Goldberg R J, Burchfiel C M, Reed D M, Wergowske G, Chiu D
Department of Medicine, University of Massachusetts Medical School, Worcester.
Circulation. 1994 Feb;89(2):651-9. doi: 10.1161/01.cir.89.2.651.
The study objective was to determine the association between reported alcohol consumption and total mortality, mortality from selected causes, and incident nonfatal chronic disease events in middle-aged (51 to 64 years old) and elderly (65 to 75 years old) men during an approximate 15-year follow-up period.
We conducted a prospective epidemiological study of Japanese-American men who were participating in the Honolulu Heart Program and were free from coronary heart disease, cerebrovascular disease, and cancer at baseline examination and at subsequent reexamination 6 years later. Self-reported alcohol consumption was determined twice: at the baseline examination in 1965 through 1968 and at reexamination approximately 6 years later (1971 through 1974). Four primary alcohol consumption groups who reported similar alcohol intake at the time of these two clinical examinations were considered: abstainers and light (1 to 14 mL of alcohol per day), moderate (15 to 39 mL of alcohol per day), and heavy (> or = 40 mL of alcohol per day) drinkers. Study end points were also determined in very light (1 to 4.9 mL of alcohol per day) drinkers and in men who reported a change in their alcohol intake between examinations. Longitudinal follow-up was carried out through the end of 1988 with determination of selected fatal and nonfatal events according to alcohol intake. After controlling for several potentially confounding factors, total mortality exhibited a J-shaped pattern in relation to alcohol consumption in middle-aged and elderly men. There was a trend for lower rates of occurrence of combined fatal and nonfatal coronary heart disease events with increasing alcohol consumption in both middle-aged and elderly men. Increasing alcohol consumption was related to an increased risk of fatal and nonfatal strokes in middle-aged men, whereas elderly light and moderate drinkers were at increased risk for fatal and nonfatal strokes. Heavy drinkers were at increased risk for fatal and nonfatal malignant neoplasms in the two age groups examined.
The results of this long-term prospective study provide a balanced perspective of the health effects of alcohol consumption in middle-aged and elderly men. High levels of alcohol consumption were shown to be related to an increasing risk of diseases of considerable public health importance. These findings suggest that caution be taken in formulating population-wide recommendations for increases in the population levels of alcohol consumed given the associated significant social and biological problems of high consumption levels.
本研究的目的是确定在大约15年的随访期内，报告的饮酒量与中年（51至64岁）和老年（65至75岁）男性的总死亡率、特定病因死亡率以及非致命性慢性病事件发生率之间的关联。
我们对参与檀香山心脏项目的日裔美国男性进行了一项前瞻性流行病学研究，这些男性在基线检查时以及6年后的后续复查时均无冠心病、脑血管疾病和癌症。自我报告的饮酒量测定了两次：一次是在1965年至1968年的基线检查时，另一次是在大约6年后（1971年至1974年）的复查时。考虑了在这两次临床检查时报告饮酒量相似的四个主要饮酒组：戒酒者和轻度饮酒者（每天饮酒1至14毫升）、中度饮酒者（每天饮酒15至39毫升）以及重度饮酒者（每天饮酒≥40毫升）。还确定了极轻度饮酒者（每天饮酒1至4.9毫升）以及在两次检查之间报告饮酒量有变化的男性的研究终点。通过1988年底进行纵向随访，根据饮酒量确定选定的致命和非致命事件。在控制了几个潜在的混杂因素后，中年和老年男性的总死亡率与饮酒量呈现J形关系。中年和老年男性中，随着饮酒量增加，致命和非致命冠心病事件的发生率有降低趋势。饮酒量增加与中年男性致命和非致命性中风风险增加有关，而老年轻度和中度饮酒者致命和非致命性中风风险增加。在两个年龄组中，重度饮酒者致命和非致命性恶性肿瘤的风险增加。
这项长期前瞻性研究的结果为中年和老年男性饮酒对健康的影响提供了一个平衡的观点。高饮酒量与具有相当公共卫生重要性的疾病风险增加有关。这些发现表明，鉴于高饮酒量相关的重大社会和生物学问题，在制定关于提高人群饮酒水平的全人群建议时应谨慎。
