Parkinson School of Health Sciences & Public Health, Loyola University Chicago, 2160 S. 1st Ave, Maywood, IL, 60153, USA.
Division of Epidemiology and Biostatics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
BMC Public Health. 2021 Dec 4;21(1):2210. doi: 10.1186/s12889-021-12128-2.
Cardiometabolic (CM) risk affects approximately 25% of adults globally, and is diagnosed by meeting 3 out of 5 of the following CM risk factors: elevated blood pressure, high triglycerides, elevated blood sugar, low high-density lipoprotein (HDL) level, and abdominal obesity. Adults with CM risk are approximately 22% more likely to have higher mortality rates, and alcohol consumption may be associated with higher CM risk. While previous studies have investigated this potential connection, the majority of them did not include African-origin adults. Therefore, the study aimed to explore the association between alcohol intake and CM risk in 5 African-origin cohorts, spanning the epidemiologic transition in Ghana, South Africa, Jamaica, Seychelles and the United States of America.
Measurements included clinical measures for CM risk and self-reported alcohol consumption. Each participant was categorized into one of three drinking categories: non-drinker, light drinker (1-3 drinks daily for men and 1-2 drinks daily for women) and heavy drinker (4 or more drinks every day for men and 3 or more drinks per day for women). Using non-drinker status as the reference, the association between alcohol consumption status and prevalence of each of the five CM risk factors and overall elevated CM risk (having 3 out of 5 risk factors) was explored, adjusting for site, age and sex. Associations were explored using logistic regression and significance was determined using odds ratios (OR) and 95% confidence intervals.
Neither light nor heavy drinking was associated with increased odds for having higher CM risk compared to nondrinkers (OR = 1.05, p = 0.792 and OR = 1.11, p = 0.489, respectively). However, light drinking was associated with lower odds for having low high density lipoproteins (HDL) cholesterol (OR = 0.69, p = 0.002) and increased risk for high triglycerides (OR = 1.48, p = 0.030). Heavy drinking was associated with elevated blood pressure (OR = 1.59, p = 0.002), high triglycerides (OR = 1.73, p = 0.006) and decreased risk of low HDL-cholesterol (OR = 0.621, p < 0.0005). Finally, country-specific analyses indicated that the relationship between heavy drinking and elevated CM risk varied widely across sites.
While several CM risk factors were associated with alcohol consumption, the associations were inconsistent and varied widely across five international cohorts of African-origin. Future studies should focus on understanding the individual site-related effects.
心血管代谢（CM）风险影响了全球约 25%的成年人，通过满足以下 5 个 CM 风险因素中的 3 个来诊断：血压升高、高甘油三酯、血糖升高、低高密度脂蛋白（HDL）水平和腹部肥胖。CM 风险较高的成年人死亡率约高 22%，而饮酒可能与更高的 CM 风险相关。尽管之前的研究已经探讨了这种潜在的联系，但其中大多数研究都没有包括非洲裔成年人。因此，该研究旨在探讨 5 个非洲裔队列中饮酒与 CM 风险之间的关联，这些队列跨越了加纳、南非、牙买加、塞舌尔和美国的流行病学转变。
测量包括 CM 风险的临床测量和自我报告的饮酒量。每位参与者被归入以下三个饮酒类别之一：非饮酒者、轻度饮酒者（男性每天 1-3 杯，女性每天 1-2 杯）和重度饮酒者（男性每天 4 杯或以上，女性每天 3 杯或以上）。以不饮酒者为参考，探讨饮酒状况与五种 CM 风险因素中每一种以及总体 CM 风险升高（有 5 个风险因素中的 3 个）的关联，同时调整了地点、年龄和性别因素。使用逻辑回归探讨关联，使用优势比（OR）和 95%置信区间确定显著性。
与不饮酒者相比，轻度或重度饮酒均与更高的 CM 风险几率无关（OR=1.05，p=0.792 和 OR=1.11，p=0.489）。然而，轻度饮酒与低高密度脂蛋白（HDL）胆固醇（OR=0.69，p=0.002）和高甘油三酯（OR=1.48，p=0.030）的几率降低相关。重度饮酒与血压升高（OR=1.59，p=0.002）、高甘油三酯（OR=1.73，p=0.006）和低 HDL-胆固醇几率降低（OR=0.621，p<0.0005）相关。最后，特定国家的分析表明，重度饮酒与 CM 风险升高之间的关系在各个地点之间差异很大。
尽管一些 CM 风险因素与饮酒有关，但这些关联不一致，并且在五个非洲裔国际队列中差异很大。未来的研究应重点了解与各个地点相关的影响。
