饮酒与新发肾病：社区动脉粥样硬化风险研究结果
Alcohol Consumption and Incident Kidney Disease: Results From the Atherosclerosis Risk in Communities Study.
作者信息
Hu Emily A, Lazo Mariana, Rosenberg Sarah D, Grams Morgan E, Steffen Lyn M, Coresh Josef, Rebholz Casey M
机构信息
Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Department of Medicine, University of California San Diego, San Diego, California.
出版信息
J Ren Nutr. 2020 Jan;30(1):22-30. doi: 10.1053/j.jrn.2019.01.011. Epub 2019 Mar 6.
OBJECTIVE(S): Moderate alcohol consumption has been found to be associated with lower risk of coronary heart disease and myocardial infarction, which share similar risk factors and pathophysiology with chronic kidney disease (CKD). However, there is inconsistent evidence on the association between alcohol consumption and CKD.
DESIGN AND METHODS
We conducted a prospective analysis of 12,692 participants aged 45-64 years from the Atherosclerosis Risk in Communities (ARIC) study. We categorized participants into 6 alcohol consumption categories: never drinkers, former drinkers, ≤1 drink per week, 2 to 7 drinks per week, 8 to 14 drinks per week, and ≥15 drinks per week based on food frequency questionnaire responses at visit 1 (1987-1989). Incident CKD was defined as estimated glomerular filtration rate <60 mL/minute/1.73 m accompanied by ≥25% estimated glomerular filtration rate decline, a kidney disease-related hospitalization or death or end-stage renal disease.
RESULTS
During a median follow-up of 24 years, there were 3,664 cases of incident CKD. Current drinkers were more likely to be men, whites, and to have a higher income level and education level. After adjusting for total energy intake, age, sex, race-center, income, education level, health insurance, smoking, and physical activity, there was no significant association between being a former drinker and risk of incident CKD. Participants who drank ≤1 drink per week, 2 to 7 drinks per week, 8 to 14 drinks per week, and ≥15 drinks per week had, respectively, a 12% (hazard ratio [HR]: 0.88, 95% confidence interval [CI]: 0.79-0.97), 20% (HR: 0.80, 95% CI: 0.72-0.89), 29% (HR: 0.71, 95% CI: 0.62-0.83), and 23% (HR: 0.77, 95% CI: 0.65-0.91) lower risk of CKD compared with never drinkers.
CONCLUSION(S): Consuming a low or moderate amount of alcohol may lower the risk of developing CKD. Therefore, moderate consumption of alcohol may not likely be harmful to the kidneys.
目的
已发现适度饮酒与冠心病和心肌梗死风险较低有关，而冠心病和心肌梗死与慢性肾脏病（CKD）具有相似的危险因素和病理生理学特征。然而，关于饮酒与CKD之间的关联，证据并不一致。
设计与方法
我们对社区动脉粥样硬化风险（ARIC）研究中12692名年龄在45 - 64岁的参与者进行了前瞻性分析。根据首次访视（1987 - 1989年）时食物频率问卷的回答，我们将参与者分为6个饮酒类别：从不饮酒者、既往饮酒者、每周饮酒≤1杯、每周饮酒2至7杯、每周饮酒8至14杯以及每周饮酒≥15杯。新发CKD定义为估计肾小球滤过率<60 mL/分钟/1.73 m²且估计肾小球滤过率下降≥25%，或因肾脏疾病住院、死亡或进入终末期肾病。
结果
在中位随访24年期间，有3664例新发CKD病例。当前饮酒者更可能是男性、白人，且收入水平和教育水平较高。在调整总能量摄入、年龄、性别、种族中心、收入、教育水平、医疗保险、吸烟和身体活动后，既往饮酒者与新发CKD风险之间无显著关联。与从不饮酒者相比，每周饮酒≤1杯、每周饮酒2至7杯、每周饮酒8至14杯以及每周饮酒≥15杯的参与者发生CKD的风险分别降低12%（风险比[HR]：0.88，95%置信区间[CI]：0.79 - 0.97）、20%（HR：0.80，95% CI：0.72 - 0.89）、29%（HR：0.71，95% CI：0.62 - 0.83）和23%（HR：0.77，95% CI：0.65 - 0.91）。
结论
饮用少量或适量酒精可能会降低发生CKD的风险。因此，适度饮酒可能对肾脏无害。
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