饮酒与中风风险:一个元分析
Kristi Reynolds1, Brian Lewis, John David L Nolen
1Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, Tulane University Health Sciences Center, 1430 Tulane Ave SL18, New Orleans, LA 70112, USA. kreynol1@tulane.edu
JAMA
|February 13, 2003
概括
过度饮酒显著增加了中风风险. 然而,根据这次元分析,轻度至中度的酒精摄入量可能会提供对全身和缺血性中风的保护性益处.
科学领域:
- 流行病学 流行病学
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 观察性研究表明,饮酒与中风风险之间存在复杂的关系.
- 建议大量饮酒会增加中风风险,而适度饮酒可能会降低中风风险.
研究的目的:
- 进行一项元分析,研究酒精消费与中风相对风险之间的关联.
- 综合多项观察性研究的发现,以澄清酒精对中风发病率的影响.
主要方法:
- 在MEDLINE和Dissertation Abstracts Online的系统文献搜索,查找1966年至2002年4月期间发表的相关英语研究.
- 包括35项观察性研究 (队列或病例控制) 报告了与量化酒精消费相关的总,缺血性或出血性中风的相对风险或几率.
- 三名独立调查人员使用标准化协议提取数据,重点关注研究设计,参与者特征,酒精水平,中风结果和混因素.
主要成果:
- 过度饮酒 (>60克/天) 与全中风 (1.64),缺血性中风 (1.69),出血性中风 (2.18) 的相对风险增加有关.
- 轻量饮酒 (<12克/天) 显示,总中风 (0.83) 和缺血性中风 (0.80) 的相对风险降低.
- 适度饮食 (12-24克/天) 与缺血性中风 (0.72) 的相对风险降低有关,在总和缺血性中风中发现了显著的非线性关系,在出血性中风中发现了线性关系.
结论:
- 严重的酒精消费无疑与中风的相对风险增加有关.
- 轻度到中度的酒精消费似乎可以防止总和缺血性中风.
- 这些发现突出了酒精摄入量和中风风险之间的剂量依赖关系.
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