Trim Ryan S, Schuckit Marc A, Smith Tom L
Department of Psychiatry, University of California, San Diego, CA 92161-2002, USA.
Alcohol Clin Exp Res. 2009 Sep;33(9):1562-70. doi: 10.1111/j.1530-0277.2009.00984.x. Epub 2009 May 26.
A low level of response (LR) to alcohol has been shown to relate to a higher risk for alcohol use disorders (AUDs). However, no previous research has examined the association between LR and the development of AUDs in the context of additional robust risk factors for AUDs. This study evaluated whether LR and other related characteristics predicted the occurrence of AUDs across adulthood using discrete-time survival analysis (DTSA).
A total of 297 probands from the San Diego Prospective Study reported on the LR to alcohol, a family history (FH) of AUDs, the typical drinking quantity, the age of drinking onset, the body mass index and the age at the baseline (T1) assessment. Alcohol use disorders (AUDs) were evaluated at the 10-year (T10), T15, T20, and T25 follow-ups.
A low LR to alcohol predicted AUD occurrence over the course of adulthood even after controlling for the effects of other robust risk factors. Interaction effects revealed that the impact of FH on AUDs was only observed for subjects with high T1 drinking levels, and probands with high T1 drinking were at high risk for AUDs regardless of their age of onset.
The findings illustrate that LR is a unique risk factor for AUDs across adulthood, and not simply a reflection of a broader range of risk factors. The continued investigation of how LR is related to AUD onset later in life will help inform treatment providers about this high-risk population, and future longitudinal evaluations will utilize DTSA to assess rates of AUD remission as well as the onset of drinking outcomes in adolescent samples.
对酒精的低反应水平(LR)已被证明与酒精使用障碍(AUDs)的较高风险相关。然而,以前没有研究在存在其他强大的AUDs风险因素的背景下,考察LR与AUDs发生之间的关联。本研究使用离散时间生存分析(DTSA)评估LR和其他相关特征是否能预测成年期AUDs的发生。
来自圣地亚哥前瞻性研究的总共297名先证者报告了对酒精的LR、AUDs的家族史(FH)、典型饮酒量、饮酒开始年龄、体重指数以及基线(T1)评估时的年龄。在10年(T10)、T15、T20和T25随访时评估酒精使用障碍(AUDs)。
即使在控制了其他强大风险因素的影响之后,对酒精的低LR仍能预测成年期AUDs的发生。交互作用表明,仅在T1饮酒水平高的受试者中观察到FH对AUDs的影响,并且T1饮酒量高的先证者无论其发病年龄如何,发生AUDs的风险都很高。
研究结果表明,LR是成年期AUDs的一个独特风险因素,而不仅仅是更广泛风险因素的反映。继续研究LR在生命后期如何与AUDs发病相关,将有助于为治疗提供者提供有关这一高风险人群的信息,并且未来的纵向评估将利用DTSA来评估AUDs缓解率以及青少年样本中饮酒结果的发病情况。