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