Urbano-Márquez A, Estruch R, Fernández-Solá J, Nicolás J M, Paré J C, Rubin E
Department of Internal Medicine and Cardiology, Hospital Clínic, University of Barcelona, Spain.
JAMA. 1995 Jul 12;274(2):149-54. doi: 10.1001/jama.1995.03530020067034.
To compare the cardiac and muscular status of male and female alcoholics to determine if the response of women to alcohol is different from that of men.
Cross-section study.
An ambulatory alcoholism treatment unit in the Hospital Clínic of Barcelona.
Fifty asymptomatic alcoholic women, 100 asymptomatic alcoholic men, and 50 female nonalcoholic controls.
Studies included clinical assessment of muscle strength, muscle biopsy, echocardiography, radionuclide cardiac angiography, and treadmill exercise electrocardiographic recording test.
The mean strength of the deltoid muscle in alcoholic women was significantly lower than that in controls (P < .001) and half suffered clinical weakness (muscle strength > or = 2 SD below controls). Muscle biopsy specimens from half of all asymptomatic women showed histologic evidence of myopathy. Left ventricular ejection fractions tended to be depressed, and a third of the alcoholic women had evidence of cardiomyopathy. Muscular strength and ejection fractions in women were inversely correlated with the total lifetime dose of ethanol, whereas the left ventricular mass showed a direct correlation. Of the alcoholic men, 39% suffered clinical weakness, and 45% had histologic evidence of myopathy. Evidence of cardiomyopathy was found in almost a third of the men, and their ejection fractions also correlated inversely with the total lifetime dose of ethanol. However, the threshold dose for the development of cardiomyopathy was considerably less in women than in men, and the decline in the ejection fraction with increasing alcohol dose was significantly steeper (P < .001).
Despite the fact that the mean lifetime dose of alcohol in female alcoholics was only 60% that in male alcoholics, cardiomyopathy and myopathy were as common in female alcoholics as in male alcoholics. This finding, together with a more pronounced response of the ejection fraction to the dose of ethanol, indicates that women are more sensitive than men to the toxic effects of alcohol on striated muscle.
比较男性和女性酗酒者的心脏和肌肉状况，以确定女性对酒精的反应是否与男性不同。
横断面研究。
巴塞罗那临床医院的门诊酗酒治疗单元。
50名无症状的酗酒女性、100名无症状的酗酒男性和50名非酗酒女性对照。
研究包括肌肉力量的临床评估、肌肉活检、超声心动图、放射性核素心血管造影以及跑步机运动心电图记录测试。
酗酒女性三角肌的平均力量显著低于对照组（P <.001），半数有临床肌无力（肌肉力量比对照组低≥2个标准差）。所有无症状女性中有一半的肌肉活检标本显示有肌病的组织学证据。左心室射血分数往往降低，三分之一的酗酒女性有心肌病证据。女性的肌肉力量和射血分数与乙醇的终生总剂量呈负相关，而左心室质量呈正相关。在酗酒男性中，39%有临床肌无力，45%有肌病的组织学证据。近三分之一的男性有心肌病证据，他们的射血分数也与乙醇的终生总剂量呈负相关。然而，女性发生心肌病的阈值剂量比男性低得多，且随着酒精剂量增加，射血分数的下降明显更陡峭（P <.001）。
尽管女性酗酒者的平均终生酒精摄入量仅为男性酗酒者的60%，但心肌病和肌病在女性酗酒者中与男性酗酒者中一样常见。这一发现，连同射血分数对乙醇剂量更明显的反应，表明女性比男性对酒精对横纹肌的毒性作用更敏感。
