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Lancet:适度饮酒并不能降低心血管疾病风险!

2019-04-06 MedSci MedSci原创

squamous一直以来,很多研究表明适度摄入酒精,相比禁酒和大量饮酒,与心血管风险降低相关。东亚的研究可帮助明确这种相关性是否存在因果关系,因为两个常见的遗传突变可明显影响酒精的摄入模式。研究人员通过这两个突变评估心血管风险与基因型预测的平均酒精摄入在男性中的相关性,并与在女性中的发现进行对比。2004年6月25日-2008年7月15日,研究人员从中国的10个地区招募了512715位成年人,记录

一直以来,很多研究表明适度摄入酒精,相比禁酒和大量饮酒,与血管风险降低相关。东亚的研究可帮助明确这种相关性是否存在因果关系,因为两个常见的遗传突变可明显影响酒精的摄入模式。研究人员通过这两个突变评估血管风险与基因型预测的平均酒精摄入在男性中的相关性,并与在女性中的发现进行对比。

2004年6月25日-2008年7月15日,研究人员从中国的10个地区招募了512715位成年人,记录酒精摄入量和其他特征。随访10年(直到2017年1月1日),通过死亡登记和医院记录监测心血管疾病(包括缺血性中风、脑出血和心肌梗死)。对161498位受试者进行基因鉴定,鉴定两个可改变酒精代谢的突变(ALDH2-rs671和ADH1B-rs1229984)。

33%(69897/210205)的男性在大部分情况下会饮酒,而女性仅2%(6245/302510)。在男性受试者中,传统流行病学研究表明个人自报的饮酒量与缺血性中风(14930例)、脑出血(3496例)和心肌梗死(2958例)存在U形关联;自报每周酒精摄入100g(每天饮酒1-2次)的男性这三种疾病的发病风险均低于不饮酒或酗酒的人。与此相反,尽管基因型预测的平均男性酒精摄入量的范围很大(4-256g/周,0-4次/天),但与疾病风险无任何U形关联。基因型预测的酒精摄入与卒中风险存在连续的正性log线性关联,而且脑出血的相关性要强于缺血性卒中(1.58,95% CI 1.36-1.84,p<0.0001 vs 1.27,1.13-1.43,p=0.0001)。但基因型预测的酒精摄入与心肌梗死风险无相关性。此外,饮酒与收缩压存在强相关性(p<0.0001)。对于女性,饮酒与血压、卒中或心肌梗死无正性关联。

遗传流行病学显示,适度饮酒预防中风的保护作用在很大程度上是没有因果关系的。相反,饮酒可升高血压、增加中风的风险,而且,本研究结果还表明饮酒对心肌梗死的风险无明显影响。

原始出处:

Iona Y Millwood,et al. Conventional and genetic evidence on alcohol and vascular disease aetiology: a prospective study of 500 000 men and women in China.The Lancet. April 4,2019.https://doi.org/10.1016/S0140-6736(18)31772-0

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    2019-10-19 howi
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    2019-04-07 天地飞扬

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