Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Experimental Research Unit, National Autonomous University of Mexico, Mexico City, Mexico.
Lancet Public Health. 2024 Nov;9(11):e907-e915. doi: 10.1016/S2468-2667(24)00228-7.
Alcohol consumption is a leading cause of premature death globally, but there is no large-scale prospective evidence from Mexico.
The Mexico City Prospective Study recruited 150 000 adults aged 35 years or older between 1998 and 2004. Participants were followed up until Oct 1, 2022 for cause-specific mortality. Cox regression in those with no self-reported chronic disease at entry (adjusted for age, sex, district, education, physical activity, smoking, and diabetes) was used to relate baseline-reported alcohol consumption (never, former, occasional [less than monthly], and regular [at least monthly, split into <70, ≥70 to <140, ≥140 to <210, and ≥210 g/week]) to mortality at ages 35-74 from all causes, and from a pre-specified alcohol-related set of underlying causes. Heavy episodic drinking (normally consuming >5 [men] or >4 [women] drinks on a single occasion) and type of preferred drink were also examined.
Among 138 413 participants aged 35-74 years at recruitment, 21 136 (15%) were regular alcohol drinkers (14 863 [33%] men, 6273 [7%] women), of whom 13 383 (63%) favoured spirits and 6580 (31%) favoured beer. During follow-up, there were 13 889 deaths at ages 35-74 years, including 3067 deaths from the pre-specified alcohol-related causes. Overall, J-shaped associations with mortality were observed. Compared with occasional drinkers, those with baseline-reported consumption ≥210 g/week had 43% higher all-cause mortality (rate ratio [RR] 1·43 [95% CI 1·30-1·56]) and nearly three times the mortality from the pre-specified alcohol-related causes (2·77 [2·39-3·20]). Death from liver disease was strongly related to alcohol consumption; the RR comparing regular drinkers of ≥140 g/week with occasional drinkers was 4·03 (3·36-4·83). Compared with occasional light drinking, occasional heavy episodic drinking was associated with 20% higher alcohol-related mortality (1·20 [1·06-1·35]), and regular heavy episodic drinking was associated with 89% higher alcohol-related mortality (1·89 [1·67-2·15]). Drinks with alcohol percentages higher than spirits were associated with the greatest increased mortality risk, even after accounting for the total alcohol consumed.
In this Mexican population, higher alcohol consumption, episodic drinking, and very high percentage alcoholic products were all associated with increased mortality.
Wellcome Trust, the Mexican Health Ministry, the National Council of Science and Technology for Mexico, Cancer Research UK, British Heart Foundation, and the UK Medical Research Council.
For the Spanish translation of the abstract see Supplementary Materials section.
饮酒是导致全球过早死亡的主要原因之一，但墨西哥没有大规模的前瞻性证据。
墨西哥城前瞻性研究招募了 1998 年至 2004 年间年龄在 35 岁或以上的 15 万名成年人。参与者随访至 2022 年 10 月 1 日，以了解特定原因的死亡率。在没有报告慢性疾病的入组者中（按年龄、性别、区、教育、体力活动、吸烟和糖尿病调整），使用 Cox 回归分析与基线报告的饮酒量（从不饮酒、曾经饮酒、偶尔饮酒[每月不到一次]和经常饮酒[至少每月饮酒一次，分为<70、≥70 至<140、≥140 至<210 和≥210g/周]）相关联，以了解 35-74 岁人群的所有原因死亡率，以及从预先指定的与酒精相关的一系列根本原因死亡率。还检查了重度间歇性饮酒（通常单次饮酒量男性超过 5 杯，女性超过 4 杯）和首选饮料类型。
在招募时年龄为 35-74 岁的 138413 名参与者中，21136 人（15%）为经常饮酒者（14863 名男性[33%]，6273 名女性[7%]），其中 13383 人（63%）喜欢烈酒，6580 人（31%）喜欢啤酒。随访期间，35-74 岁人群中有 13889 人死亡，其中 3067 人死于预先指定的与酒精相关的原因。总体上，与死亡率呈 J 形关联。与偶尔饮酒者相比，基线报告的每周饮酒量≥210g 的人全因死亡率高出 43%（RR 1.43 [95%CI 1.30-1.56]），与预先指定的与酒精相关的原因死亡率几乎高出三倍（2.77 [2.39-3.20]）。死于肝病与饮酒密切相关；与偶尔饮酒者相比，每周饮酒≥140g 的经常饮酒者的 RR 为 4.03（3.36-4.83）。与偶尔轻度饮酒相比，偶尔重度间歇性饮酒与酒精相关死亡率增加 20%（1.20 [1.06-1.35]），而经常重度间歇性饮酒与酒精相关死亡率增加 89%（1.89 [1.67-2.15]）。与烈酒相比，酒精含量更高的饮料与更高的死亡率风险相关，即使考虑到总饮酒量也是如此。
在墨西哥人群中，更高的饮酒量、间歇性饮酒和高酒精含量的酒类均与死亡率增加有关。
威康信托基金会、墨西哥卫生部、墨西哥国家科学技术理事会、英国癌症研究中心、英国心脏基金会和英国医学研究理事会。
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