Shaper A G, Wannamethee G, Walker M
Department of Clinical Epidemiology and General Practice, Royal Free Hospital School of Medicine, London.
Lancet. 1988 Dec 3;2(8623):1267-73. doi: 10.1016/s0140-6736(88)92890-5.
In a prospective study of 7735 middle-aged 7 British men, 504 of whom died in a follow-up period of 7.5 years, there was a U-shaped relationship between alcohol intake and total mortality and an inverse relationship with cardiovascular mortality, even after adjustment for age, cigarette smoking, and social class. These mortality patterns were seen in all smoking categories (with ex-smoking non-drinkers having the highest mortality) and were observed in manual but not in non-manual workers. The alcohol-mortality relationships (total and cardiovascular) were present only in men with cardiovascular or cardiovascular-related doctor-diagnosed illnesses at initial examination. The data suggest that the observed alcohol-mortality relationships are produced by pre-existing disease and by the movement of men with such disease into non-drinking or occasional-drinking categories. The concept of a "protective" effect of drinking on mortality, ignoring the dynamic relationship between ill-health and drinking behaviour, is likely to be ill founded.
在一项对7735名英国中年男性的前瞻性研究中，其中504人在7.5年的随访期内死亡，即使在对年龄、吸烟情况和社会阶层进行调整之后，酒精摄入量与总死亡率之间呈U形关系，与心血管疾病死亡率呈负相关。所有吸烟类别中均出现了这些死亡率模式（已戒烟的不饮酒者死亡率最高），并且在体力劳动者中观察到了这种模式，而非体力劳动者中未观察到。酒精与死亡率的关系（总死亡率和心血管疾病死亡率）仅在初次检查时有心血管疾病或与心血管相关的疾病且由医生诊断的男性中存在。数据表明，观察到的酒精与死亡率的关系是由既有疾病以及患有此类疾病的男性转向不饮酒或偶尔饮酒类别所致。忽视健康不良与饮酒行为之间的动态关系，认为饮酒对死亡率有“保护”作用的观点可能是没有根据的。
