饮酒量和饮酒模式对日本人群全因死亡率和主要死因死亡率的影响。
Impact of Alcohol Intake and Drinking Patterns on Mortality From All Causes and Major Causes of Death in a Japanese Population.
机构信息
Graduate School of Medicine, The University of Tokyo.
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center.
出版信息
J Epidemiol. 2018 Mar 5;28(3):140-148. doi: 10.2188/jea.JE20160200. Epub 2017 Nov 11.
BACKGROUND
We examined the associations of alcohol consumption and liver holidays with all-cause mortality and with mortality due to cancer, heart disease, cerebrovascular disease, respiratory disease, and injury using a large-scale prospective study in Japan.
METHODS
We followed 102,849 Japanese who were aged between 40 and 69 years at baseline for 18.2 years on average, during which 15,203 deaths were reported. Associations between alcohol intake and mortality risk were assessed using a Cox proportional hazards model, with analysis by the number of liver holidays (in which a person abstains from drinking for several days a week).
RESULTS
A J-shaped association was observed between alcohol intake and total mortality in men (nondrinkers: reference; occasional drinkers: hazard ratio [HR] 0.74; 95% confidence interval [CI], 0.68-0.80; 1-149 g/week: HR 0.76; 95% CI, 0.71-0.81; 150-299 g/week: HR 0.75; 95% CI, 0.70-0.80; 300-449 g/week: HR 0.84; 95% CI, 0.78-0.91; 450-599 g/week: HR 0.92; 95% CI, 0.83-1.01; and ≥600 g/week: HR 1.19; 95% CI, 1.07-1.32) and in women (nondrinkers: reference; occasional: HR 0.75; 95% CI, 0.70-0.82; 1-149 g/week: HR 0.80; 95% CI, 0.73-0.88; 150-299 g/week: HR 0.91; 95% CI, 0.74-1.13; 300-449 g/week: HR 1.04; 95% CI, 0.73-1.48; and ≥450 g/week: HR 1.59; 95% CI, 1.07-2.38). In current drinkers, alcohol consumption was associated with a linear, positive increase in mortality risk from all causes, cancer, and cerebrovascular disease in both men and women, but not heart disease in men. Taking of liver holidays was associated with a lower risk of cancer and cerebrovascular disease mortality in men.
CONCLUSIONS
Alcohol intake showed J-shaped associations with the risk of total mortality and three leading causes of death. However, heavy drinking increases the risk of mortality, which highlights the necessity of drinking in moderation coupled with liver holidays.
背景
我们通过在日本进行的一项大规模前瞻性研究，考察了饮酒和肝脏假与全因死亡率以及癌症、心脏病、脑血管病、呼吸道疾病和损伤导致的死亡率之间的关系。
方法
我们对 102849 名年龄在 40 至 69 岁之间的日本人进行了平均 18.2 年的随访，在此期间报告了 15203 例死亡。使用 Cox 比例风险模型评估饮酒与死亡风险之间的关联，并按肝脏假的数量进行分析（一个人每周有几天不饮酒）。
结果
在男性（不饮酒者：参考；偶尔饮酒者：危险比 [HR] 0.74；95%置信区间 [CI]，0.68-0.80；1-149 g/周：HR 0.76；95%CI，0.71-0.81；150-299 g/周：HR 0.75；95%CI，0.70-0.80；300-449 g/周：HR 0.84；95%CI，0.78-0.91；450-599 g/周：HR 0.92；95%CI，0.83-1.01；和≥600 g/周：HR 1.19；95%CI，1.07-1.32）和女性（不饮酒者：参考；偶尔：HR 0.75；95%CI，0.70-0.82；1-149 g/周：HR 0.80；95%CI，0.73-0.88；150-299 g/周：HR 0.91；95%CI，0.74-1.13；300-449 g/周：HR 1.04；95%CI，0.73-1.48；和≥450 g/周：HR 1.59；95%CI，1.07-2.38）中，饮酒与全因死亡率和三种主要死因的风险呈 J 形关联。然而，大量饮酒会增加死亡风险，这突出表明需要适度饮酒并结合肝脏假。
结论
饮酒与总死亡率和三种主要死因的风险呈 J 形关联。然而，大量饮酒会增加死亡风险，这突出表明需要适度饮酒并结合肝脏假。
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