Kerr William C, Williams Edwina, Li Libo, Lui Camillia K, Ye Yu, Greenfield Thomas K, Lown E Anne
Alcohol Research Group, Public Health Institute, 6001 Shellmound Ave, Suite 450, Emeryville, CA 94608, United States.
Alcohol Research Group, Public Health Institute, 6001 Shellmound Ave, Suite 450, Emeryville, CA 94608, United States.
Prev Med. 2018 Apr;109:22-27. doi: 10.1016/j.ypmed.2018.01.010. Epub 2018 Feb 3.
One of the major limitations in studying alcohol's effect on risk for diabetes is the issue of classifying drinking patterns across the life course prior to the onset of diabetes. Furthermore, this research often overlooks important life course risk factors such as obesity and early-life health problems that may complicate estimation of the relationship between alcohol and diabetes. This study used data from the US National Longitudinal Survey of Youth 1979 cohort of 14-21 year olds followed through 2012 (n = 8289). Alcohol use was captured through time-varying measures of past month volume and frequency of days with 6+ drinks. Discrete-time survival models controlling for demographics, early-life characteristics and time-varying risk factors of employment, smoking, and body mass index (BMI) group, stratified by sex and race/ethnicity, were estimated. Increased odds of diabetes onset was found among lifetime abstainers for women compared to the low volume reference group (odds ratio (OR) 1.57; 95% Confidence Interval (CI) 1.07-2.3). Increased odds of diabetes onset was also found among women who reported drinking 6+ drinks in a day on a weekly basis during the prior 10 years (OR 1.55; CI 1.04-2.31). Models interacting alcohol and BMI groups found increased odds of diabetes onset from lifetime abstention among overweight women only (OR 3.06; CI 1.67-5.60). This study confirms previous findings of protective effects from low volume drinking compared to lifetime abstention and harmful effects from regular heavy occasion drinking for women. Further, protective effects in this US sample were found to be limited to overweight women only.
研究酒精对糖尿病风险影响的主要局限之一,是在糖尿病发病前对一生饮酒模式进行分类的问题。此外,这项研究常常忽略重要的生命历程风险因素,如肥胖和早期健康问题,这些因素可能会使酒精与糖尿病之间关系的评估变得复杂。本研究使用了来自美国国家青年纵向调查1979队列的数据,该队列由14至21岁的青少年组成,随访至2012年(n = 8289)。通过过去一个月饮酒量以及6杯及以上饮酒天数的时变测量来获取饮酒情况。估计了离散时间生存模型,该模型控制了人口统计学特征、早期生活特征以及就业、吸烟和体重指数(BMI)组等时变风险因素,并按性别和种族/族裔进行分层。与低饮酒量参考组相比,终生戒酒的女性患糖尿病的几率增加(优势比(OR)1.57;95%置信区间(CI)1.07 - 2.3)。在过去10年中每周有一天报告饮酒6杯及以上的女性中,也发现患糖尿病的几率增加(OR 1.55;CI 1.04 - 2.31)。酒精与BMI组相互作用的模型发现,仅超重女性中终生戒酒会增加患糖尿病的几率(OR 3.06;CI 1.67 - 5.60)。本研究证实了先前的研究结果,即与终生戒酒相比,低饮酒量有保护作用,而女性经常大量饮酒有有害作用。此外,在美国这个样本中,保护作用仅限于超重女性。