中国五地区饮酒情况及相关问题调查Ⅲ.普通人群的饮酒相关问题

目的：了解我国社区普通人群饮酒相关问题的患病率和主要社会损害。方法：应用半定式健康状况调查表和酒依赖及相关问题筛查问卷，调查24992例受试饮酒相关的心理社会和躯体疾病，应用DSM-Ⅲ-R诊断标准，对1874例问题饮酒者进行酒精所致精神疾病的诊断。结果：酒精所致精神障碍的男性、女性和总体时点患病率分别为9．0％、0．2％和5．1％；酒依赖时点患病率分别为6．625％、0．200％和3．797％；三月急性醉酒率分别是14．237％、0．745％和8．299％，均是男性高于女性。酒依赖者的社会损害严重于问题饮酒者。躯体损害以胃炎或胃溃疡和腰背痛的发生率最高。结论：饮酒相关问题已严重影响着我国人民的身心健康，需要得到政府、社会团体和医务工作者的极大关注，以采取相应措施进行有效防治。     

中国五地区饮酒情况及相关问题调查Ⅰ.普通人群的饮酒状况

目的：了解我国5地区普通人群饮酒现状。方法：采用整群抽样的方法，使用定式检查问卷调查我国5地区社区中24992人的饮酒情况。结果：普通人群男、女及整体年饮酒率分别是74．9％、38．8％和59．0％，男、女及整体三月饮酒率分别是63．8％、18．3％和43．8％，饮酒率随年龄增加而增加，至40-50岁达高峰，尔后下降；89．0％的女性饮酒者和43．6％的男性饮酒者每周饮酒1次或以下，22．2％的男性饮酒者和2．5％的女性饮酒者每天皆饮，每次饮酒量男性高于女性；样本人均年饮酒量4．5升纯酒精，男性是女性的13．4倍；未注册酒类的使用率是7．1％，消耗量占酒精消耗总量的14．9％。结论：我国饮酒是一种普通的社会行为，酒精消费量比上世纪末增加，未统计酒类在我国酒精消费中具有重要作用。     

国内六地区饮酒情况及相关问题调查 Ⅰ.方法学及普通人群的饮酒情况

目的：描述我国六地区普通人群饮酒情况。方法：整群抽样调查，使用定式问卷向２３５１３受试者（１８～６５岁）调查饮酒情况。结果：普通人群的男、女及整体饮酒率分别为８４．１％、２９．３％和５９．５％，男性饮酒率及饮酒频度明显高于女性。９０．０％女性饮酒者每周饮酒１次或以下，男性饮酒者每周饮酒在１次或以下占５６．４％。１６．１％以上男性饮酒者、２．５％的女性饮酒者每天皆饮。男性每次饮酒量明显高于女性，普通人群人均年饮酒量为３．６０升纯酒精，男性饮酒量为女性的１８．６倍。结论：我国饮酒问题将会是下世纪的公共卫生问题。     

国内六地区饮酒情况及相关问题调查 Ⅲ.四种特殊职业人群饮酒情况及相关问题

目的：描述我国六地区四种特殊职业人群的饮酒情况及与饮酒相关问题发生率，并与普通人群相比较。方法：抽样调查，使用定式问卷及ＤＳＭ－ＩＩ－Ｒ诊断标准向９８００名受试者（１８－６５岁）调查饮酒情况、饮酒相关的社会、心理和躯体问题。结果：男女及总饮酒率分别为８６．２％、４４．１％和７４．１％，年平均饮酒量分别为８．２５、０．５６及６．００升纯酒精。酒依赖的男性、女性和总的时点患病率分别为１０．５４５％、０．１４１％和７．５６１％，急性酒中毒的半年患病率分别为７．９１６％、０．０７１％和５．６６８％。与普通人群相比，四种特殊职业人群的饮酒率、年饮酒量和与饮酒相关的损害均较高。结论：职业环境是影响饮酒的重要因素之一，处于特殊环境的人群是出现酒问题的高危人群。     

国内六地区饮酒情况及相关问题调查：I.方法学及交通人群的饮 …

目的：描述我国六地区普通人群饮酒情况，方法：整群抽样调查，使用定式问卷向２３５１３受试者（１８～６５岁）调查饮酒情况，结果：普通人群的男，女及整体饮酒率分别为８４．１％，２９．３％和５９．５％，男性饮酒率及饮酒频率明显高于女性，９０．０％女性饮酒者每周饮酒１次或以下，男性饮酒者每周次酒在１次或以下占５６．４％，１６．１％以上男性饮酒者２．５％，的女性饮酒者每天皆饮，男性每天饮明显高于女性，普通人群     

国内六地区饮酒情况及相关问题调查 Ⅱ.普通人群的饮酒相关问题

目的：描述我国六地区普通人群饮酒相关问题的患病率。方法：使用ＤＳＭ－ＩＩ－Ｒ诊断标准和系统询问，向２３５１３受试者（１８～６５岁）调查饮酒相关的社会、心理、躯体疾病。结果：男性饮酒问题发生率明显高于女性。酒依赖的男性、女性和总的时点患病率分别为６．６３２％、０．１０４％和３．４２８％；急性酒中毒的半年患病率分别为５．１６２％、０．０１７％和２．６３７％。与饮酒相关的躯体损害以消化道疾病为主。工作、家庭问题是饮酒者的主要社会损害。结论：随着生活水平提高和西方文化影响，我国的饮酒问题将会是下一个世纪的公共卫生问题     

国内六地区饮酒情况及相关问题调查：Ⅲ.四种特殊职业人群？…

目的：描述我国六地区四种特殊职业人群的饮酒情况及与饮酒相关问题发生率，并与普通人群相比较。方法：抽样调查，使用定式问卷及ＤＳＭ－Ⅲ－Ｒ诊断标准向９８００名受试者（１８－６５岁）调查饮酒情况、饮酒相关的神经、心理和躯体问题。结果：男女及总饮酒经分别为８６．２％、４４．１％和７４．１％，年平均饮酒量分别为８．２５、０．５６及６．００升纯酒精。酒依赖的男性、女性的总的时点患病率分别为１０．５４５％、０．     

危险及有害饮酒、酒依赖与适量饮酒引起各种损害的比较

目的：比较危险及有害饮酒组，酒依赖组在酒精所致损害方面与正常饮酒和酒依赖组的区别。方法：使用AUDIT量表和ICD-10诊断标准对420例被测查者进行了筛查和评定。将其分为“危险及有害饮酒”组，酒依赖组和正常饮酒组。比较了三组之间酒精所致损害的差别。结果：三组之间饮酒量，饮酒频率及发生中种损害的情况均有显著性差异。危险及有害饮酒者发生各种损害的机率明显高于正常饮酒组，损害的发生直接与饮酒量和饮酒频度相关。结论：危险及有害饮酒者降低饮酒量，减少饮酒频度已势在必行。不但有望减少一系列躯体损害的相关。结论：危险及有害饮酒者降低饮酒量，减少饮酒频度已势在必行。不但有望减少一系列躯体损害的发生。减少国家的医疗开支；而且可能减少多种社会问题的发生。减少犯罪。这也是使社会安定的因素之一。     

国内六地区饮酒情况及相关问题调查 Ⅳ.酒依赖的危险因素分析

目的：找出影响酒依赖的相关因素。方法：整群抽样，使用定式问卷及ＤＳＭ－Ⅲ－Ｒ诊断标准，调查２３５１３例一般人群（１８～６５岁）中不同特征的受试者的酒依赖率，并通过单因素和多因素的方法，计算这些因素对酒依赖的作用强度。结果：大量饮酒者、男性、年龄较大者、体力劳动者、受教育年限较少者和吸烟者酒依赖患病率较高，其中，年饮酒量对产生酒依赖的作用最大。结论：控制人群的总体饮酒量有助于减少我国饮酒问题的发生率     

国内六地区饮酒情况及相关问题调查

目的：找出影响酒依赖的相关因素，方法：整群抽样，使用定式问卷及ＤＳＭ－Ⅲ－Ｐ诊断标准，调查２３５１３例一般人群（１８－６５岁）中不同特征的受试者的酒依赖者，并通过单因素和多因素的方式，计算这些因素对酒依赖的作用强度。结果：大量饮酒者、男性、年龄较大者、体力劳动者，受教育年限较少者和吸烟者依赖患病率较高，其中，年饮酒量地产生酒依赖的作用最大。结论：控制人群的决体饮本量有助于减少我国饮酒问题的发生率。     

Changes in drinking habits in middle-aged British men

The drinking behaviour of 7735 middle-aged men drawn from general practices in 24 British towns was determined in 1978-80 and five years later in 1983-85. Those with heavier initial drinking were more likely to have reduced consumption after five years. At every level of consumption manual workers showed a greater tendency to decrease drinking than non-manual workers. Of those who became non-drinkers over the five years, 12% had been moderate or heavy drinkers. Men who were told by a doctor that they had developed ischaemic heart disease during the five years were more likely to reduce their alcohol consumption than men who remained free of ischaemic heart disease. Similarly, men who were put on regular medical treatment of any kind or who acquired two or more diagnoses of illness (including ischaemic heart disease) were more likely to become occasional or non-drinkers. Nondrinkers at both reviews had higher rates of diagnosed illness than drinkers. In particular, the ex-drinkers, who comprised 70% of non-drinkers at follow up, had higher rates of ischaemic heart disease and cardiovascular-related problems, such as high blood pressure and diabetes, than drinkers.

It is essential to be aware of the tendency for moderate or heavy drinkers to reduce or stop drinking over time, particularly if illness has been diagnosed. Non-drinkers and exdrinkers should not be used as a baseline in studies relating alcohol to disease.

     

Alcohol consumption and the CAGE questionnaire in Korean adults: results from the Second Korea National Health and Nutrition Examination Survey

We evaluated alcohol consumption and alcohol-related problems in Korean adults by evaluating alcohol consumption and responses to the CAGE questionnaire obtained from the second Korea National Health and Nutrition Examination Survey. The age-adjusted prevalence of males who consumed 0, 0.1-20, 20.1-40, or >40 g/day of alcohol were 28.0, 51.5, 12.5, and 8.0%, respectively; 26.9% of male drinkers were CAGE-positive (> or =2 affirmative responses to the CAGE). The age-adjusted prevalence of females who consumed 0, 0.1-10, 10.1-20, or >20 g/day of alcohol were 67.7, 26.6, 3.9, and 1.8%; 11.9% of female drinkers were CAGE-positive. The risk factors for high alcohol consumption were old age, low education level, smoking, and drinking onset at young ages in male drinkers, whereas low education level and smoking in female drinkers. The risk factors for a positive CAGE were young age, marriage, low education level, smoking, high amount of alcohol consumed on a single occasion, and high drinking frequency in male drinkers, whereas high household income, ex-smoking, high amount of alcohol consumed on a single occasion, and high drinking frequency in female drinkers. Our results suggest that high alcohol consumption and alcohol-related problems in Korean adults are not negligible and require intervention.     

Alcohol consumption in pregnancy — a health education problem

The drinking habits, demographic characteristics and knowledge about the effects of drinking during pregnancy of 380 pregnant women in Belfast were investigated. Forty-five per cent of the women were non-drinkers, 39% were occasional drinkers and 16% were regular drinkers. The majority of women knew that alcohol could harm their babies but were unsure of the specific effects. Regular drinkers were more likely than occasional drinkers or non-drinkers to say that harm would only be done if alcohol was taken in excess. The topic of alcohol is rarely discussed at antenatal clinics and cases of fetal alcohol syndrome, an uncommon but preventable condition, are probably being missed as a result. There is a need for more health education for the general public, especially school children, and for increased awareness among health professionals that the problem of alcohol in pregnancy exists and is likely to increase if the trend towards alcohol abuse among the younger members of the population continues.     

Proprotein Convertase Subtilisin/Kexin Type 9 Gene E670G Polymorphism Interacts with Alcohol Consumption to Modulate Serum Lipid Levels

Backgroud: Both alcohol consumption and the proprotein convertase subtilisin/kexin type 9 (PCSK9) gene polymorphism modulate serum lipid levels, but their interactions on serum lipid profiles are still unknown. The present study was undertaken to detect the interactions of PCSK9 E670G polymorphism and alcohol consumption on serum lipid levels.Methods: Genotypes of the PCSK9 E670G in 1352 unrelated subjects (785 non-drinkers and 567 drinkers) were determined by polymerase chain reaction and restriction fragment length polymorphism combined with gel electrophoresis, and then confirmed by direct sequencing. The interactions between PCSK9 E670G genotypes and alcohol consumption on serum lipid parameters were detected by using a factorial design covariance analysis after controlling for potential confounders.Results: The levels of serum triglyceride, high-density lipoprotein cholesterol, apolipoprotein (Apo) A1, and the ratio of ApoA1 to ApoB were higher in drinkers than in non-drinkers (P < 0.01 for all), whereas the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and ApoB were lower in drinkers than in non-drinkers (P < 0.001 for all). The genotypic and allelic frequencies of PCSK9 E670G were not different between non-drinkers and drinkers (P > 0.05 for each). The subjects with AA genotype in non-drinkers had higher serum LDL-C levels than the subjects with AG genotype, whereas the subjects with AG genotype in drinkers had higher serum TC levels than the subjects with AA genotypes (P < 0.05 for each). The effects of alcohol consumption on TC and LDL-C levels depended upon genotypes, the subjects with AA genotype had lower serum TC and LDL-C levels in drinkers than in non-drinkers.Conclusions: Alcohol consumption can modify the effects of the PCSK9 E670G polymorphism on serum TC and LDL-C levels. The subjects with AA genotype of the PCSK9 E670G benefit more from alcohol consumption than the subjects with AG genotype in decreasing serum TC and LDL-C levels.     

Are stress related factors associated with alcohol intake?

Moderate alcohol consumption is related to reduced risks of coronary heart disease and all-cause mortality. Our goal is to advance our understanding of the associations between stress-related factors and alcohol consumption, using cutoff points for alcohol intake that reflect health benefits rather than health risks. Cross-sectional data were used from 4,131 respondents (age 20-65 years) participating in a cohort study in the Netherlands on psychosocial factors and cancer risk. Analyses were performed among drinkers only, for men and women separately. Heavy alcohol intake (≥ 3 glasses per day for men, ≥ 2 glasses per day for women) was associated with only a few stress-related factors in multivariate analyses. No significant associations between the total amount of stressors and alcohol intake were found. We conclude that stress-related factors are only marginally associated with a heavy alcohol intake compared with fair drinking, using the safe limits of drinking as cutoff point.     

Alcohol and cardiovascular health

The substantial medical risks of heavy alcohol drinking as well as the probable existence of a less harmful or safe drinking limit have been evident for centuries. Modern epidemiology studies suggest lowered risk of morbidity and mortality among lighter drinkers. Thus, defining “heavy” drinking as ≥ 3 standard drinks per day, the alcohol-mortality relationship is a J-curve with risk highest for heavy drinkers, lowest for light drinkers and intermediate for abstainers. A number of non-cardiovascular and cardiovascular problems contribute to the increased mortality risk of heavier drinkers. The lower risk of light drinkers is due mostly to lower risk of the most common cardiovascular condition, coronary heart disease (CHD). These disparate relationships of alcoholic drinking to various cardiovascular and non-cardiovascular conditions constitute a modern concept of alcohol and health. Increased cardiovascular risks of heavy drinking include: (1) alcoholic cardiomyopathy, (2) systemic hypertension (high blood pressure), (3) heart rhythm disturbances, and (4) hemorrhagic stroke. Lighter drinking is not clearly related to increased risk of any cardiovascular condition and, in observational studies, is related to lower risk of CHD, ischemic stroke, and diabetes mellitus. A protective hypothesis for CHD is supported by evidence for plausible biological mechanisms attributable to ethyl alcohol. International comparisons and some prospective study data suggest that wine is more protective against CHD than liquor or beer. Possible non-alcohol beneficial components in wine (especially red) support possible extra protection by wine, but a healthier pattern of drinking or more favorable risk traits in wine drinkers may be involved.     

Joint effect of alcohol and usual sleep duration on the risk of dysglycemia

STUDY OBJECTIVES: Sleep duration and alcohol use influence metabolic function. However, limited information exists regarding a combined effect of alcohol and sleep duration on glucose metabolism. The aim of this study was to assess the potential interaction effect of alcohol and inappropriate sleep duration on dysglycemia epidemiologically. DESIGN: Cross-sectional and observational retrospective study. SETTING: A medical health checkup program in a general hospital. PARTICIPANTS: 2933 apparently healthy Japanese individuals, aged 46 to 60 years. INTERVENTION: N/A. MEASUREMENTS AND RESULTS: We examined the relationships between usual sleep duration and dysglycemia, and furthermore assessed the combined effects of alcohol consumption and sleep time on glucose dysmetabolism. A U-shaped relationship between sleep duration and the prevalence of hyperglycemia (fasting plasma glucose level > or =110 mg/dL) was observed when sleep duration was treated as a continuous variables and centered at 7.0 h (quadratic term P = 0.024). In a multivariate quadratic regression model, there was a significant interaction effect between sleep duration and alcohol consumption category (nondrinkers, light-moderate drinkers [ethanol comsumption < or =210 g/wk], and heavy drinkers [ethanol consumption of >210 g/wk]) on fasting plasma glucose levels, with shorter or longer sleep duration being more diabetogenic in individuals who consumed more alcohol (P interaction = 0.018). Furthermore, we found a similar interaction effect of sleep duration and alcohol consumption on the incidence of hyperglycemia during the past 5 years (P interaction = 0.039). CONCLUSION: Alcohol interacts with reduced sleep duration to increase the risk of dysglycemia.     

Calling time on responsible drinking: A qualitative study of perceptions of information on alcohol product labels

Objectives

This study aimed to explore (a) how people interpret responsible drinking messages on alcohol product labels, and (b) the acceptability of including health information on labels.

Design

Qualitative interviews.

Methods

Face-to-face semi-structured interviews were conducted with 20 people aged 21–63; 18 were classified risky drinkers using AUDIT-C. They were shown three sets of alcohol product labels: one including three responsible drinking messages (drink responsibly), one with three positively worded health messages (drinking less reduces risks) and one with three negatively worded health messages (drinking more increases risks). Health messages included information about cancer, liver and heart disease.

Results

Thematic analysis identified three themes: ambiguity about alcohol labelling; identifying oneself as responsible; and acceptability of enhanced product labelling. Participants were critical of responsible drinking messages and wary of conflicting health information in the media. They positioned themselves as responsible, knowledgeable drinkers and distanced themselves from problem drinkers. They did not appear to support the inclusion of health information on labels; however, novel information was considered more impactful.

Conclusions

Responsible drinking messages were seen by our sample as an alcohol industry ploy. Although health messages about cancer were seen as potentially impactful, the ability of consumers to position themselves as unproblematic drinkers means that they may not see the information on the label as relevant to themselves. Understanding factors that increase the personal relevance of messages is needed, alongside an exploration of a wider range of methods for alcohol health communication.