Department of Epidemiology, School of Public Health, Shandong University, Jinan, People's Republic of China.
Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas.
J Am Coll Cardiol. 2017 Aug 22;70(8):913-922. doi: 10.1016/j.jacc.2017.06.054.
Previous studies have revealed inconsistent findings regarding the association of light to moderate alcohol consumption with cardiovascular disease (CVD) and cancer mortality.
The aim of this study was to examine the association between alcohol consumption and risk of mortality from all causes, cancer, and CVD in U.S. adults.
Data were obtained by linking 13 waves of the National Health Interview Surveys (1997 to 2009) to the National Death Index records through December 31, 2011. A total of 333,247 participants ≥18 years of age were included. Self-reported alcohol consumption patterns were categorized into 6 groups: lifetime abstainers; lifetime infrequent drinkers; former drinkers; and current light, moderate, or heavy drinkers. Secondary exposure included participants' binge-drinking status. The main outcome was all-cause, cancer, or CVD mortality.
After a median follow-up of 8.2 years (2.7 million person-years), 34,754 participants died of all causes (including 8,947 CVD deaths and 8,427 cancer deaths). Compared with lifetime abstainers, those who were light or moderate alcohol consumers were at a reduced risk of mortality for all causes (light-hazard ratio [HR]: 0.79; 95% confidence interval [CI]: 0.76 to 0.82; moderate-HR: 0.78; 95% CI: 0.74 to 0.82) and CVD (light-HR: 0.74; 95% CI: 0.69 to 0.80; moderate-HR: 0.71; 95% CI: 0.64 to 0.78), respectively. In contrast, there was a significantly increased risk of mortality for all causes (HR: 1.11; 95% CI: 1.04 to 1.19) and cancer (HR: 1.27; 95% CI: 1.13 to 1.42) in adults with heavy alcohol consumption. Binge drinking ≥1 d/week was also associated with an increased risk of mortality for all causes (HR: 1.13; 95% CI: 1.04 to 1.23) and cancer (HR: 1.22; 95% CI: 1.05 to 1.41).
Light and moderate alcohol intake might have a protective effect on all-cause and CVD-specific mortality in U.S. adults. Heavy or binge drinking was associated with increased risk of all-cause and cancer-specific mortality.
先前的研究表明，轻至中度饮酒与心血管疾病（CVD）和癌症死亡率之间的关联存在不一致的结果。
本研究旨在探讨美国成年人中饮酒与各种原因、癌症和心血管疾病死亡率之间的关联。
通过将 13 波全国健康访谈调查（1997 年至 2009 年）与全国死亡指数记录（截至 2011 年 12 月 31 日）相关联，获得数据。共有 333247 名年龄≥18 岁的参与者被纳入研究。自我报告的饮酒模式分为 6 组：终身不饮酒者；终身不常饮酒者；曾经饮酒者；以及当前的轻度、中度或重度饮酒者。次要暴露因素包括参与者的狂饮状态。主要结局是全因、癌症或心血管疾病死亡率。
在中位数为 8.2 年（270 万人年）的随访后，34754 名参与者死于各种原因（包括 8947 例 CVD 死亡和 8427 例癌症死亡）。与终身不饮酒者相比，轻度或中度饮酒者的全因死亡率降低（轻度 HR：0.79；95%置信区间 [CI]：0.76 至 0.82；中度 HR：0.78；95% CI：0.74 至 0.82）和 CVD 死亡率（轻度 HR：0.74；95% CI：0.69 至 0.80；中度 HR：0.71；95% CI：0.64 至 0.78）。相比之下，重度饮酒者的全因死亡率（HR：1.11；95% CI：1.04 至 1.19）和癌症死亡率（HR：1.27；95% CI：1.13 至 1.42）显著增加。每周狂饮≥1 天也与全因死亡率（HR：1.13；95% CI：1.04 至 1.23）和癌症死亡率（HR：1.22；95% CI：1.05 至 1.41）的增加相关。
美国成年人中，轻至中度饮酒可能对全因和心血管疾病特异性死亡率具有保护作用。重度或狂饮与全因和癌症特异性死亡率的增加相关。
