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糖尿病患者中轻度至中度饮酒与脂质相关指标之间的负相关关系。

Inverse associations between light-to-moderate alcohol intake and lipid-related indices in patients with diabetes.

作者信息

Shimomura Tomoko, Wakabayashi Ichiro

出版信息

Cardiovasc Diabetol. 2013 Jul 17;12:104. doi: 10.1186/1475-2840-12-104.

Abstract

BACKGROUND

Dyslipidemia is a common complication in patients with diabetes and is involved in being prone to cardiovascular disease. The risk of coronary artery disease is known to be lower in light-to-moderate drinkers than in abstainers. The aim of this study was to clarify whether and how alcohol drinking influences the lipid-related indices, good predictors for cardiovascular disease, such as the ratio of LDL cholesterol to HDL cholesterol (LDL-C/HDL-C ratio), the ratio of triglycerides to HDL cholesterol (TG/HDL-C ratio), and the lipid accumulation product (LAP), in patients with diabetes.

METHODS

The subjects were men with diabetes (n = 1477; mean age, 54.0 years) and they were divided into non-, light (< 22 g ethanol/day), moderate (≥ 22 and < 44 g ethanol/day) and heavy (≥ 44 g ethanol/day) drinkers. The relationships between alcohol intake and the lipid-related indices were investigated by the multivariate analyses with adjustment for age, smoking, regular exercise and drug therapy for diabetes.

RESULTS

The odds ratio (OR) vs. nondrinkers for high LDL-C/HDL-C ratio tended to be lower with an increase in alcohol intake (OR with 95% confidence interval (CI): 0.80 [0.50-1.29] in light drinkers; 0.24 [0.15-0.38] in moderate drinkers and 0.10 [0.05-0.19] in heavy drinkers). Alcohol intake showed an inverse association with a high TG/HDL-C ratio (OR with 95% CI vs. nondrinkers for high TG/HDL-C ratio: 0.54 [0.36-0.80] in light drinkers; 0.73 [0.56-0.97] in moderate drinkers and 0.72 [0.53-0.98] in heavy drinkers) and a J-shaped relationship with a high LAP (OR with 95% CI vs. nondrinkers for high LAP: 0.66 [0.43-1.02] in light drinkers; 0.82 [0.61-1.10] in moderate drinkers, and 1.29 [0.95-1.77] in heavy drinkers). Similar associations between alcohol intake and the lipid indices were obtained in a covariance analysis.

CONCLUSIONS

In patients with diabetes, light-to-moderate alcohol consumption is inversely associated with lipid-related indices, and this correlates with previous findings of cardiovascular risk reduction by modest drinking in patients with diabetes.

摘要

背景

血脂异常是糖尿病患者常见的并发症,且与心血管疾病易感性相关。已知轻度至中度饮酒者患冠状动脉疾病的风险低于戒酒者。本研究旨在阐明饮酒是否以及如何影响糖尿病患者的脂质相关指标,这些指标是心血管疾病的良好预测指标,如低密度脂蛋白胆固醇与高密度脂蛋白胆固醇之比(LDL-C/HDL-C 比值)、甘油三酯与高密度脂蛋白胆固醇之比(TG/HDL-C 比值)以及脂质蓄积产物(LAP)。

方法

研究对象为男性糖尿病患者(n = 1477;平均年龄 54.0 岁),他们被分为不饮酒者、轻度饮酒者(<22 克乙醇/天)、中度饮酒者(≥22 克且<44 克乙醇/天)和重度饮酒者(≥44 克乙醇/天)。通过多变量分析,在调整年龄、吸烟、规律运动和糖尿病药物治疗的情况下,研究饮酒量与脂质相关指标之间的关系。

结果

随着饮酒量增加,高 LDL-C/HDL-C 比值相对于不饮酒者的优势比(OR)呈下降趋势(轻度饮酒者的 OR 及其 95%置信区间(CI):0.80 [0.50 - 1.29];中度饮酒者为 0.24 [0.15 - 0.38];重度饮酒者为 0.10 [0.05 - 0.19])。饮酒量与高 TG/HDL-C 比值呈负相关(高 TG/HDL-C 比值相对于不饮酒者的 OR 及其 95%CI:轻度饮酒者为 0.54 [0.36 - 0.80];中度饮酒者为 0.73 [0.56 - 0.97];重度饮酒者为 0.72 [0.53 - 0.98]),与高 LAP 呈 J 形关系(高 LAP 相对于不饮酒者的 OR 及其 95%CI:轻度饮酒者为 0.66 [0.43 - 1.02];中度饮酒者为 0.82 [0.61 - 1.10];重度饮酒者为 1.29 [0.95 - 1.77])。在协方差分析中也得到了饮酒量与脂质指标之间类似的关联。

结论

在糖尿病患者中,轻度至中度饮酒与脂质相关指标呈负相关,这与先前关于适度饮酒可降低糖尿病患者心血管风险的研究结果相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edc0/3723450/a68dbf136853/1475-2840-12-104-1.jpg

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