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日本男性饮酒与心血管疾病及其亚型死亡的相关性,以及按血脂异常分层:NIPPON DATA90 的 20 年随访。

Association between alcohol intake and death from cardiovascular diseases and its subtypes stratified by dyslipidemia in Japanese men: 20-years follow-up of NIPPON DATA90.

机构信息

Human Care Research Team, Tokyo Metropolitan Institute for Geriatrics and Gerontology.

Department of Preventive Medicine and Public Health, Keio University School of Medicine.

出版信息

Environ Health Prev Med. 2024;29:61. doi: 10.1265/ehpm.24-00164.

Abstract

BACKGROUND

The association between alcohol consumption and atherosclerotic cardiovascular disease (ASCVD) was controversial, and no previous studies have shown the impact of dyslipidemia on the association. We aimed to clarify the association between alcohol consumption and death from cardiovascular disease (CVD) and its subtypes and the impact of dyslipidemia on the association.

METHODS

We conducted a 20-year cohort study to clarify the association between alcohol intake and death from CVD and its subtypes in 2,909 Japanese men. We estimated the hazard ratio (HR) and 95% confidence intervals (CIs) for current drinkers with non-drinkers as the reference, after adjusting for potential confounders using Cox proportional hazards models. We also investigated the association between alcohol consumption and ASCVD or CVD death stratified by the presence or absence of dyslipidemia.

RESULTS

During 50,782 person-years of follow-up period, 223 participants died from total CVD, 110 participants died from ASCVD, and 25 participants died from cerebral hemorrhage. Current drinkers with 1 gou/day were significantly associated with lower risk of ASCVD (HR: 0.60, 95%CI: 0.37-0.98), which is more apparent in those without dyslipidemia, and current drinkers with ≥3 gou/day were significantly associated with higher risk of cerebral hemorrhage (HR: 4.13, 95%CI: 1.12-15.19).

CONCLUSIONS

Small amounts of alcohol drinking were associated with lower risk of ASCVD in Japanese men, especially those without dyslipidemia. Meanwhile, excessive alcohol drinking was associated with higher risk of cerebral hemorrhage. Our findings suggest that it is important for current Japanese drinkers to reduce alcohol consumption for preventing ASCVD or cerebral hemorrhage.

摘要

背景

饮酒与动脉粥样硬化性心血管疾病(ASCVD)之间的关联存在争议,且既往研究尚未显示血脂异常对这种关联的影响。我们旨在阐明饮酒与心血管疾病(CVD)死亡及其亚型之间的关系,以及血脂异常对这种关联的影响。

方法

我们进行了一项为期 20 年的队列研究,以阐明 2909 名日本男性中饮酒与 CVD 死亡及其亚型之间的关系。我们使用 Cox 比例风险模型,在调整了潜在混杂因素后,估计了当前饮酒者与非饮酒者的危险比(HR)和 95%置信区间(CI)。我们还根据是否存在血脂异常,对饮酒与 ASCVD 或 CVD 死亡之间的关系进行了分层分析。

结果

在 50782 人年的随访期间,223 名参与者死于总 CVD,110 名参与者死于 ASCVD,25 名参与者死于脑出血。每天饮酒 1 蛊的当前饮酒者 ASCVD 的风险显著降低(HR:0.60,95%CI:0.37-0.98),这种关联在没有血脂异常的人群中更为明显,而每天饮酒 ≥3 蛊的当前饮酒者脑出血的风险显著升高(HR:4.13,95%CI:1.12-15.19)。

结论

少量饮酒与日本男性 ASCVD 风险降低相关,尤其是在没有血脂异常的人群中。同时,过量饮酒与脑出血风险升高相关。我们的研究结果表明,对于当前的日本饮酒者来说,减少饮酒量对于预防 ASCVD 或脑出血非常重要。

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