Lee K S, Park C Y, Meng K H, Bush A, Lee S H, Lee W C, Koo J W, Chung C K
Department of Preventive Medicine, Catholic University Medical College, Seoul, Korea.
Ann Epidemiol. 1998 Jan;8(1):31-8. doi: 10.1016/s1047-2797(97)00113-0.
To explore the effects of cigarette smoking and alcohol consumption on cardiovascular disease risk factors such as hypertension, dyslipidemia, and glucose intolerance in Korean men.
In this cross-sectional study, we gathered the smoking and drinking history by self-administered questionnaire between June 1994 and May 1995 among 1053 men, age 20-77, who visited a prevention center for a multiphasic health check at St. Mary's Hospital, Seoul.
Cigarette smoking had a significant inverse association with systolic and diastolic blood pressure. Adjusted for age, body mass index (BMI), and alcohol consumption, the odds ratio of hypercho-lesterolemia (> or = 240 mg/dl) was 1.30 (95% confidence interval (CI) 1.09-1.55), lower high density lipoprotein (HDL) cholesterol (< 40 mg/dl) was 1.29 (95% CI 1.08-1.54), higher low density lipoprotein (LDL) cholesterol (> or = 160 mg/dl) was 1.30 (95% CI 1.07-1.56), and hypertriglyceridemia (> or = 200 mg/dl) was 1.40 (95% CI 1.16-1.68) among men who smoked 21-30 cigarettes per day compared with nonsmokers. Adjusted for age. BMI, and cigarette smoking in men who consumed 90-179 and 180-269 g/week of alcohol compared with nondrinkers, the odds ratio of hypertension was 1.73 (95% CI 1.01-3.00) and 1.48 (95% CI 1.01-2.17), respectively. Alcohol consumption had a significant protective effect (adjusted odds ratio: 0.60-0.78) against lower HDL cholesterol in all categories > or = 90 g of alcohol per week compared with nondrinkers. The adjusted odds ratio of hypertriglyceridemia was 1.17 (95% CI 1.04-1.31), and glucose intolerance (fasting blood sugar (FBS) > or = 120 mg/dl) was 1.27 (95% CI 1.11-1.14) among those who consumed > or = 360 g/week of alcohol compared with nondrinkers.
In this Korean population study, although alcohol consumption increased HDL cholesterol, which might have a protective effect on coronary heart disease, cigarette smoking was associated with decreased blood pressure, smoking was confirmed to have dyslipidemic effect such as increasing total cholesterol, LDL cholesterol, triglyceride and decreasing HDL cholesterol, and alcohol consumption was confirmed to be associated with hypertension, hypertriglyceridemia, and glucose intolerance as in Caucasian. Further prospective intervention studies are needed for evaluating cardiovascular effects after cessation of smoking and drinking.
探讨吸烟和饮酒对韩国男性心血管疾病危险因素如高血压、血脂异常和糖耐量异常的影响。
在这项横断面研究中，我们于1994年6月至1995年5月期间，通过自填问卷收集了1053名年龄在20 - 77岁之间、前往首尔圣玛丽医院预防中心进行多相健康检查的男性的吸烟和饮酒史。
吸烟与收缩压和舒张压呈显著负相关。在调整年龄、体重指数（BMI）和饮酒量后，与不吸烟者相比，每天吸21 - 30支烟的男性高胆固醇血症（≥240mg/dl）的优势比为1.30（95%置信区间（CI）1.09 - 1.55），低高密度脂蛋白（HDL）胆固醇（<40mg/dl）的优势比为1.29（95%CI 1.08 - 1.54），高低密度脂蛋白（LDL）胆固醇（≥160mg/dl）的优势比为1.30（95%CI 1.07 - 1.56），高甘油三酯血症（≥200mg/dl）的优势比为1.40（95%CI 1.16 - 1.68）。在调整年龄、BMI和吸烟量后，与不饮酒者相比，每周饮酒90 - 179克和180 - 269克的男性高血压的优势比分别为1.73（95%CI 1.01 - 3.00）和1.48（95%CI 1.01 - 2.17）。与不饮酒者相比，每周饮酒量≥90克的所有类别中，饮酒对低HDL胆固醇有显著的保护作用（调整后的优势比：0.60 - 0.78）。与不饮酒者相比，每周饮酒量≥360克的人群中，高甘油三酯血症的调整后优势比为1.17（95%CI 1.04 - 1.31），糖耐量异常（空腹血糖（FBS）≥120mg/dl）的调整后优势比为1.27（95%CI 1.11 - 1.14）。
在这项韩国人群研究中，尽管饮酒可增加HDL胆固醇，这可能对冠心病有保护作用，但吸烟与血压降低相关，吸烟被证实具有血脂异常作用，如增加总胆固醇、LDL胆固醇、甘油三酯并降低HDL胆固醇，并且饮酒被证实与高血压、高甘油三酯血症和糖耐量异常有关，这与白种人情况相同。需要进一步进行前瞻性干预研究以评估戒烟和戒酒对心血管的影响。
