Service d'Endocrinologie-Métabolisme, AP-HP, Hôpital de la Pitié, Paris, France.
Eur J Clin Nutr. 2010 Jun;64(6):561-8. doi: 10.1038/ejcn.2010.61. Epub 2010 May 19.
BACKGROUND/OBJECTIVES: Observational studies document the inverse relationship between cardiovascular disease (CVD) and moderate alcohol intake. However, the causal role for alcohol in cardioprotection remains uncertain as such protection may be caused by confounders and misclassification. The aim of our study was to evaluate potential confounders, which may contribute to putative cardioprotection by alcohol.
SUBJECTS/METHODS: We evaluated clinical and biological characteristics, including cardiovascular (CV) risk factors and health status, of 149,773 subjects undergoing examination at our Center for CVD Prevention (The Urban Paris-Ile-de-France Cohort). The subjects were divided into four groups according to alcohol consumption: never, low (<or=10 g/day), moderate (10-30 g/day) and high (>30 g/day); former drinkers were analyzed as a separate group.
After adjustment for age, moderate male drinkers were more likely to display clinical and biological characteristics associated with lower CV risk, including low body mass index, heart rate, pulse pressure, fasting triglycerides, fasting glucose, stress and depression scores together with superior subjective health status, respiratory function, social status and physical activity. Moderate female drinkers equally displayed low waist circumference, blood pressure and fasting triglycerides and low-density lipoprotein-cholesterol. Alcohol intake was strongly associated with plasma high-density lipoprotein-cholesterol in both sexes. Multivariate analysis confirmed that moderate and low drinkers displayed better health status than did never drinkers. Importantly, few factors were causally related to alcohol intake.
Moderate alcohol drinkers display a more favorable clinical and biological profile, consistent with lower CV risk as compared with nondrinkers and heavy drinkers. Therefore, moderate alcohol consumption may represent a marker of higher social level, superior health status and lower CV risk.
背景/目的：观察性研究记录了心血管疾病（CVD）与适量饮酒之间的反比关系。然而，酒精对心脏的保护作用的因果关系尚不确定，因为这种保护作用可能是由混杂因素和分类错误引起的。我们研究的目的是评估可能的混杂因素，这些因素可能导致酒精对心脏的保护作用。
受试者/方法：我们评估了 149773 名在我们的心血管疾病预防中心（巴黎都市-法兰西岛队列）接受检查的受试者的临床和生物学特征，包括心血管（CV）危险因素和健康状况。根据饮酒量将受试者分为四组：从不饮酒、低（<=10g/天）、中（10-30g/天）和高（>30g/天）；以前饮酒者作为单独一组进行分析。
调整年龄后，中度男性饮酒者更有可能表现出与较低心血管风险相关的临床和生物学特征，包括低体重指数、心率、脉压、空腹甘油三酯、空腹血糖、压力和抑郁评分，以及更好的主观健康状况、呼吸功能、社会地位和体力活动。中度女性饮酒者同样表现出较低的腰围、血压和空腹甘油三酯和低密度脂蛋白胆固醇。饮酒与男女两性的血浆高密度脂蛋白胆固醇强烈相关。多变量分析证实，中度和轻度饮酒者的健康状况优于从不饮酒者。重要的是，很少有因素与饮酒量有因果关系。
与不饮酒者和重度饮酒者相比，中度饮酒者表现出更有利的临床和生物学特征，与较低的心血管风险一致。因此，适量饮酒可能代表着更高的社会地位、更好的健康状况和较低的心血管风险的标志物。
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