北方农村地区男性代谢综合征与饮酒关系研究

目的 了解北方农村地区男性代谢综合征(metabolic syndrome,MS)现状及其与饮酒的关系.方法 采用整群随机抽样的方法,在甘肃榆中县、北京顺义区、吉林东丰县和吉林靖宇县等4个区县分别抽取4个村.每个区县分别调查＞35岁人群1 250人,男女各半.各村平均分配样本量.收集吸烟、饮酒、血压、身高、体重等相关因素资料并采集血样.将人群分为不饮酒、少量饮酒(＜20 g/d)、中量饮酒(20～80g/d)和大量饮酒(＞80 g/d)四组.选取其中的2 062例男性进行分析.MS定义选用中国糖尿病学会的标准.用多因素非条件Logistic回归方法分析饮酒与MS的关系.结果 调查对象平均年龄(55.9±10.8)岁,41.4％饮酒.MS患病率为11.6％,饮酒者(13.1％)高于不饮酒者(10.5％)(x2=3.30,P=0.069).MS患病率随着饮酒量(Z =39.08,P＜0.001)和饮酒频率(Z =39.65,P＜0.001)的增加上升.调整其他因素后,中量以上饮酒可显著增加MS患病风险(均有P＜0.05);饮酒频度与MS关系并不显著(均有P＞0.05).结论 在男性人群中,中量饮酒可增加MS风险.应该给与针对性的干预,限制饮酒量.     

上海市男性饮酒与死亡关系的前瞻性研究

目的　探讨饮酒与上海市市区中老年男性死亡的关系。方法　自 1986年 1月～ 1989年 9月调查上海市区 4 5～ 6 4岁男性居民 182 4 4人 ,每年上门随访一次 ;用COX比例风险模型计算相对危险度。结果　至 2 0 0 2年度随访结束 ,全队列共随访 2 35 76 2人年 ,人均随访 12 .9年。在此期间共死亡 336 5人 ,其中恶性肿瘤死亡 1381人。在调整年龄、吸烟情况及教育程度后 ,相对于不饮酒者每天饮酒酒精量 <15 g和 15～ 2 9g者总死亡相对危险度 (RR)分别为 0 .80 (95 %CI:0 .72～ 0 .89)和 0 .87(95 %CI :0 .78～ 0 .97) ,每天饮酒酒精量 90 g及以上者RR为 1.2 5 (95 %CI:1.0 4～ 1.5 1)。少量饮酒者缺血性心脏病和慢性阻塞性肺部疾病死亡危险性显著降低。每天饮酒酒精量 70 g及以上者食管癌、结直肠癌、脑血管病死亡危险性显著升高 ,RR分别为 5 .0 8,2 .5 7和 1.5 7,肝硬化死亡危险性在每天饮酒酒精量 30 g及以上者中也显著上升 ,RR为 1.89。 结论　少量饮酒会降低中老年男性总死亡危险性 ,大量饮酒则会增加中老年男性食管癌、结直肠癌、脑血管病及肝硬化的死亡危险性。     

The association of alcohol consumption with metabolic syndrome and its individual components: the Taichung community health study

Alcohol has both adverse and protective effects on the individual components of metabolic syndrome (MS). We hypothesize that alcohol consumption increases the risk of developing MS and that the consumption of different types of alcoholic beverages has different effects on the development of MS and its individual components. We enrolled 2358 men for this cross-sectional study. The data were collected from self-reported nutrition and lifestyle questionnaires. Individuals who drank at least once per week for 6 consecutive months were classified as current drinkers. Current drinkers were at a higher risk of developing MS, abdominal obesity, and high triglyceride levels, but they were at a lower risk of developing low levels of high-density lipoprotein cholesterol (HDL-C). The increased risk of developing MS, high triglyceride, and high fasting glucose levels was dose dependent, whereas low HDL-C levels demonstrated a reverse relationship. The dose needed to reduce the risk of having low HDL-C levels was ≧50 g/d. This dose, however, resulted in an increased risk of developing high fasting glucose and high triglyceride levels. Consuming mixed types of alcohol increased the risk of developing MS and abdominal obesity. Meanwhile, those who drank liquor or wine had a greater risk of developing high triglyceride or high fasting glucose levels, respectively. In conclusion, alcohol consumption dose-dependently increased the risk of developing MS and some of its individual components while dose-dependently decreasing the risk of developing low HDL-C levels. The type of alcoholic beverage had different effects on the development of the individual components of MS.     

Moderate alcohol consumption is more cardioprotective in men with the metabolic syndrome

The aim of the present study was to evaluate the relation among alcohol consumption, the metabolic syndrome, and the risk of ischemic heart disease (IHD). The study was conducted in a cohort of 1966 men from the Quebec Cardiovascular Study. All men were initially free of IHD and, during the follow-up period of 13 y, 219 first cases of IHD were diagnosed. Alcohol consumption was determined by calculating the g/d intake based on standard portions of beer, wine, and spirits. Metabolic syndrome was diagnosed according to a modification of the National Cholesterol Education Program Adult Treatment Panel III definition. Men who consumed >or=15.2 g of alcohol/d (4th quartile of the distribution) were younger (P < 0.001), had elevated plasma HDL-C concentrations (P < 0.001), and lower plasma concentrations of insulin (P = 0.01), CRP (P = 0.01), and fibrinogen (P < 0.001) than men in the 1st quartile (<1.3 g of alcohol/d). After adjustment for a series of coronary risk factors, alcohol consumption >or=15.2 g/d was associated with a 39% reduction in the 13-y risk of IHD [relative risk (RR) of IHD = 0.61, P = 0.02]. Finally, an alcohol consumption <15.2 g/d was associated with an increase of the risk of IHD in men with the metabolic syndrome (RR = 2.24, P < 0.001) but not in men without the metabolic syndrome (RR = 1.31, P = 0.22). These results confirm that moderate daily alcohol consumption has cardioprotective properties and suggest that the effects may be more important in subjects with a deteriorated risk profile, such as those with the metabolic syndrome.     

Prospective study of alcohol consumption quantity and frequency and cancer-specific mortality in the US population

Prospective associations between quantity and frequency of alcohol consumption and cancer-specific mortality were studied using a nationally representative sample with pooled data from the 1988, 1990, 1991, and 1997-2004 administrations of the National Health Interview Survey (n = 323,354). By 2006, 8,362 participants had died of cancer. Cox proportional hazards regression was used to estimate relative risks. Among current alcohol drinkers, for all-site cancer mortality, higher-quantity drinking (≥ 3 drinks on drinking days vs. 1 drink on drinking days) was associated with increased risk among men (relative risk (RR) = 1.24, 95% confidence interval (CI): 1.09, 1.41; P for linear trend = 0.001); higher-frequency drinking (≥ 3 days/week vs. <1 day/week) was associated with increased risk among women (RR = 1.32, 95% CI: 1.13, 1.55; P-trend < 0.001). Lung cancer mortality results were similar, but among never smokers, results were null. For colorectal cancer mortality, higher-quantity drinking was associated with increased risk among women (RR = 1.93, 95% CI: 1.17, 3.18; P-trend = 0.03). Higher-frequency drinking was associated with increased risk of prostate cancer (RR = 1.55, 95% CI: 1.01, 2.38; P for quadratic effect = 0.03) and tended to be associated with increased risk of breast cancer (RR = 1.44, 95% CI: 0.96, 2.17; P-trend = 0.06). Epidemiologic studies of alcohol and cancer mortality should consider the independent effects of quantity and frequency.     

Coffee consumption and the occurrence and intensity of metabolic syndrome: a cross-sectional study

The objective of the study was to investigate associations between coffee consumption and the occurrence of metabolic syndrome (MetS) and its components in individuals with a normal BMI, as well in those who are overweight and obese. The analysis was based on the data of 10,367 participants. The studies included a questionnaire interview, anthropometric measurements, blood pressure measurements and analyses of collected fasting-blood samples. In the overweight and obese participants, lower coffee consumption, compared with higher consumption was correlated with a significantly higher risk of abdominal obesity, hypertension, an abnormal glucose concentration, HDL cholesterol, triglycerides and MetS (p?p?相似文献   

Milk and dairy consumption, diabetes and the metabolic syndrome: the Caerphilly prospective study

OBJECTIVES: To report a negative association between milk or dairy consumption and the metabolic syndrome and to examine associations within the Caerphilly cohort. SETTING: A representative sample of men aged 45-59 years in Caerphilly, UK. PARTICIPANTS AND DATA: Data on fasting blood glucose and plasma insulin, fasting plasma triglycerides and high-density lipoprotein cholesterol, body mass index, and blood pressure were used to define the metabolic syndrome in terms of levels of two or more variates within the top 10%. The clinical importance of the syndrome was assessed from 20-year incidence of diabetes, vascular events and deaths. The relationships between the syndrome and the consumption of milk and dairy products was examined using data from both a semiquantitative food frequence questionnaire, and from a 7-day weighed intake record which had been kept by a 1:3 subsample of the men. MAIN RESULTS: There were 2,375 men without diabetes in the cohort. The prevalence of the metabolic syndrome was 15%. Men with the syndrome had significantly increased risks of a subsequent ischaemic heart disease event, death or diabetes. Negative relationships were shown between both the consumption of milk and dairy produce, and the syndrome. Adjusted odds ratio in men who regularly drank a pint of milk or more daily was 0.38 (0.18 to 0.78) and that for dairy food consumption was 0.44 (0.21 to 0.91). Milk intake showed no significant trend with incident diabetes. CONCLUSIONS: The consumption of milk and dairy products is associated with a markedly reduced prevalence of the metabolic syndrome, and these items therefore fit well into a healthy eating pattern.     

Prospective study of alcohol consumption and the risk of colorectal cancer before and after folic acid fortification in the United States

PurposeTo evaluate the influence of alcohol consumption on the risk of colorectal cancer according to folic acid fortification period in the United States.MethodsWe evaluated the association between alcohol consumption and colorectal cancer by fortification period (before 1998 vs. after 1998) in 2 prospective cohort studies, the Nurses’ Health Study (NHS) of women and the Health Professionals Follow-up Study (HPFS) of men, in which 2793 cases of invasive colorectal cancer were documented.ResultsAlcohol consumption was associated with an increased risk of colorectal cancer. Among nonusers of multivitamins and/or folic acid supplements, the pooled multivariate relative risk for ≥30 g/d drinkers versus nondrinkers was 1.36 (95% confidence interval [95% CI], 1.09–1.70; P for trend, 0.02). The effect of alcohol consumption was slightly stronger in the prefolic acid fortification period (1980 NHS/1986 HPFS-1998) than in the postfortification period (1998–2008); the pooled multivariate relative risks for ≥30 g/d drinkers versus nondrinkers were 1.31 (95% CI, 1.00–1.71; P for trend, 0.10) in the prefortification period and 1.07 (95% CI, 0.69–1.65; P for trend, 0.67) in the postfortification period.ConclusionsFolic acid fortification may attenuate the adverse effect of high alcohol consumption on the risk of colorectal cancer.     

中国人群饮酒与代谢综合征发病关系的前瞻性研究

目的研究我国成年人饮酒状况对代谢综合征（MS）发病的影响。方法本项目为前瞻性队列研究。2007至2008年对分别于1998和2000年基线调查的中国心血管病流行病学多中心协作研究35～74岁的27020例队列人群开展随访调查。结果基线14572例非MS人群经8年随访,共发生MS2362例。在调整了年龄、南北方、城乡、受教育程度、体力活动、吸烟、体质指数以及MS组分数后,和不饮酒者相比,男性饮酒者发生MS的相对危险度（RR）为1．24（95％CI：1．06～1．45）,人群归因危险度为10．13％;每日摄入酒精量10．1～20g,20．1—40g,〉40g组的RR分别为1．36（95％CI：1．02～1．82）,1．34（95％CI：1．03—1．74）和1．41（95％CI：1．13,～1．77）;每周饮酒2～5次和／〉6次的RR分别为1．25（95％CI：1．01～1．55）和1．26（95％CI：1．04～1．52）;只喝啤酒组、只喝白酒组和混合饮酒组的RR分别为1．60（95％CI：1．05～2．45）、1．30（95％CI：1．02～1．65）和1．27（95％CI：1．06～1．52）。女性每日摄入酒精量在10．1～20g组和〉20g组RR分别为2．67（95％CI：1．26—5．65）和2．38（95％CI：1．35—4．22）。结论在全人群中,每13摄入酒精量〉10g就会显著增加MS发病风险,在女性中尤为明显。男性每周饮酒≥2次以及只饮啤酒、只饮白酒和混合饮酒者均明显升高MS的发病风险。为减少MS的流行,应提倡限制酒精过量摄入,尤其女性更应限制酒精摄入量（≤10g／d）。     

Health professionals' knowledge, practice and opinions about fetal alcohol syndrome and alcohol consumption in pregnancy

OBJECTIVE: To measure the knowledge, attitudes and practices of health professionals regarding fetal alcohol syndrome (FAS) and alcohol use during pregnancy. METHOD: A postal survey of a representative random sample of health professionals was conducted in Western Australia (WA) in 2002/03. 1,143 (79%) of 1,443 eligible health professionals completed the survey (87 Aboriginal Health Workers, 286 allied health professionals, 537 community nurses, 170 general practitioners and 63 obstetricians). RESULTS: Of 1,143 health professionals, 12% identified all four essential diagnostic features of FAS. Most (95%) had never diagnosed FAS. Although 82% believed that making a diagnosis of FAS might improve treatment plans and 85% agreed FAS was preventable, 53% said the diagnosis might be stigmatising. Only 2% felt very prepared to deal with FAS and most wanted information for themselves and their clients. Of the 659 health professionals caring for pregnant women, only 45% routinely ask about alcohol use in pregnancy, only 25% routinely provide information on the consequences of alcohol use in pregnancy and only 13% provide advice consistent with NHMRC guidelines on alcohol consumption in pregnancy. CONCLUSION: Health professionals have identified the need for educational materials for themselves and their clients. IMPLICATIONS: FAS is likely to be under-ascertained in Australia due to a lack of knowledge of FAS by health professionals. Until this lack of knowledge is addressed, opportunities for diagnosis and prevention of FAS will be limited.     

中国成年人肉类食物摄入与代谢综合征的相关性研究

目的 分析我国≥18岁成年人肉类食物摄入量与MS患病的关系。方法 2010－2012年中国居民营养与健康状况监测中34 923名≥18岁完成膳食调查并具有完整体检及血糖、血脂检测结果的成年人作为研究对象,根据2013年中华医学会糖尿病分会提出的中国人的MS诊断标准,经复杂抽样加权处理后,计算患病率与成年人肉类摄入量间关系。结果 成年居民人均肉类食物摄入量为94.8 g/d。平均每日摄入量在100～199 g/d的人群MS、腹型肥胖和高血糖的患病率最低。随着摄入量的增加,男性MS患病率显著增加,且摄入量≥300 g/d的人群发生MS的风险显著高于低摄入水平人群,调整后患病率比（PR）为1.46（95% CI：1.14～1.87）,但未在摄入量≥300 g/d的女性人群中观察到相似趋势。结论 中国成年人群摄入适量肉类发生MS的风险较低。     

An epidemiological case-control study of breast cancer and alcohol consumption

A case-control study of breast cancer and alcohol consumption was conducted with 1617 patients diagnosed with a primary cancer of the breast between 1982 and 1984 in 18 New York State counties. For each case, one control, matched for year of birth and county of residence, was selected from the driver's license files of the New York State Department of Motor Vehicles. Breast cancer risk was shown to increase as daily consumption of alcohol increased, with a risk of 1.37 (95% Cl = 1.07, 1.75) observed among women who consumed 15 or more grams of alcohol per day. Breast cancer risk did not appear to be related to the total number of years a woman drank or to be restricted to specific types of alcoholic beverages. The data suggest that this may be higher in women who began drinking at a later age. The increased risk associated with alcohol consumption, observed in the current study, persisted within strata of various breast cancer risk factors.     

Dietary consumption of advanced glycation end products and risk of metabolic syndrome

Metabolic syndrome (MetS) is a complex disorder which has become one of the major public health challenges worldwide. This study was conducted to evaluate the association between dietary advanced glycation end products (AGEs) and risk of MetS and its components. This cross-sectional study was conducted in a representative sample of 5848 adults, aged 19–70 years. Daily consumption of carboxymethyl lysine, a major type of AGEs, was determined using a validated semi-quantitative food frequency questionnaire. Across increasing trend of AGEs consumption, the percentage of fat intake increased and that of carbohydrate significantly decreased (p?<?0.001). Subjects in the highest (>10 506 kU/d) compared to the lowest (<6673 kU/d) quartile category of AGEs had higher risk of abdominal obesity (OR: 1.19, 95% CI: 1.01–1.39) and hypertriglyceridemia (OR: 1.26, 95% CI: 1.07–1.49). Therefore, recommendation on restriction of AGEs intake could be a practical approach to prevent metabolic abnormalities.     

Stressors and alcohol consumption

The objective of this study was to examine the relationship between negative life events and chronic stressors and drinking behaviour. Data suggested that some life events (getting divorced) and some chronic stressors (financial difficulties, unfavourable marital status, and unfavourable employment status) were positively related to abstinence among men and women. Furthermore, some life events (being a victim of a crime, decrease in financial position, divorce or reporting two or more life events) were positively associated with heavy drinking among men. Chronic stressors, such as unfavourable marital status and unfavourable employment status, were also related to heavy drinking among both men and women. Results presented here suggest that people under stressful conditions are more likely to either abstain or drink heavily rather than to drink lightly or moderately.