National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol BS10 5NB, UK.
Department of Internal Medicine, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands.
Clin Chim Acta. 2021 Sep;520:1-7. doi: 10.1016/j.cca.2021.05.024. Epub 2021 May 26.
Self-reported alcohol consumption is an established risk factor for cardiovascular disease (CVD). Carbohydrate deficient transferrin (CDT) is an established objective marker of excessive alcohol consumption, but data on its prospective association with CVD are lacking. We aimed to evaluate the associations of self-reported alcohol consumption and CDT (expressed as %CDT, a more reliable marker than absolute CDT levels) with CVD risk.
In the PREVEND prospective study of 5,206 participants (mean age, 53 years; 47.7% males), alcohol consumption by self-reports, absolute CDT measured using the Siemens nephelometric assay and %CDT calculated as the percentage of total transferrin concentrations, were assessed at baseline. Alcohol consumption was classified into 5 categories: abstention (reference), light, light-moderate, moderate and heavy alcohol consumption.Hazard ratios (HRs) (95% confidence intervals [CI]) for first CVD events were estimated.
Mean (SD) of %CDT was 1.59 (0.54) %. During a median follow-up of 8.3 years, 326 first CVD events were recorded. Compared with abstainers, the multivariable-adjusted HRs (95% CIs) of CVD for light, light-moderate, moderate and heavy alcohol consumption were 0.66 (0.46-0.95), 0.83 (0.62-1.11), 0.83 (0.61-1.14) and 0.80 (0.48-1.36), respectively. Light alcohol consumption was associated with reduced coronary heart disease risk 0.62 (0.40-0.96), whereas light-moderate alcohol consumption was associated with reduced stroke risk 0.45 (0.24-0.83). The association of %CDT with CVD risk was not significant.
Our findings confirm the established association between self-reported light to moderate alcohol consumption and reduced CVD risk. However, %CDT within the normal reference range may not be a risk indicator for CVD.
自我报告的饮酒量是心血管疾病(CVD)的既定危险因素。转铁蛋白缺乏(CDT)是过量饮酒的既定客观标志物,但缺乏其与 CVD 前瞻性关联的数据。我们旨在评估自我报告的饮酒量和 CDT(表示为%CDT,比绝对 CDT 水平更可靠的标志物)与 CVD 风险的关联。
在 5206 名参与者的 PREVEND 前瞻性研究中(平均年龄 53 岁;47.7%为男性),在基线时评估了自我报告的饮酒量、使用西门子散射比浊法测量的绝对 CDT 和作为总转铁蛋白浓度百分比的%CDT。饮酒量分为 5 类:禁欲(参考)、轻度、轻度至中度、中度和重度饮酒。估计首次 CVD 事件的风险比(HR)(95%置信区间[CI])。
%CDT 的平均值(标准差)为 1.59(0.54)%。在中位数为 8.3 年的随访期间,记录了 326 例首次 CVD 事件。与禁欲者相比,轻、轻至中度、中度和重度饮酒的 CVD 的多变量调整 HR(95%CI)分别为 0.66(0.46-0.95)、0.83(0.62-1.11)、0.83(0.61-1.14)和 0.80(0.48-1.36)。轻度饮酒与降低冠心病风险相关(0.62(0.40-0.96)),而轻至中度饮酒与降低中风风险相关(0.45(0.24-0.83))。%CDT 与 CVD 风险的关联不显著。
我们的发现证实了自我报告的轻至中度饮酒与降低 CVD 风险之间的既定关联。然而,正常参考范围内的%CDT 可能不是 CVD 的风险指标。