Rosengren A, Wilhelmsen L, Pennert K, Berglund G, Elmfeldt D
Department of Internal Medicine, Ostra Hospital, Göteborg, Sweden.
Acta Med Scand. 1987;222(3):201-13. doi: 10.1111/j.0954-6820.1987.tb10661.x.
High alcohol consumption is one of the major risk indicators for premature death in middle-aged men. An indicator of alcohol abuse--registration with the social authorities for alcoholic problems--was used to evaluate the role of alcohol in relation to general and cause-specific mortality in a general population sample. Altogether 1,116 men (11%) out of a total population of 10,004 men were registered for alcoholic problems. Total mortality during 11.8 years' follow-up was 10.4% among the non-registered men, compared to 20.5% among men with occasional convictions for drunkenness and 29.6% among heavy abusers. Fatal cancer as a whole was not independently associated with alcohol abuse, but oropharyngeal and oesophageal cancers together were seven times more common in the alcohol-registered groups. Total coronary heart disease (CHD) was significantly and independently associated with alcohol abuse, but nearly all the excess CHD mortality among the alcohol-registered men could be attributed to sudden coronary death. Cases with definite recent myocardial infarction were not more common in the alcoholic population. A combined effect of coronary arteriosclerosis and heart muscle damage secondary to alcohol abuse is suggested. Other causes of death strongly associated with registration for alcohol abuse include pulmonary embolism, pneumonia and peptic ulcer, as well as death from liver cirrhosis and alcoholism. Of the excess mortality among alcohol-registered subjects, 20.1% could be attributed to CHD, 18.1% to violent death, 13.6% to alcoholism without another diagnosis and 11.1% to liver cirrhosis.
高酒精摄入量是中年男性过早死亡的主要风险指标之一。酒精滥用的一个指标——因酒精问题向社会当局登记——被用于评估在一般人群样本中酒精与全因死亡率及特定病因死亡率之间的关系。在10004名男性的总人口中，共有1116名男性（11%）因酒精问题进行了登记。在11.8年的随访期间，未登记男性的总死亡率为10.4%，而偶尔因醉酒被定罪的男性为20.5%，重度滥用者为29.6%。总体而言，致命癌症与酒精滥用并无独立关联，但在登记有酒精问题的人群中，口咽癌和食道癌的发病率是其他人群的7倍。总的冠心病（CHD）与酒精滥用存在显著且独立的关联，但登记有酒精问题的男性中几乎所有额外的冠心病死亡率都可归因于冠心病猝死。近期明确发生心肌梗死的病例在酗酒人群中并不更为常见。提示存在冠状动脉粥样硬化与酒精滥用继发的心肌损伤的联合作用。与酒精滥用登记密切相关的其他死因包括肺栓塞、肺炎和消化性溃疡，以及肝硬化和酒精中毒导致的死亡。在登记有酒精问题的人群中，额外死亡率的20.1%可归因于冠心病，18.1%归因于暴力死亡，13.6%归因于无其他诊断的酒精中毒，11.1%归因于肝硬化。
