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轻度至中度饮酒与对乙酰氨基酚治疗剂量:肾功能障碍风险评估

Light to moderate drinking and therapeutic doses of acetaminophen: An assessment of risks for renal dysfunction.

作者信息

Ndetan Harrison, Evans Marion W, Singal Ashwani K, Brunner Lane J, Calhoun Kirk, Singh Karan P

机构信息

Department of Epidemiology and Biostatistics, School of Community and Rural Health, University of Texas Health Science Center, 11937 US Hwy 271, Tyler, TX 75708, United States of America.

Department of Food Science, Nutrition, and Health Promotion, 105 Herzer Building, Box 9805, Mississippi State, MS 39762, United States of America.

出版信息

Prev Med Rep. 2018 Oct 24;12:253-258. doi: 10.1016/j.pmedr.2018.10.013. eCollection 2018 Dec.

Abstract

This study investigated the potential effect of therapeutic doses of acetaminophen (APAP) in combination with light-moderate amounts of alcohol on kidney functions controlling for factors such as hypertension, diabetes and obesity that may predispose the kidney to APAP and/or alcohol toxicity. Secondary analysis of the 2003-2004 National Health and Nutrition Examination Survey data was performed using SAS 9.4. Odds ratios (OR) and 95% confidence intervals (CI) comparing the likelihood that individuals who ingested therapeutic doses of APAP and light-moderate amount of alcohol, compared to those who did not, would have kidney dysfunction were generated from multiple logistics regression models by further controlling for potential predisposing factors namely hypertension, diabetes and obesity. Kidney dysfunction was defined based on self-reports and laboratory examination of serum creatinine (SCr), blood urea nitrogen (BUN), glomerular filtration rate (GFR) and albumin creatinine ratio (ABCR). Statistically significant increased odds of renal dysfunction were noted among respondents who reported use of therapeutic doses of APAP and light-moderate amount of alcohol [OR(95% CI) = 1.64(1.28-2.10) self-report, 2.18(1.81-2.63) SCr, 4.60(3.03-7.00) BUN, 3.14(2.42-4.07) GFR, and 1.71(1.36-2.14) ALBCR)] even after adjusting for hypertension, diabetes and obesity [Adjusted OR (95% CI) = 1.78 (1.22-2.58) self-report, 2.05 (1.07-3.92) GFR]. The toxic effects of APAP and alcohol on the kidney were hypothesized. The threshold doses at which these effects begin to occur are unknown. The findings of this study suggest that even therapeutic doses of APAP and light-moderate amount of alcohol could be health problematic if consumed concomitantly.

摘要

本研究调查了治疗剂量的对乙酰氨基酚(APAP)与少量至适量酒精联合使用对肾功能的潜在影响,同时控制了可能使肾脏易受APAP和/或酒精毒性影响的因素,如高血压、糖尿病和肥胖。使用SAS 9.4对2003 - 2004年国家健康和营养检查调查数据进行了二次分析。通过进一步控制潜在的易感因素,即高血压、糖尿病和肥胖,从多个逻辑回归模型中得出比值比(OR)和95%置信区间(CI),比较摄入治疗剂量APAP和少量至适量酒精的个体与未摄入者相比出现肾功能障碍的可能性。肾功能障碍根据自我报告以及血清肌酐(SCr)、血尿素氮(BUN)、肾小球滤过率(GFR)和白蛋白肌酐比值(ABCR)的实验室检查来定义。在报告使用治疗剂量APAP和少量至适量酒精的受访者中,即使在调整了高血压、糖尿病和肥胖因素后,仍发现肾功能障碍的统计学显著增加的几率[自我报告的OR(95% CI)= 1.64(1.28 - 2.10),SCr的OR(95% CI)= 2.18(1.81 - 2.63),BUN的OR(95% CI)= 4.60(3.03 - 7.00),GFR的OR(95% CI)= 3.14(2.42 - 4.07),ALBCR的OR(95% CI)= 1.71(1.36 - 2.14)] [调整后的OR(95% CI)= 1.78(1.22 - 2.58)自我报告,GFR的调整后OR(95% CI)= 2.05(1.07 - 3.92)]。推测了APAP和酒精对肾脏的毒性作用。这些作用开始出现的阈值剂量尚不清楚。本研究结果表明,如果同时服用,即使是治疗剂量的APAP和少量至适量酒精也可能对健康有问题。

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