Liu Minyu, Pan Yuxiong, Wang Ziyong, Wang Jvhong, Shi Yibao, Chu Jun
Department of Cardiology, The First People's Hospital of Hefei, The Third Affiliated Hospital of Anhui Medical University, Hefei, 230000, Anhui, China.
Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
Nutr Metab Cardiovasc Dis. 2025 May;35(5):103783. doi: 10.1016/j.numecd.2024.10.021. Epub 2024 Oct 29.
The "J"-shaped relationship between alcohol consumption and cardiovascular health is recognized as potentially influenced by residual confounders, and this study aimed to clarify the role that social determinants play in the relationship.
Using NHANES data from 2005 to 2018, this study analyzed 30,648 participants to assess how eight social determinants (employment, income, food security, education, healthcare access, insurance, housing stability, and marital status) influence the relationship between alcohol consumption and cardiovascular disease (CVD). Moderate drinking reduces CVD risk (HR: 0.741, 95%CI: 0.661, 0.831, P < 0.001), while heavy drinking increases it (HR: 1.025, 95%CI: 1.004, 1.095, P = 0.035). Structural equation modeling revealed that ideal social determinants and health metrics contribute significantly to the cardiovascular protective effects of moderate drinking (path proportion: 42.31 %). Conversely, heavy drinking is associated with poorer social determinants and health metrics, masking the cardiovascular protective effect (path proportion: 90.91 %).
This study quantifies the role of social and health factors in the relationship between alcohol consumption and CVD. Despite identifying direct cardiovascular protective effects of alcohol consumption, global health initiatives should continue to advocate for reduced heavy drinking, given the significant risks involved.
饮酒与心血管健康之间的“J”形关系被认为可能受到残余混杂因素的影响，本研究旨在阐明社会决定因素在这种关系中所起的作用。
利用2005年至2018年的美国国家健康与营养检查调查（NHANES）数据，本研究分析了30648名参与者，以评估八个社会决定因素（就业、收入、食品安全、教育、医疗保健可及性、保险、住房稳定性和婚姻状况）如何影响饮酒与心血管疾病（CVD）之间的关系。适度饮酒可降低心血管疾病风险（风险比：0.741，95%置信区间：0.661，0.831，P<0.001），而重度饮酒则会增加风险（风险比：1.025，95%置信区间：1.004，1.095，P = 0.035）。结构方程模型显示，理想的社会决定因素和健康指标对适度饮酒的心血管保护作用有显著贡献（路径比例：42.31%）。相反，重度饮酒与较差的社会决定因素和健康指标相关，掩盖了心血管保护作用（路径比例：90.91%）。
本研究量化了社会和健康因素在饮酒与心血管疾病关系中的作用。尽管确定了饮酒对心血管有直接保护作用，但鉴于重度饮酒存在重大风险，全球健康倡议应继续倡导减少重度饮酒。
