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适量饮酒会增加心房颤动的风险吗?挪威亨于普(特隆赫姆郡)研究。

Does Moderate Drinking Increase the Risk of Atrial Fibrillation? The Norwegian HUNT (Nord-Trøndelag Health) Study.

机构信息

Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden

Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

J Am Heart Assoc. 2017 Oct 20;6(10):e007094. doi: 10.1161/JAHA.117.007094.

Abstract

BACKGROUND

Compelling evidence suggests that excessive alcohol consumption increases the risk of atrial fibrillation (AF), but the effect of light-moderate alcohol consumption is less certain. We investigated the association between alcohol consumption within recommended limits and AF risk in a light-drinking population.

METHODS AND RESULTS

Among 47 002 participants with information on alcohol consumption in a population-based cohort study in Norway, conducted from October 2006 to June 2008, 1697 validated AF diagnoses were registered during the 8 years of follow-up. We used Cox proportional hazard models with fractional polynomials to analyze the association between alcohol intake and AF. Population attributable risk for drinking within the recommended limit (ie, at most 1 drink per day for women and 2 drinks per day for men without risky drinking) compared with nondrinking was also calculated. The average alcohol intake was 3.8±4.8 g/d. The adjusted hazard ratio for AF was 1.38 (95% confidence interval, 1.06-1.80) when we compared participants consuming >7 drinks per week with abstainers. When we modeled the quantity of alcohol intake as a continuous variable, the risk increased in a curvilinear manner. It was higher with heavier alcohol intake, but there was virtually no association at <1 drink per day for women and <2 drinks per day for men in the absence of risky drinking. The population attributable risk among nonrisky drinkers was 0.07% (95% confidence interval, -0.01% to 0.13%).

CONCLUSIONS

Although alcohol consumption was associated with a curvilinearly increasing risk of AF in general, the attributable risk of alcohol consumption within recommended limits among participants without binge or problem drinking was negligible in this population.

摘要

背景

大量证据表明,过量饮酒会增加房颤(AF)的风险,但轻度至中度饮酒的影响尚不确定。我们研究了在轻度饮酒人群中,适量饮酒与 AF 风险之间的关系。

方法和结果

在挪威一项基于人群的队列研究中,共有 47002 名参与者提供了饮酒信息,该研究于 2006 年 10 月至 2008 年 6 月进行,在 8 年的随访期间共登记了 1697 例确诊的 AF。我们使用 Cox 比例风险模型和分数多项式来分析饮酒量与 AF 之间的关联。还计算了在推荐范围内饮酒(即女性每天最多 1 份,男性每天最多 2 份,且不酗酒)与不饮酒相比的人群归因风险。平均酒精摄入量为 3.8±4.8 g/d。与不饮酒者相比,每周饮酒>7 杯的参与者发生 AF 的调整后风险比为 1.38(95%置信区间,1.06-1.80)。当我们将酒精摄入量作为连续变量建模时,风险呈曲线上升。随着饮酒量的增加,风险会增加,但在女性每天不超过 1 份、男性每天不超过 2 份且不存在酗酒的情况下,风险几乎没有关联。非风险饮酒者的人群归因风险为 0.07%(95%置信区间,-0.01%至 0.13%)。

结论

尽管总的来说,饮酒与房颤风险呈曲线上升相关,但在无 binge 或酗酒的参与者中,适量饮酒在推荐范围内的归因风险在该人群中可以忽略不计。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a66f/5721892/56d5826d893b/JAH3-6-e007094-g001.jpg

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