饮酒是肝肿瘤和非肿瘤疾病的重要危险因素。问题依然存在,然而,关于饮酒模式和酒精耐受性与疾病风险的相关性,这在中国和西方人口之间有很大的不同。
前瞻性的中国嘉道理生物库包括2004-2008年从十个地区招募的512,715名30-79岁的成年人(占男性的41%),记录酒精摄入量,饮酒模式,和其他特征。经过10年的平均随访,2531例肝癌,2040肝硬化,260酒精性肝病(ALD),在基线时无癌症或慢性肝病的492,643名参与者中,记录了1262例非酒精性脂肪性肝病(NAFLD)病例.Cox回归用于估计将酒精摄入和饮酒模式与每种疾病相关的调整后的风险比(HR)。
总的来说,33%的男性和2%的女性在基线时定期(即至少每周一次)饮酒。在男性目前经常喝酒的人中,饮酒与几种主要慢性肝病的风险呈正剂量反应关系,对于肝癌(n=547),每280克/周的HR(即大约4杯/天)较高的常规酒精摄入量为1.44(95%CI1.23-1.69),1.83(1.60-2.09)用于肝硬化(n=388),2.01(1.77-2.28)用于ALD(n=200),NAFLD为1.71(1.35-2.16)(n=198),和1.52(1.40-1.64)为总肝病(n=1775)。与ALD的关联在报告潮红的男性中似乎更强(即,酒精耐受性低)。调整每周饮酒总量后,与非每日饮酒者相比,每日饮酒者患ALD的风险显著增加(2.15,1.40-3.31),和不吃饭饮酒与肝癌的风险显著增加(1.32,1.01-1.72),肝硬化(1.37,1.02-1.85),和ALD(1.60,1.09-2.33)与随餐饮酒相比。女性目前经常饮酒的人患ALD的风险明显更高,但不是其他肝脏疾病,而不是女性弃权者。
在中国男人中,饮酒与几种主要慢性肝病的风险显着增加有关,和某些饮酒模式(例如,每天饮酒,不吃饭喝酒)可能会进一步加剧疾病风险。
Alcohol consumption is an important risk factor for hepatic neoplastic and non-neoplastic diseases. Questions remain, however, about the relevance to disease risk of drinking patterns and alcohol tolerability, which differ appreciably between Chinese and Western populations.
The prospective China Kadoorie Biobank included 512,715 adults (41% men) aged 30-79 years recruited from ten areas during 2004-2008, recording alcohol intake, drinking patterns, and other characteristics. After median 10 years\' follow-up, 2531 incident liver cancer, 2040 liver cirrhosis, 260 alcoholic liver disease (ALD), and 1262 non-alcoholic fatty liver disease (NAFLD) cases were recorded among 492,643 participants without prior cancer or chronic liver disease at baseline. Cox regression was used to estimate adjusted hazard ratios (HR) relating alcohol intake and drinking patterns to each disease.
Overall, 33% of men and 2% of women drank alcohol regularly (i.e. at least weekly) at baseline. Among male current regular drinkers, alcohol consumption showed positive dose-response associations with risks of several major chronic liver diseases, with HRs per 280 g/week (i.e. around four drinks/day) higher usual alcohol intake of 1.44 (95% CI 1.23-1.69) for liver cancer (n = 547), 1.83 (1.60-2.09) for liver cirrhosis (n = 388), 2.01 (1.77-2.28) for ALD (n = 200), 1.71 (1.35-2.16) for NAFLD (n = 198), and 1.52 (1.40-1.64) for total liver disease (n = 1775). The association with ALD appeared stronger among men reporting flushing (i.e., with low alcohol tolerance). After adjustment for the total amount of weekly alcohol consumption, daily drinkers had significantly increased risk of ALD (2.15, 1.40-3.31) compared with non-daily drinkers, and drinking without meals was associated with significantly greater risks of liver cancer (1.32, 1.01-1.72), liver cirrhosis (1.37, 1.02-1.85), and ALD (1.60, 1.09-2.33) compared with drinking with meals. Female current regular drinkers had significantly higher risk of ALD, but not other liver diseases, than female abstainers.
In Chinese men, alcohol intake was associated with significantly increased risks of several major chronic liver diseases, and certain drinking patterns (e.g. drinking daily, drinking without meals) may further exacerbate the disease risks.