Park Ji-Eun, Ryu Yeonhee, Cho Sung-Il
Graduate School of Public Health , Seoul National University, Seoul, Korea.
Korea Institute of Oriental Medicine , Daejeon, Korea.
Alcohol Clin Exp Res. 2017 Feb;41(2):379-387. doi: 10.1111/acer.13299. Epub 2017 Jan 18.
Many studies suggest that mild alcohol consumption can help avert cardiovascular disease (CVD). This study investigated the association between alcohol consumption and CVD incidence, and assessed whether this differed by reference group classification. As alcohol consumption amounts may change over time, the results of simple and time-dependent analyses were compared.
Data were from a community-based cohort study on 40- to 69-year-old Koreans recruited in 2001 to 2002. A total of 8,330 participants were followed up for 10 years and classed as nondrinkers (0 g/d), drinker group 1 (<15 g/d), and drinker group 2 (≥15 g/d). The risk of CVD, including myocardial infarction and coronary artery disease, was compared among groups using simple and time-dependent Cox analysis. Occasional drinkers (<2.5 g/d), nondrinkers, and lifetime abstainers were used as comparison reference groups.
Simple Cox analysis indicated that drinker group 1 exhibited a significantly lower risk of myocardial infarction (hazard ratio [HR]: 0.44, 95% confidence interval [CI]: 0.21, 0.92) and coronary artery disease (HR: 0.61, 95% CI: 0.4, 0.94) than nondrinkers. Time-dependent analysis based on alcohol consumption change showed that the beneficial effects of drinker group 1 were significant only for myocardial infarction, not for coronary artery disease. The benefits did not change significantly when either nondrinkers or lifetime abstainers were the reference group. However, when occasional drinkers were included in the reference group, the benefits of drinker group 1 were not significant for myocardial infarction (HR: 0.65, 95% CI: 0.29, 1.45) or coronary artery disease (HR: 0.71, 95% CI: 0.42, 1.19). Occasional drinkers and drinkers had more similar sociodemographic characteristics than did nondrinkers and drinkers.
Further studies on alcohol consumption and its effects on health must use repeated measurement to define drinking status, as simple and time-dependent analyses can show different alcohol consumption risks. These findings do not indicate a beneficial effect of drinking <15 g/d when occasional drinkers and nondrinkers are included in the reference group.
许多研究表明，适度饮酒有助于预防心血管疾病（CVD）。本研究调查了饮酒与CVD发病率之间的关联，并评估了这种关联是否因参照组分类而异。由于饮酒量可能随时间变化，因此对简单分析和时间依赖性分析的结果进行了比较。
数据来自2001年至2002年招募的40至69岁韩国人的社区队列研究。共有8330名参与者被随访10年，并被分类为不饮酒者（0克/天）、饮酒组1（<15克/天）和饮酒组2（≥15克/天）。使用简单和时间依赖性Cox分析比较各组中心血管疾病（包括心肌梗死和冠状动脉疾病）的风险。偶尔饮酒者（<2.5克/天）、不饮酒者和终生戒酒者被用作比较参照组。
简单Cox分析表明，饮酒组1发生心肌梗死（风险比[HR]：0.44，95%置信区间[CI]：0.21，0.92）和冠状动脉疾病（HR：0.61，95%CI：0.4，0.94）的风险显著低于不饮酒者。基于饮酒量变化的时间依赖性分析表明，饮酒组1的有益作用仅对心肌梗死显著，对冠状动脉疾病不显著。当以不饮酒者或终生戒酒者为参照组时，益处没有显著变化。然而，当参照组中包括偶尔饮酒者时，饮酒组1对心肌梗死（HR：0.65，95%CI：0.29，1.45）或冠状动脉疾病（HR：0.71，95%CI：0.42，1.19）的益处不显著。偶尔饮酒者和饮酒者的社会人口学特征比不饮酒者和饮酒者更相似。
关于饮酒及其对健康影响的进一步研究必须使用重复测量来定义饮酒状态，因为简单分析和时间依赖性分析可能显示不同的饮酒风险。当参照组中包括偶尔饮酒者和不饮酒者时，这些发现并未表明每天饮酒<15克有有益作用。
