Saarni Samuli I, Joutsenniemi Kaisla, Koskinen Seppo, Suvisaari Jaana, Pirkola Sami, Sintonen Harri, Poikolainen Kari, Lönnqvist Jouko
National Public Health Institute, Department of Mental Health and Alcohol Research, Helsinki, Finland.
Alcohol Alcohol. 2008 May-Jun;43(3):376-86. doi: 10.1093/alcalc/agn003. Epub 2008 Feb 1.
To examine the associations between alcohol consumption and utility-based health-related quality of life (HRQoL), subjective quality of life (QoL), self-rated health (SRH), and mental distress.
Representative general population survey in Finland, with 5871 persons aged 30-64 years. HRQoL was measured with two health utility instruments (15D and EQ-5D), QoL and SRH were measured with RATING scales, and mental distress with a General Health Questionnaire (GHQ-12). Past alcohol problems were diagnosed with a structured psychiatric interview known as the composite international diagnostic interview (CIDI). Alcohol consumption was examined with a self-report questionnaire.
Negative associations between alcohol and well-being were observed on several measures for women consuming more than 173 g and men more than 229 g per week. Former drinkers scored worst on most measures, even in comparison to the highest drinking decile. For men, all statistically significant associations between moderate drinking and well-being disappeared when sociodemographic factors and former drinkers were controlled for. For women, moderate alcohol use associated with better SRH and EQ-5D as compared to abstainers. However, the possible health utility benefits associated with moderate alcohol consumption were of clinically insignificant magnitude.
Failure to separate former drinkers and other abstainers produces a significant bias favoring moderate drinkers. As the possible health utility benefits of moderate alcohol use were clinically insignificant, it suffices to investigate mortality, when estimating the public health impact of moderate alcohol consumption using quality-adjusted life years.
研究饮酒与基于效用的健康相关生活质量（HRQoL）、主观生活质量（QoL）、自评健康（SRH）以及精神困扰之间的关联。
在芬兰进行具有代表性的普通人群调查，共有5871名年龄在30 - 64岁之间的人参与。HRQoL采用两种健康效用工具（15D和EQ - 5D）进行测量，QoL和SRH采用评分量表进行测量，精神困扰采用一般健康问卷（GHQ - 12）进行测量。过去的酒精问题通过一种名为综合国际诊断访谈（CIDI）的结构化精神病学访谈进行诊断。饮酒情况通过自我报告问卷进行调查。
对于每周饮酒超过173克的女性和超过229克的男性，在多项测量指标上观察到酒精与幸福感之间存在负相关。即使与饮酒量最高的十分位数人群相比，戒酒者在大多数测量指标上得分最差。对于男性，在控制了社会人口统计学因素和戒酒者后，适度饮酒与幸福感之间所有具有统计学意义的关联均消失。对于女性，与戒酒者相比，适度饮酒与更好的SRH和EQ - 5D相关。然而，适度饮酒可能带来的健康效用益处的临床意义不大。
未能区分戒酒者和其他不饮酒者会产生显著偏向适度饮酒者的偏差。由于适度饮酒可能带来的健康效用益处的临床意义不大，在使用质量调整生命年估计适度饮酒对公共卫生的影响时，研究死亡率就足够了。
