Levitt Danielle E, Wohlgemuth Kealey J, Burnham Emilie F, Conner Michael J, Collier J Jason, Mota Jacob A
Metabolic Health and Muscle Physiology Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, Texas, USA.
Neuromuscular and Occupational Performance Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, Texas, USA.
Alcohol Clin Exp Res (Hoboken). 2025 Feb;49(2):392-406. doi: 10.1111/acer.15517. Epub 2025 Jan 2.
Alcohol misuse is prevalent among firefighters, and associated adverse cardiometabolic health consequences could negatively impact readiness for duty. Mental health conditions may confer additional risk. Therefore, we aimed to determine whether alcohol misuse increases cardiometabolic risk among firefighters and whether mental health conditions modify these relationships.
Deidentified data from firefighters (N = 2405; 95.8% males, 38 ± 9 years, 29.6 ± 4.6 kg/m) included demographics, Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C scores, mental health screening scores, anthropometrics, metabolic panel, and cardiorespiratory testing results. Differences in cardiometabolic parameters between firefighters with low AUDIT-C (<3 [females] or <4 [males]; no or low-risk alcohol use) or high AUDIT-C (≥3 [females] or ≥4 [males]; hazardous alcohol use) were determined and odds ratios for clinical risk factors were calculated. Posttraumatic stress disorder (PTSD), insomnia, depression, and anxiety were assessed as moderators.
Firefighters with high AUDIT-C had significantly (p < 0.05) higher total cholesterol (TC), high-density lipoprotein (HDL-C), and systolic blood pressure (SBP) and diastolic blood pressure (DBP) and lower hemoglobin A1C (HbA1c) than those with low AUDIT-C. In unadjusted and/or adjusted analyses, those with high AUDIT-C had increased risk for overweight/obesity, hypercholesterolemia, and prehypertension/hypertension, and decreased risk for low HDL and elevated HbA1c. There were inverse moderation effects by posttraumatic stress disorder (PTSD), depression, and anxiety on relationships between AUDIT-C score and BP. Insomnia (directly) and anxiety (inversely) moderated relationships between AUDIT-C score and circulating lipids.
Firefighters with high AUDIT-C have differential cardiometabolic risk, with specific relationships altered by mental health status. Whether higher HDL and lower HbA1c with high AUDIT-C in firefighters is protective long-term remains to be explored. Overall, these results underscore the need for alcohol screening and intervention to maintain cardiometabolic health and long-term occupational readiness among firefighters.
消防员中酒精滥用现象普遍，相关的不良心脏代谢健康后果可能会对执勤准备产生负面影响。心理健康状况可能会带来额外风险。因此，我们旨在确定酒精滥用是否会增加消防员的心脏代谢风险，以及心理健康状况是否会改变这些关系。
来自消防员的匿名数据（N = 2405；95.8%为男性，年龄38±9岁，体重指数29.6±4.6kg/m²）包括人口统计学信息、酒精使用障碍识别测试（AUDIT）和AUDIT-C评分、心理健康筛查评分、人体测量学、代谢指标以及心肺功能测试结果。比较了AUDIT-C评分低（女性<3或男性<4；无或低风险饮酒）或高（女性≥3或男性≥4；有害饮酒）的消防员之间心脏代谢参数的差异，并计算了临床风险因素的比值比。将创伤后应激障碍（PTSD）、失眠、抑郁和焦虑作为调节因素进行评估。
AUDIT-C评分高的消防员总胆固醇（TC）、高密度脂蛋白（HDL-C）、收缩压（SBP）和舒张压（DBP）显著高于（p<0.05）AUDIT-C评分低的消防员，而糖化血红蛋白（HbA1c）较低。在未调整和/或调整分析中，AUDIT-C评分高的消防员超重/肥胖、高胆固醇血症和高血压前期/高血压的风险增加，而HDL低和HbA1c升高的风险降低。创伤后应激障碍（PTSD）、抑郁和焦虑对AUDIT-C评分与血压之间的关系有反向调节作用。失眠（直接）和焦虑（反向）调节了AUDIT-C评分与循环脂质之间的关系。
AUDIT-C评分高的消防员存在不同的心脏代谢风险，其特定关系会因心理健康状况而改变。消防员中AUDIT-C评分高时HDL较高和HbA1c较低是否具有长期保护作用仍有待探索。总体而言，这些结果强调了进行酒精筛查和干预以维持消防员心脏代谢健康和长期职业准备状态的必要性。
