Research Centre for Prevention and Health, Glostrup University Hospital, Nordre Ringvej 57, Building 84/85, DK-2600, Glostrup, Denmark.
Addiction. 2015 Mar;110(3):451-60. doi: 10.1111/add.12823. Epub 2015 Jan 7.
To estimate the association between educational status and alcohol-related somatic and non-somatic morbidity and mortality among full siblings in comparison with non-related individuals.
Cohort study.
Denmark.
Approximately 1.4 million full siblings born in Denmark between 1950 and 1979 were followed from age 28-58 years or censoring due to alcohol-related hospitalization and mortality.
Cox regression analyses were used to estimate associations of educational status with alcohol-related outcomes. Results from cohort analyses based on non-related individuals and inter-sibling analyses were compared.
A lower educational status was associated with a higher rate of alcohol-related outcomes, especially among the youngest (aged 28-37 years) and individuals born 1970-79. Compared with the cohort analyses, the associations attenuated slightly in the inter-sibling analysis. For example, in the cohort analysis, females with a basic school education born 1970-79 had an increased rate of alcohol-related non-somatic morbidity and mortality [hazard rate ratio (HR) = 4.05, 95% confidence interval (CI) = 3.27-5.02] compared to those with a vocational education. In the inter-sibling analysis, the HR attenuated (HR = 2.66, 95% CI = 1.95-3.63). For alcohol-related somatic outcomes the corresponding figures were HR = 3.47 (95% CI = 2.63-4.58) and HR = 3.36 (95% CI = 2.10-5.38), respectively. In general, the associations were stronger among females than males (aged 28-37) in the analyses of alcohol-related non-somatic outcomes. Health conditions earlier in life explained only a minor part of the associations.
The association between educational status and alcohol-related somatic and non-somatic morbidity and mortality is only driven by familial factors to a small degree.
比较同胞间与非亲属个体间，教育程度与酒精相关躯体和非躯体发病率和死亡率的关联。
队列研究。
丹麦。
1950 年至 1979 年期间在丹麦出生的约 140 万对同胞，随访年龄 28-58 岁或因酒精相关住院和死亡而终止随访。
使用 Cox 回归分析来估计教育程度与酒精相关结局的关联。比较基于非亲属个体的队列分析结果和同胞间分析结果。
教育程度较低与更高的酒精相关结局发生率相关，尤其是在最年轻（28-37 岁）和 1970-79 年出生的个体中。与队列分析相比，同胞间分析中关联略有减弱。例如，在队列分析中，1970-79 年出生、接受基本学校教育的女性发生酒精相关非躯体发病率和死亡率的风险增加[风险比（HR）=4.05，95%置信区间（CI）=3.27-5.02]，与接受职业教育的女性相比。在同胞间分析中，HR 减弱（HR=2.66，95%CI=1.95-3.63）。对于酒精相关躯体结局，相应的 HR 分别为 3.47（95%CI=2.63-4.58）和 3.36（95%CI=2.10-5.38）。一般来说，在酒精相关非躯体结局的分析中，女性（28-37 岁）的关联强于男性。生命早期的健康状况仅能解释关联的一小部分。
教育程度与酒精相关躯体和非躯体发病率和死亡率的关联仅在很小程度上受到家族因素的驱动。
