Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany; Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Germany.
Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Center for Preventive Medicine and Digital Health Baden-Württemberg (CPDBW), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Atherosclerosis. 2021 Oct;335:119-125. doi: 10.1016/j.atherosclerosis.2021.08.014. Epub 2021 Aug 12.
One of the most important risk factors for morbidity and mortality is the consumption of alcohol. The aim of our study was to examine the effect of alcohol consumption on all-cause mortality and cardiovascular mortality.
The Ludwigshafen Risk and Cardiovascular Health (LURIC) study includes 3316 patients hospitalized for coronary angiography at a tertiary care centre in Southwest Germany. Patients were followed-up for a median of 9.9 (range 0.1-11.9 years) years. Total mortality number in the follow-up period was 995, and the number of incident cases, i.e. cardiovascular death, was 622. Information on alcohol consumption assessed by self-report questionnaires was used to calculate intake in grams of ethanol per day. Associations of alcohol consumption with morbidity and mortality were analysed using Cox proportional hazards regression.
We found significantly increased mortality for patients in the highest alcohol intake group age- and sex-adjusted (hazard ratio of 1.59 (95%CI, 0.93-2.72)) and a reduced risk for the group of low-volume drinkers (hazard ratio of 0.75 (95%CI, 0.65-0.86)). After adjustment for cardiovascular risk factors, the risk difference between abstainers and low-volume drinkers was not significant anymore.
In the LURIC study, the risk of overall mortality and cardiovascular mortality is significantly increased in study participants with very high alcohol consumption and slightly increased in total abstainers as compared to participants with low consumption in unadjusted analysis, replicating the well-known J-curve. Adjusting for cardiovascular risk factors rendered the risk decrease observed for low-volume drinkers insignificant. Therefore, our results do not show a significant health benefit of low-volume alcohol consumption in a cohort of patients at medium-to-high cardiovascular risk.
发病率和死亡率的最重要的危险因素之一是饮酒。我们的研究目的是检验饮酒对全因死亡率和心血管死亡率的影响。
德国西南部一家三级保健中心因冠状动脉造影住院的 3316 名患者参与了 Ludwigshafen 风险与心血管健康（LURIC）研究。患者中位随访时间为 9.9 年（范围 0.1-11.9 年）。随访期间的总死亡人数为 995 人，心血管死亡的病例数为 622 例。使用自我报告问卷评估饮酒量来计算每天乙醇的摄入量。使用 Cox 比例风险回归分析来评估饮酒与发病率和死亡率的关系。
我们发现，在最高饮酒量组中，年龄和性别调整后的死亡率显著增加（危险比为 1.59（95%CI，0.93-2.72）），而低饮酒量组的风险降低（危险比为 0.75（95%CI，0.65-0.86））。调整心血管危险因素后，禁酒者和低饮酒量者之间的风险差异不再显著。
在 LURIC 研究中，与低饮酒量组相比，极高饮酒量组的总死亡率和心血管死亡率的风险显著增加，而完全禁酒组的总死亡率和心血管死亡率的风险略有增加，复制了众所周知的 J 曲线。调整心血管危险因素后，低饮酒量组观察到的风险降低不再显著。因此，我们的结果并未显示在中高危心血管风险患者队列中，低饮酒量与健康之间存在显著的关联。
