Frantz S, Wollmer P, Dencker M, Engström G, Nihlén U
Clinical Physiology and Nuclear Medicine Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Clinical Physiology and Nuclear Medicine Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Respir Med. 2014 Jan;108(1):114-21. doi: 10.1016/j.rmed.2013.08.041. Epub 2013 Sep 7.
Studies on the influence of alcohol consumption on lung function have shown conflicting results. Self-reported alcohol consumption may be inaccurate. This study used both a validated alcohol questionnaire and a blood marker of heavy alcohol consumption, and examined potential associations with different lung physiological variables.
The study population (450 subjects) answered an alcohol questionnaire (AUDIT-C) and performed spirometry, body plethysmography and a test for diffusing capacity for CO (DL,CO). Carbohydrate deficient transferrin (CDT), a clinically used blood marker for identifying heavy alcohol consumption, and C-reactive protein (CRP), a marker of systemic inflammation were analysed.
Using AUDIT-C, 407 subjects were alcohol drinkers and 29 non-drinkers. Of the alcohol drinkers, 224 subjects were "hazardous drinkers" and 183 "moderate drinkers". Thirty-four subjects had a CDT ≥2.0% (=heavy drinkers). There was no difference in lung function between hazardous and moderate drinkers. Heavy drinkers had lower DL,CO (74% vs 83% PN, p = 0.003), more symptoms of chronic bronchitis (p = 0.001) and higher AUDIT-C scores (p < 0.001) than non-heavy drinkers. After adjustments (pack years and CRP) the difference in DL,CO (p = 0.037) remained. Multiple regression showed an association between CDT and both FEV1 (p = 0.004) and DL,CO (p = 0.012) in all alcohol drinkers, but not in never-smokers. The AUDIT-C score was associated with CDT (also after adjustments, p < 0.001) but not with any lung function variable.
The results from this study suggest that alcohol and particularly heavy drinking has an independent additive negative effect on lung function in smokers.
关于饮酒对肺功能影响的研究结果相互矛盾。自我报告的饮酒情况可能不准确。本研究使用了经过验证的饮酒问卷和重度饮酒的血液标志物，并研究了与不同肺生理变量的潜在关联。
研究人群（450名受试者）回答了一份饮酒问卷（AUDIT-C），并进行了肺活量测定、体容积描记法和一氧化碳弥散能力（DL,CO）测试。分析了碳水化合物缺乏转铁蛋白（CDT），一种临床上用于识别重度饮酒的血液标志物，以及全身炎症标志物C反应蛋白（CRP）。
使用AUDIT-C，407名受试者为饮酒者，29名不饮酒者。在饮酒者中，224名受试者为“危险饮酒者”，183名受试者为“适度饮酒者”。34名受试者的CDT≥2.0%（=重度饮酒者）。危险饮酒者和适度饮酒者的肺功能没有差异。与非重度饮酒者相比，重度饮酒者的DL,CO较低（74%对83%，PN，p = 0.003），慢性支气管炎症状更多（p = 0.001），AUDIT-C评分更高（p < 0.001）。调整后（吸烟包年数和CRP），DL,CO的差异仍然存在（p = 0.037）。多元回归显示，在所有饮酒者中，CDT与FEV1（p = 0.004）和DL,CO（p = 0.012）均相关，但在从不吸烟者中不相关。AUDIT-C评分与CDT相关（调整后也是如此，p < 0.001），但与任何肺功能变量均不相关。
本研究结果表明，酒精尤其是重度饮酒对吸烟者的肺功能有独立的附加负面影响。
