Samokhvalov Andriy V, Irving Hyacinth M, Rehm Jürgen
Public Health and Regulatory Policy Section, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Eur J Cardiovasc Prev Rehabil. 2010 Dec;17(6):706-12. doi: 10.1097/HJR.0b013e32833a1947.
Alcohol exposure is one of the major risk factors for global burden of disease, but atrial fibrillation (AF) had not yet been included in these estimates. The purpose of this contribution was to examine the dose–response relationship between alcohol consumption and AF and to explore potential causal pathways.
Systematic literature review and meta-analyses.
Overall, a consistent dose–response relationship between the amount of alcohol consumed daily and the probability of the onset of AF was found. Women consuming 24, 60 and 120 g of alcohol daily had relative risks of 1.07 [95%confidence interval (CI): 1.04–1.10], 1.42 (95% CI: 1.23–1.64) and 2.02 (95% CI: 1.60–2.97), respectively, relative to nondrinkers. Among men, the corresponding relative risks were 1.08 (95% CI: 1.04–1.11), 1.44 (95% CI: 1.23–1.69) and 2.09(95% CI: 1.52–2.86). Based on the categorical analyses, we could not exclude the existence of a threshold (three drinks a day for men and two drinks a day for women). Several pathogenic mechanisms for the development of AF in alcohol users were identified.
Epidemiological criteria for causality were met to conclude a causal impact of alcohol consumption on the onset of AF with a monotonic dose–response relationship. However, the impact of light drinking is not clear.
酒精暴露是全球疾病负担的主要风险因素之一，但心房颤动（AF）尚未纳入这些评估之中。本研究的目的是探讨酒精摄入量与房颤之间的剂量反应关系，并探索潜在的因果途径。
系统文献综述和荟萃分析。
总体而言，发现每日酒精摄入量与房颤发作概率之间存在一致的剂量反应关系。与不饮酒者相比，每日摄入24克、60克和120克酒精的女性的相对风险分别为1.07[95%置信区间（CI）：1.04-1.10]、1.42（95%CI：1.23-1.64）和2.02（95%CI：1.60-2.97）。在男性中，相应的相对风险分别为1.08（95%CI：1.04-1.11）、1.44（95%CI：1.23-1.69）和2.09（95%CI：1.52-2.86）。基于分类分析，我们不能排除存在阈值的可能性（男性每天三杯，女性每天两杯）。确定了酒精使用者发生房颤的几种致病机制。
满足因果关系的流行病学标准，可得出饮酒对房颤发作有因果影响且存在单调剂量反应关系的结论。然而，轻度饮酒的影响尚不清楚。
