Keil U, Chambless L E, Döring A, Filipiak B, Stieber J
Institute of Epidemiology and Social Medicine, University of Münster, Germany.
Epidemiology. 1997 Mar;8(2):150-6. doi: 10.1097/00001648-199703000-00005.
Epidemiologic studies indicate that light to moderate alcohol consumption from beer, wine, or spirits is associated with a reduction in all-cause mortality, owing primarily to a reduced risk of coronary heart disease (CHD). To find out whether this protective effect of small to moderate amounts of alcohol could be confirmed in Germany, where much of the alcohol consumed is taken in the form of beer, we studied the relation between alcohol and CHD and total mortality in a population of southern Germany. We conducted a prospective cohort study from 1984 to 1992 among 1,071 men and 1,013 women, age 45-64 years at baseline, from the Augsburg region. Eighty-seven per cent of men and 56% of women reported drinking alcohol at baseline. Among drinkers, men had an average alcohol intake of 42 gm per day, of which 33 gm per day came from beer. Women who drank had an average alcohol intake of 16 gm per day and derived about half of it from beer and the other half from wine. During the 8 years of follow-up, 96 deaths (all causes) and 62 incident CHD events (nonfatal and fatal) occurred in men, and 45 deaths (all causes) occurred in women. Adjusting for a number of potential confounders, in men the adjusted hazard rate ratio (HRR) of CHD events for drinkers as compared with nondrinkers was 0.51 [95% confidence interval (CI) = 0.27-0.95]; this protective effect starts with the 0.1-19.9 gm per day alcohol category and does not change much with higher intake. In men, the adjusted total mortality HRR for drinkers as compared with nondrinkers was 0.59 (95% CI = 0.36-0.97). The total mortality HRRs for the different alcohol groups compared with nondrinkers show a U-shaped curve, with the lowest HRR of 0.46 (95% CI = 0.20-0.80) for the 20-39.9 gm per day alcohol group and an HRR of 1.04 (95% CI = 0.54-2.00) for the > or = 80 gm per day alcohol group. In women, the total mortality HRR for those drinking up to 19.9 gm per day as compared with nondrinkers was 0.46 (95% CI = 0.22-0.96).
流行病学研究表明，适量饮用啤酒、葡萄酒或烈酒与全因死亡率降低有关，这主要是由于冠心病（CHD）风险降低。为了确定在德国（该国消费的大部分酒精是以啤酒形式摄入的）是否能证实少量至适量饮酒的这种保护作用，我们研究了德国南部人群中酒精与冠心病及全因死亡率之间的关系。我们在1984年至1992年期间对奥格斯堡地区1071名男性和1013名女性进行了一项前瞻性队列研究，这些人在基线时年龄为45 - 64岁。87%的男性和56%的女性在基线时报告饮酒。在饮酒者中，男性平均每日酒精摄入量为42克，其中33克来自啤酒。饮酒的女性平均每日酒精摄入量为16克，约一半来自啤酒，另一半来自葡萄酒。在8年的随访期间，男性中有96例（各种原因）死亡和62例冠心病事件（非致命和致命）发生，女性中有45例（各种原因）死亡。在对一些潜在混杂因素进行调整后，男性中饮酒者与不饮酒者相比，冠心病事件的调整后风险率比（HRR）为0.51[95%置信区间（CI）= 0.27 - 0.95]；这种保护作用从每日酒精摄入量0.1 - 19.9克的类别开始，摄入量增加时变化不大。在男性中，饮酒者与不饮酒者相比，调整后的全因死亡率HRR为0.59（95% CI = 0.36 - 0.97）。与不饮酒者相比，不同酒精摄入组的全因死亡率HRR呈U形曲线，每日酒精摄入量20 - 39.9克组的最低HRR为0.46（95% CI = 0.20 - 0.80），每日酒精摄入量≥80克组的HRR为1.04（95% CI = 0.54 - 2.00）。在女性中，每日饮酒量达19.9克及以下者与不饮酒者相比，全因死亡率HRR为0.46（95% CI = 0.22 - 0.96）。
