Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland.
Department of Psychiatry and Psychotherapy, Charite-Universitaetsmedizin Berlin, Berlin, Germany.
JAMA Netw Open. 2019 Jun 5;2(6):e195844. doi: 10.1001/jamanetworkopen.2019.5844.
The prevalence of high-intensity binge drinking (HIBD), defined as consuming 2 or more times the binge threshold defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), is rapidly increasing in the United States. While the relationship between alcohol consumption and lipid and liver function enzyme (LFT) biomarkers has been previously examined, the associations of HIBD with those biomarkers remain unknown.
To examine associations of HIBD with lipid and LFT levels in a cross-sectional sample enriched with participants who engage in HIBD.
DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study using data from the NIAAA clinical sample collected from March 3, 2005, to August 21, 2017, with participants recruited for either the NIAAA screening protocols or inpatient alcohol treatment program. For this study, participants were stratified by self-reported alcohol consumption into 4 sex-specific binge levels: nonbinge and 1, 2, and 3 or more times the binge threshold (levels I, II, and III). Multivariable analyses examined the odds of clinically high levels of lipids and LFTs across binge levels. Analyses were performed from December 3, 2018, to January 30, 2019.
Serum levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, total cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, and γ-glutamyltransferase.
A total of 2065 participants underwent protocol screening; 1519 with data available on alcohol consumption, body mass index, lipid levels, and LFT levels were included in the final analyses. Mean (SD) age was 39.7 (12.1) years; mean (SD) body mass index was 26.6 (5.1); 978 (64.4%) were male; 718 (47.3%) were white; and 578 (31.1%) consumed alcohol at the nonbinge level, 321 (21.2%) at level I, 239 (15.7%) at level II, and 318 (25.1%) at level III. High-intensity binge drinking was associated with 2- to 8-fold increased odds for clinically high levels of HDL-C, total cholesterol, triglycerides, and all LFTs (eg, for HDL-C: level III odds ratio [OR], 8.65; 95% CI, 4.75-15.77 and for γ-glutamyltransferase: level III OR, 8.21; 95% CI, 5.90-11.43). Increased HIBD frequency (days consuming at levels II and III) was associated with increased odds for clinically high levels of HDL-C, total cholesterol, and all LFTs (per unit increase in days consuming at the respective binge level) (eg, for HDL-C: level II OR, 1.025; 95% CI, 1.014-1.036 and level III OR, 1.033; 95% CI, 1.019-1.047 and for γ-glutamyltransferase: level II OR, 1.028; 95% CI, 1.019-1.037 and level III OR, 1.033; 95% CI, 1.019-1.047).
High-impact binge drinking was significantly associated with increased odds for clinically high levels of lipids and LFTs. Given that HIBD is increasingly common among US adults, targeted interventions aimed at reducing HIBD may have important health benefits.
重要性：在美国，高强度 binge drinking（HIBD）的流行率正在迅速上升，高强度 binge drinking 被定义为摄入超过国家酒精滥用和酒精中毒研究所（NIAAA）定义的 binge 阈值的 2 倍。尽管之前已经研究了饮酒量与脂质和肝功能酶（LFT）生物标志物之间的关系，但 HIBD 与这些生物标志物的关联仍不清楚。
目的：在一个富含高强度 binge drinker 的横断面样本中，检查 HIBD 与脂质和 LFT 水平之间的关系。
设计、地点和参与者：使用 2005 年 3 月 3 日至 2017 年 8 月 21 日期间从 NIAAA 临床样本中收集的数据进行横断面研究，参与者是根据自我报告的饮酒情况招募的，分为 4 种性别特异性 binge 水平：非 binge 和 1、2 和 3 次或更多次 binge 阈值（水平 I、II 和 III）。多变量分析检查了 binge 水平下脂质和 LFT 水平升高的几率。分析于 2018 年 12 月 3 日至 2019 年 1 月 30 日进行。
主要结果和测量：高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇、总胆固醇、甘油三酯、丙氨酸氨基转移酶、天冬氨酸氨基转移酶和γ-谷氨酰转移酶的血清水平。
结果：共有 2065 名参与者接受了方案筛选；1519 名有酒精消费、体重指数、血脂水平和 LFT 水平数据的参与者被纳入最终分析。平均（SD）年龄为 39.7（12.1）岁；平均（SD）体重指数为 26.6（5.1）；978（64.4%）为男性；718（47.3%）为白人；578（31.1%）为非 binge 饮酒者，321（21.2%）为 level I，239（15.7%）为 level II，318（25.1%）为 level III。高强度 binge drinking 与临床上高水平的 HDL-C、总胆固醇、甘油三酯和所有 LFTs（例如，HDL-C：level III 比值比[OR]，8.65；95%CI，4.75-15.77 和γ-谷氨酰转移酶：level III OR，8.21；95%CI，5.90-11.43）相关。增加 HIBD 频率（在 II 级和 III 级饮酒的天数）与临床上高水平的 HDL-C、总胆固醇和所有 LFTs（在各自 binge 水平上增加的饮酒天数）（例如，HDL-C：level II OR，1.025；95%CI，1.014-1.036 和 level III OR，1.033；95%CI，1.019-1.047 和γ-谷氨酰转移酶：level II OR，1.028；95%CI，1.019-1.037 和 level III OR，1.033；95%CI，1.019-1.047）相关。
结论和相关性：高强度 binge drinking 与临床上脂质和 LFTs 水平升高的几率显著相关。鉴于 HIBD 在美成年人中越来越普遍，针对减少 HIBD 的有针对性的干预措施可能会带来重要的健康益处。
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