Palomäki H, Kaste M
Department of Neurology, University of Helsinki, Finland.
Stroke. 1993 Dec;24(12):1828-32. doi: 10.1161/01.str.24.12.1828.
To evaluate the association between different patterns of alcohol consumption and the risk of ischemic stroke in young or middle-aged men.
One hundred fifty-six patients and 153 control subjects were included in this case-control study. The pattern and the estimated average weekly intake of alcohol were assessed using a structured questionnaire. The pattern of drinking was defined as regular (daily or almost daily) or irregular (up to three times per week), and the weekly amount of consumption was defined as nondrinking, light-to-moderate drinking (up to 150 g/wk), moderate drinking (> 150 to 300 g/wk), and heavy drinking (> 300 g/wk). Multiple stepwise logistic regression models were used, and adjustments were carried out for potential confounders.
Heavy alcohol intake associated with an increased risk of stroke (odds ratio, 4.45; 95% confidence interval, 1.09 to 18.1), whereas the risk tended to be reduced in light-to-moderate drinkers (odds ratio, 0.54; 95% confidence interval, 0.28 to 1.05). Accounting for the pattern of alcohol intake in addition to the average weekly amount in grams, regular light-to-moderate drinking showed a significant inverse association with stroke (odds ratio, 0.12; 95% confidence interval, 0.02 to 0.65), and an irregular pattern of consumption attenuated this association. Based on the same multivariate analyses, other significant independent risk factors for stroke were arterial hypertension, coronary heart disease, and history of snoring, whereas the contributions of age, diabetes mellitus, smoking, and body mass index proved to be nonsignificant.
Light-to-moderate alcohol intake appears to have an inverse association with the risk of ischemic stroke. The beneficial effect appears to be most prominent if the consumption of alcohol is regular and evenly distributed throughout the week, whereas a sporadic or an occasional pattern of drinking seems to weaken the association. This study also supports the role of heavy drinking as an independent risk factor for ischemic stroke.
评估不同饮酒模式与年轻或中年男性缺血性卒中风险之间的关联。
本病例对照研究纳入了156例患者和153例对照者。使用结构化问卷评估饮酒模式和估计的每周平均饮酒量。饮酒模式定义为规律饮酒（每日或几乎每日饮酒）或不规律饮酒（每周至多3次），每周饮酒量定义为不饮酒、轻度至中度饮酒（每周至多150克）、中度饮酒（>150至300克/周）和重度饮酒（>300克/周）。使用多个逐步逻辑回归模型，并对潜在混杂因素进行了校正。
重度饮酒与卒中风险增加相关（比值比，4.45；95%置信区间，1.09至18.1），而轻度至中度饮酒者的风险有降低趋势（比值比，0.54；95%置信区间，0.28至1.05）。除了以克为单位的每周平均饮酒量外，考虑饮酒模式，规律的轻度至中度饮酒与卒中呈显著负相关（比值比，0.12；95%置信区间，0.02至0.65），不规律的饮酒模式减弱了这种关联。基于相同的多变量分析，卒中的其他显著独立危险因素是动脉高血压、冠心病和打鼾史，而年龄、糖尿病、吸烟和体重指数的影响不显著。
轻度至中度饮酒似乎与缺血性卒中风险呈负相关。如果饮酒规律且每周均匀分布，有益效果似乎最为显著，而偶尔或不规律的饮酒模式似乎会削弱这种关联。本研究也支持重度饮酒作为缺血性卒中独立危险因素的作用。
