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长期饮酒或戒酒的健康男性的冠状动脉斑块负荷和钙化积分

Coronary artery plaque burden and calcium scores in healthy men adhering to long-term wine drinking or alcohol abstinence.

作者信息

Luz P L da, Coimbra S, Favarato D, Albuquerque C, Mochiduky R I, Rochitte C E, Hojaij E, Gonsalves C R L, Laurindo F R

机构信息

Divisão de Cardiologia Clínica, Instituto do Coração (Incor), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.

Divisão de Radiologia, Instituto do Coração (Incor), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.

出版信息

Braz J Med Biol Res. 2014 Aug;47(8):697-705. doi: 10.1590/1414-431x20143880. Epub 2014 Jul 4.

Abstract

Observational studies suggest there are clinical benefits to moderate red wine (RW) consumption. However, the effects on coronary vasculature and overall lifestyle are unclear. We investigated whether a lifestyle of regular long-term RW consumption is associated with changes in coronary plaque burden, calcium score, carotid intima/media thickness, endothelial function, and metabolic variables, compared with alcohol abstinence. Healthy volunteers were evaluated by coronary computed tomography angiography (CTA) as well as carotid and brachial artery ultrasound. Nutritional status, psychological status, and metabolic variables were assessed. The study included 101 drinkers [aged 58.9 ± 7.3 years (means ± SD)], from wine brotherhoods, and 104 abstainers, from Anglican, Evangelical and Catholic churches both in the city of São Paulo, Brazil. No significant differences in demographics were noted. Lesion prevalence per patient assessed by coronary CTA and classified as absent (0), 1-25, 26-49, and ≥ 50% stenosis was similar between groups. When analyzed by individual arteries, i.e., left anterior descending, circumflex, and right coronary, prevalence was also not different. On the other hand, calcium scores were higher among drinkers than abstainers (144.4 ± 362.2 vs 122.0 ± 370.3; P<0.01). However, drinkers reported less history of diabetes and exercised more. RW drinkers consumed 2127.9 ± 387.7 kcal/day while abstainers consumed 1836.0 ± 305.0 (P<0.0001). HDL cholesterol was significantly higher among drinkers compared to abstainers (46.9 ± 10.9 vs 39.5 ± 9.0 mg/dL; P<0.001), while fasting plasma glucose was lower (97.6 ± 18.2 vs 118.4 ± 29.6 mg/dL; P<0.02). Liver enzymes were normal in both groups. In conclusion, long-term wine drinkers displayed a similar plaque burden but greater calcium score than abstainers, despite a more atherogenic diet, and the mechanisms for the increased calcium scores in the former remain speculative.

摘要

观察性研究表明,适量饮用红酒(RW)对临床有益。然而,其对冠状动脉血管和整体生活方式的影响尚不清楚。我们调查了与戒酒相比,长期规律饮用RW的生活方式是否与冠状动脉斑块负担、钙评分、颈动脉内膜/中膜厚度、内皮功能和代谢变量的变化有关。通过冠状动脉计算机断层扫描血管造影(CTA)以及颈动脉和肱动脉超声对健康志愿者进行评估。评估营养状况、心理状态和代谢变量。该研究纳入了来自巴西圣保罗市葡萄酒兄弟会的101名饮酒者[年龄58.9±7.3岁(均值±标准差)]和来自圣公会、福音派和天主教会的104名戒酒者。在人口统计学方面未发现显著差异。通过冠状动脉CTA评估的每位患者的病变患病率,并分类为无(0)、1 - 25%、26 - 49%和≥50%狭窄,两组之间相似。按个体动脉分析,即左前降支、回旋支和右冠状动脉,患病率也无差异。另一方面,饮酒者的钙评分高于戒酒者(144.4±362.2 vs 122.0±370.3;P<0.01)。然而,饮酒者报告的糖尿病病史较少且运动更多。RW饮酒者每天消耗2127.9±387.7千卡,而戒酒者消耗1836.0±305.0千卡(P<0.0001)。饮酒者的高密度脂蛋白胆固醇显著高于戒酒者(46.9±10.9 vs 39.5±9.0毫克/分升;P<0.001),而空腹血糖较低(97.6±18.2 vs 118.4±29.6毫克/分升;P<0.02)。两组的肝酶均正常。总之,尽管长期饮酒者的饮食更具致动脉粥样硬化性,但与戒酒者相比,他们的斑块负担相似但钙评分更高,前者钙评分增加的机制仍具有推测性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab3e/4165297/40c074d46d8f/1414-431X-bjmbr-47-08-00697-gf001.jpg

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