95%置信区间（CI）1.00，1.71]、低高密度脂蛋白胆固醇（1.62；95%CI 1.27，2.08）、腹型肥胖（1.48；95%CI 1.23，1.78）和超重（1.32；95%CI 1.10，1.60）适度相关。
青春期和成年早期过早开始饮酒及大量饮酒可能与不良的心脏代谢特征相关。
