| ObjectiveTo examine the potential impact of cumulative alcohol consumption on stroke,type 2 diabetes mellitus(T2DM)and impaired fasting glucose(IFG),and all-cause mortality.MethodsThis study is based on The Kailuan Study,which is a prospective,community-based cohort study.The participants were followed through every two years with face-to-face questionnaires,physical examinations and blood tests initiated in 2006.To represent long-term alcohol exposure of individuals,we calculated cumulative alcohol consumption as follows: [(alcohol 1 + alcohol 2)/2 × time1-2]+[(alcohol 2 + alcohol 3)/2 × time 1-2].According to the cumulative alcohol consumption(g/day × year),the participants were divided into four groups:nondrinkers,light,moderate,and heavy group.The follow-up began at the third medical examination in 2010-2011 and continued until the first occurrence of the end event,death or December 31,2016.Cox proportional hazards models were used to examine the associations between cumulative alcohol consumption and the end points by calculating the hazard ratios(HRs)and 95% confidence intervals(CIs),nondrinkers were used as the reference category.The fitting degree of the model was analyzed by the likelihood ratio test.Results1.The cohort study on cumulative alcohol consumption and stroke included23433 participants.During the 5.9 ± 0.8 years of follow-up,we documented 678 total stroke cases,including 595 ischemic stroke(IS),90 intracerebral hemorrhage and 19 intracerebral hemorrhage cases.Compared with those of the nondrinkers,significant associations were found between cumulative alcohol consumption and total stroke in the light(HR 1.23,95% CI 1.01-1.51),moderate(HR 1.49,95% CI 1.13-1.97),and heavy(HR 1.50,95% CI 1.21-1.86)groups.The results were similar for IS.2.The cohort study on cumulative alcohol consumption and T2 DM or IFG included 14107,10040 participants,respectively.During the 6.3 years of follow-up,we documented 2963 T2 DM,1172 IFG cases.Compared with those of the nondrinkers,no significant associations were found between cumulative alcohol consumption and T2 DM in the light or moderate groups,but heavy intake increases the risk of T2DM(HR 1.18,95% CI 1.04-1.34).The stratified analysis of average body mass index showed that heavy cumulative alcohol consumption increased the risk of T2 DM only in people with normal body weight,and the HR 1.33,95% CI1.01-1.76.There was no statistical significance between light cumulative drinking and IFG,while heavy cumulative drinking has critical risk of IFG.With the increase of cumulative alcohol consumption,the risk of IFG increased(P for trend= 0.0289).3.The cohort study on cumulative alcohol consumption and all-cause mortality included 24150 participants.During the 5.9 ± 0.8 years of follow-up,we documented1172 all-cause death cases.Compared with those of the nondrinkers,light(HR 0.83,95% CI 0.71-0.97)and moderate(HR 0.73,95% CI 0.57-0.95)cumulative drinking decreased the risk of all-cause mortality,respectively,while no significant association was found in the heavy group.4.The likelihood ratio tests indicated that cumulative alcohol consumption fit the models better than that of baseline or single drinking for total stroke,IS and all-cause mortality(P <0.05).Conclusions1.Cumulative alcohol consumption is an independent risk factor of total stroke and IS.Even light alcohol intake increases the risk of total stroke and IS.2.Heavy cumulative drinking is an independent risk factor of T2 DM and IFG,and no protective effect of light cumulative drinking on T2 DM or IFG is found.3.Light and moderate cumulative alcohol consumption are associated with a reduced risk of all-cause mortality.4.The predictive value of cumulative alcohol consumption for total stroke,IS and all-cause mortality is better than that of baseline or single alcohol consumption. |
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