Alcohol consumption and the risk of cirrhosis.

OBJECTIVE: To determine risk levels for the development of cirrhosis in Australian men who consume alcohol and to compare this risk with that of Australian women. DESIGN AND SETTING: A case-control study using an interview technique, based in two major tertiary referral hospitals in Sydney. PATIENTS: Forty-three men with newly diagnosed cirrhosis of the liver and a total of 115 male control subjects, age matched with the case subjects. The data for women (36 cases and 99 controls) have been reported previously. RESULTS: The risk of men developing cirrhosis increases significantly above the baseline when the alcohol intake exceeds 40 g per day. The risk to women is significant at a similar intake level. Dietary intake and past major illnesses appear to have no role in determining risk. CONCLUSION: The recommended safe drinking level for men and women should be 40 g per day, as suggested by the National Health and Medical Research Council.     

Alcohol consumption and risk of stroke: a meta-analysis

Context  Observational studies suggest that heavy alcohol consumption may increase the risk of stroke while moderate consumption may decrease the risk. Objective  To examine the association between alcohol consumption and relative risk of stroke. Data Sources  Studies published in English-language journals were retrieved by searching MEDLINE (1966–April 2002) using Medical Subject Headings alcohol drinking, ethanol, cerebrovascular accident, cerebrovascular disorders, and intracranial embolism and thrombosis and the key word stroke; Dissertation Abstracts Online using the keywords stroke and alcohol; and bibliographies of retrieved articles. Study Selection  From 122 relevant retrieved reports, 35 observational studies (cohort or case control) in which total stroke, ischemic stroke, or hemorrhagic (intracerebral or total) stroke was an end point; the relative risk or relative odds and their variance (or data to calculate them) of stroke associated with alcohol consumption were reported; alcohol consumption was quantified; and abstainers served as the reference group. Data Extraction  Information on study design, participant characteristics, level of alcohol consumption, stroke outcome, control for potential confounding factors, and risk estimates was abstracted independently by 3 investigators using a standardized protocol. Data Synthesis  A random-effects model and meta-regression analysis were used to pool data from individual studies. Compared with abstainers, consumption of more than 60 g of alcohol per day was associated with an increased relative risk of total stroke, 1.64 (95% confidence interval [CI], 1.39-1.93); ischemic stroke, 1.69 (95% CI, 1.34-2.15); and hemorrhagic stroke, 2.18 (95% CI, 1.48-3.20), while consumption of less than 12 g/d was associated with a reduced relative risk of total stroke, 0.83 (95%, CI, 0.75-0.91) and ischemic stroke, 0.80 (95% CI, 0.67-0.96), and consumption of 12 to 24 g/d was associated with a reduced relative risk of ischemic stroke, 0.72 (95%, CI, 0.57-0.91). The meta-regression analysis revealed a significant nonlinear relationship between alcohol consumption and total and ischemic stroke and a linear relationship between alcohol consumption and hemorrhagic stroke. Conclusions  These results indicate that heavy alcohol consumption increases the relative risk of stroke while light or moderate alcohol consumption may be protective against total and ischemic stroke.      

Cardiac arrhythmia and myocardial ischaemia related to cocaine and alcohol consumption

Following the drinking of 150 g of alcohol and a large amount of intra-nasal cocaine a previously healthy 31 year old man developed severe retrosternal pain and circulatory failure. An electrocardiogram showed supra-ventricular tachycardia with widespread ischaemic changes. Following electrical cardioversion electrocardiographic evidence of myocardial ischaemia persisted for 1 h. Two days later basal and exercise electrocardiograms were normal. The combination of alcohol and cocaine may be life threatening.     

Prospective study of alcohol consumption and risk of dementia in older adults

Context  Alcohol consumption has been associated with complex changes in cerebral vasculature and structure in older adults. How alcohol consumption affects the incidence of dementia is less clear. Objective  To determine the prospective relationship of alcohol consumption and risk of dementia among older adults. Design, Setting, and Participants  Nested case-control study of 373 cases with incident dementia and 373 controls who were among 5888 adults aged 65 years and older who participated in the Cardiovascular Health Study, a prospective, population-based cohort study in 4 US communities. The controls were frequency-matched on age, death before 1999, and their attendance of a 1998-1999 clinic. Participants in this study underwent magnetic resonance imaging (MRI) of the brain and cognitive testing between 1992 and 1994 and were followed up until 1999. Main Outcome Measures  Odds of incident dementia, ascertained by detailed neurological and neuropsychological examinations according to average alcohol consumption, assessed by self-reported intake of beer, wine, and liquor at 2 visits prior to the date of the MRI. Results  Compared with abstention, the adjusted odds for dementia among those whose weekly alcohol consumption was less than 1 drink were 0.65 (95% confidence interval [CI], 0.41-1.02); 1 to 6 drinks, 0.46 (95% CI, 0.27-0.77); 7 to 13 drinks, 0.69 (95% CI, 0.37-1.31); and 14 or more drinks, 1.22 (95% CI, 0.60-2.49; P for quadratic term = .001). A trend toward greater odds of dementia associated with heavier alcohol consumption was most apparent among men and participants with an apolipoprotein E 4 allele. We found generally similar relationships of alcohol use with Alzheimer disease and vascular dementia. Conclusions  Compared with abstention, consumption of 1 to 6 drinks weekly is associated with a lower risk of incident dementia among older adults.      

酒精摄入量与心血管病危险因子的相关性研究

目的:研究酒精摄入量与心血管病危险因子吸烟、血压、谷氨酰转肽酶(GGT)、缺糖基转铁蛋白百分比(%CDT)、超敏C反应蛋白(hs-CRP)、血同型半胱氨酸(HCY)、血脂的相关性.方法:将226例研究对象分成轻度、中度、重度饮酒和不饮酒4组,分别检测GGT、%CDT、hs-CRP、HCY等指标.结果:重度饮酒者吸烟比例明显高于其余各组(均P<0.05),且患高血压的比率也明显高于其余各组(均P<0.05).重度饮酒者GGT明显高于其余各组(均P<0.05),且随着酒精摄入量的增加而升高;重度饮酒者的%CDT明显高于不饮酒者(P<0.05),重度饮酒者hs-CRP明显高于轻度饮酒和中度饮酒者(P<0.05),而中度饮酒者的hs-CRP明显低于不饮酒者(P<0.05);中度饮酒者和轻度饮酒者TG、LDL-C明显低于不饮酒者(P<0.05);各组间的HCY、CHOL、WBC、HDL-C、MCV均无明显差异(均P>0.05).结论:重度饮酒与GGT、%CDT和hs-CRP的升高有关,其可能与其他心血管病危险因素如吸烟、高血压等共同作用增加患心血管疾病的危险性;少到中量饮酒者与低水平的hs-CRP有关,这可能通过抗炎作用对心血管系统有一定的保护作用.     

Trends in alcohol consumption by pregnant women. 1985 through 1988

To examine trends in alcohol consumption among pregnant women, we examined data collected from 21 states participating in the Behavioral Risk Factor Surveillance System for 4 consecutive years: 1985 through 1988. Overall, 429 (25%) of 1712 pregnant women and 19,903 (55%) of 36,057 nonpregnant women 18 to 45 years of age reported using alcohol in the previous month. Pregnant women who used any alcohol reported consuming a median of four drinks per month, whereas nonpregnant women who used any alcohol reported nine. The prevalence of alcohol consumption among pregnant women declined steadily, from 32% in 1985 to 20% in 1988, but the median number of drinks per month for pregnant women who drank did not change. No decline was observed among the less educated or those under the age of 25 years. In 1988, the prevalence of alcohol use among pregnant women remained highest among smokers (37%) and the unmarried (28%). Although the overall consumption of alcohol by pregnant women in the United States appears to be declining, special efforts are needed to reduce alcohol use among pregnant women who are smokers, unmarried, less educated, or younger, women who may already be at high risk of a poor pregnancy outcome.     

Moderate alcohol consumption and risk of heart failure among older persons

CONTEXT: Heavy consumption of alcohol can lead to heart failure, but the relationship between moderate alcohol consumption and risk of heart failure is largely unknown. OBJECTIVE: To determine whether moderate alcohol consumption predicts heart failure risk among older persons, independent of the association of moderate alcohol consumption with lower risk of myocardial infarction (MI). DESIGN: Prospective cohort study conducted from 1982 through 1996, with a maximum follow-up of 14 years. SETTING AND PARTICIPANTS: Population-based sample of 2235 noninstitutionalized elderly persons (mean age, 73.7 years; 41.2% male; 21.3% nonwhite) residing in New Haven, Conn, who were free of heart failure at baseline. Persons who reported alcohol consumption of more than 70 oz in the month prior to baseline were excluded. MAIN OUTCOME MEASURE: Time to first fatal or nonfatal heart failure event, according to the amount of alcohol consumed in the month prior to baseline. RESULTS: Increasing alcohol consumption in the moderate range was associated with decreasing heart failure rates. For persons consuming no alcohol (50.0%), 1 to 20 oz (40.2%), and 21 to 70 oz (9.8%) in the month prior to baseline, crude heart failure rates per 1000 years of follow-up were 16.1, 12.2, and 9.2, respectively. After adjustment for age, sex, race, education, angina, history of MI and diabetes, MI during follow-up, hypertension, pulse pressure, body mass index, and current smoking, the relative risks of heart failure for those consuming no alcohol, 1 to 20 oz, and 21 to 70 oz in the month prior to baseline were 1.00 (referent), 0.79 (95% confidence interval [CI], 0.60-1.02), and 0.53 (95% CI, 0.32-0.88) (P for trend =.02). CONCLUSIONS: Increasing levels of moderate alcohol consumption are associated with a decreasing risk of heart failure among older persons. This association is independent of a number of confounding factors and does not appear to be entirely mediated by a reduction in MI risk.     

A meta-analysis of alcohol consumption in relation to risk of breast cancer

Epidemiologic findings regarding the relation between alcohol consumption and risk of breast cancer have been inconsistent. We performed a meta-analysis (a quantitative review) of the available data. To evaluate whether there was a dose-response relation between alcohol consumption and risk of breast cancer, we fitted mathematical models to the pooled data. There was strong evidence to support a dose-response relation in both the case-control and follow-up epidemiologic data. Using the dose-response curves that we calculated, the risk of breast cancer at an alcohol intake of 24 g (1 oz) of absolute alcohol daily (about two drinks daily) relative to nondrinkers was 1.4 (95% confidence interval, 1.0 to 1.8) in the case-control data and was 1.7 (95% confidence interval, 1.4 to 2.2) in the follow-up data. We interpret these findings not as proof of causality, but as strongly supportive of an association between alcohol consumption and risk of breast cancer.     

饮酒与老年性痴呆关系的前瞻性队列研究

目的探讨饮酒和老年性痴呆的关系。方法对重庆市2632名≥60岁老年人进行2年前瞻性队列研究，受试者分为不饮酒，轻中度饮酒，重度饮酒，用简易智能量表（MMSE）和美国精神障碍诊断与统计手册第三版修订本（DSM—Ⅲ—R）进行痴呆诊断，随访时间内记录痴呆发生的例数，采用运用Logistic回归方法对饮酒和痴呆的关系进行分析。结果在调整了年龄、性别、教育、血压、吸烟、中风史、MMSE评分等危险因素后，与不饮酒者相比，轻中度饮酒使痴呆的危险度降低（RR=0.52，95％CI=0.32-0．85），与不饮酒者相比，轻中度饮酒者患阿尔茨海默病的相对危险度为0.63（RR=0．63，95％CI=0．55—0．72），其他类型痴呆为0.45（RR=0．45，95％CI=0.12-1.69），血管性痴呆为0.31（RR=0.31，95％CI=0.19-0．51）。与不饮啤酒者相比，轻中度饮啤酒者患痴呆的危险度增高（RR=2．47，95％CI=1．23—4.96）；与不饮葡萄酒者相比，轻中度饮葡萄酒者患痴呆的危险度降低（RR=0．68，95％CI=0．50—0．92）。结论轻中度饮酒与痴呆的危险度降低有关。     

关于酒精的知识（一）：身体内的酒精

酒精(即乙醇)是一种药物，作为医疗卫生工作者，应该了解其对人体生理机能的影响及其致病作用，电应了解乙醇在人体内的代谢过程。乙醇为可溶于水的小分子．在胃内吸收较慢．但在小肠中吸收较快．可分布到身体各个部位。酒精可提供大量热卡，6品脱啤酒含500卡；半升威士忌含1650卡。而一个中等活动量的男性每日需3000卡，女性仅需2200卡。     

Nut and peanut butter consumption and risk of type 2 diabetes in women

Context  Nuts are high in unsaturated (polyunsaturated and monounsaturated) fat and other nutrients that may improve glucose and insulin homeostasis. Objective  To examine prospectively the relationship between nut consumption and risk of type 2 diabetes. Design, Setting, and Participants  Prospective cohort study of 83 818 women from 11 states in the Nurses' Health Study. The women were aged 34 to 59 years, had no history of diabetes, cardiovascular disease, or cancer, completed a validated dietary questionnaire at baseline in 1980, and were followed up for 16 years. Main Outcome Measure  Incident cases of type 2 diabetes. Results  We documented 3206 new cases of type 2 diabetes. Nut consumption was inversely associated with risk of type 2 diabetes after adjustment for age, body mass index (BMI), family history of diabetes, physical activity, smoking, alcohol use, and total energy intake. The multivariate relative risks (RRs) across categories of nut consumption (never/almost never, <once/week, 1-4 times/week, and 5 times/week) for a 28-g (1 oz) serving size were 1.0, 0.92 (95% confidence interval [CI], 0.85-1.00), 0.84 (0.95% CI, 0.76-0.93), and 0.73 (95% CI, 0.60-0.89) (P for trend <.001). Further adjustment for intakes of dietary fats, cereal fiber, and other dietary factors did not appreciably change the results. The inverse association persisted within strata defined by levels of BMI, smoking, alcohol use, and other diabetes risk factors. Consumption of peanut butter was also inversely associated with type 2 diabetes. The multivariate RR was 0.79 (95% CI, 0.68-0.91; P for trend <.001) in women consuming peanut butter 5 times or more a week (equivalent to 140 g [5 oz] of peanuts/week) compared with those who never/almost never ate peanut butter. Conclusions  Our findings suggest potential benefits of higher nut and peanut butter consumption in lowering risk of type 2 diabetes in women. To avoid increasing caloric intake, regular nut consumption can be recommended as a replacement for consumption of refined grain products or red or processed meats.      

饮酒对宜昌市职业人群代谢综合征患病率及其相关因素的影响

目的：研究饮酒对宜昌市职业人群代谢综合征（MS）患病率及其相关因素的影响,为该市MS人群生活方式干预提供决策依据。方法抽样调查宜昌市15个单位职业人群共3640人（男2285人,女1355人,年龄20～70岁）,详细询问其饮酒习惯并填写调查表,进行体格检查和实验室检查,根据日饮酒量分为3组（不饮和偶尔饮酒组、适量饮酒组、过量饮酒组）,对结果进行统计分析。结果与不饮和偶尔饮酒组比较,适量饮酒组MS患病率及体质量指数（BMI）、舒张压（DBP）、三酰甘油（TG）、尿酸（UA）异常率显著升高（P＜0．05）,收缩压（SBP）异常率显著下降（P＜0．05）;过量饮酒组BMI、DBP、SBP、葡萄糖（GLU）、总胆固醇（TCH）、TG、低密度脂蛋白胆固醇（LDL‐C）、UA、MS患病率显著升高（P＜0．05）。与适量饮酒组比较,过量饮酒组MS患病率及BMI、DBP、GLU、TCH、TG、LDL‐C、UA异常率上升显著（P＜0．05）。不论适量还是过量饮酒,C‐反应蛋白（CRP）及高密度脂蛋白胆固醇（HDL‐C）异常率没有显著变化（P＞0．05）。结论适量饮酒对宜昌市职业人群BMI、DBP、TG、LDL‐C、UA有显著影响,对GLU、TCH、HDL‐C、CRP影响不明显。MS患病率及其相关因素异常率与乙醇摄入量呈正相关。适量饮酒有降低SBP和GLU作用,但不能降低MS发病率。