Wannamethee S G, Shaper A G
Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London, UK.
Neuroepidemiology. 1998;17(6):288-95. doi: 10.1159/000026182.
The consistent findings of higher risk of coronary heart disease (CHD) and total mortality in non-drinkers compared to light to moderate drinking has been interpretated as showing that light or moderate drinking is beneficial to health. Non-drinkers, both ex-drinkers and lifelong teetotallers, have an increased prevalence of conditions likely to increase morbidity and mortality compared with occasional or light drinkers. In addition, regular light drinkers tend to have characteristics extremely advantageous to health. Whilst there is considerable evidence that alcohol intake at some level has a beneficial effect on CHD, the degree of protection claimed is almost certainly exaggerated by comparison with an inappropriate control group and by the limited adjustment procedures used to take into account the differing characteristics of the various alcohol intake groups. The benefit of light to moderate drinking for stroke and all-cause mortality is less convincing than the benefit for CHD. If occasional drinkers are used as a baseline, no benefit is seen for stroke or all-cause mortality in regular or light drinkers and all-cause mortality increases progressively from levels of 2 drinks a day. Non-drinkers or lifelong abstainers are unsuitable as a baseline group in studies of the effects of alcohol on morbidity and mortality. The public health message should emphasise the potential harm of heavier drinking rather than concentrating on the possible benefits of light drinking.
与少量至适量饮酒者相比，不饮酒者患冠心病（CHD）和全因死亡率更高这一一致发现，被解读为表明少量或适量饮酒对健康有益。与偶尔饮酒或少量饮酒者相比，不饮酒者（包括戒酒者和终身戒酒者）中可能增加发病率和死亡率的疾病患病率更高。此外，经常少量饮酒者往往具有对健康极为有利的特征。虽然有大量证据表明一定程度的酒精摄入对冠心病有有益影响，但与不适当的对照组相比，以及与用于考虑不同酒精摄入组不同特征的有限调整程序相比，所声称的保护程度几乎肯定被夸大了。少量至适量饮酒对中风和全因死亡率的益处不如对冠心病的益处那样有说服力。如果将偶尔饮酒者作为基线，经常饮酒或少量饮酒者在中风或全因死亡率方面没有益处，且全因死亡率从每天饮用2杯酒的水平开始逐渐增加。在酒精对发病率和死亡率影响的研究中，不饮酒者或终身戒酒者不适合作为基线组。公共卫生信息应强调大量饮酒的潜在危害，而不是专注于少量饮酒的可能益处。
