Mediating Effect Of Hemoglobin And Hematocrit On The Association Between Alcohol Consumption And Blood Pressure

Part 1: A study on the association between alcohol consumption,alcohol consumption changes and hemoglobin,red blood cell volumeBackground: Blood viscosity is one of the important influence factors of cardiovascular disease.Studies suggest that ethanol and its metabolites acetaldehyde have blood toxicity effect,can cause the red blood cell volume and hemoglobin changes,that affect blood viscosity.And domestic reports of the association between alcohol consumption,alcohol consumption changes and red blood cell volume,hemoglobin is relatively lacking.We therefore to implement such research base on the baseline data of Guangzhou Biobank Cohort Study(GBCS).Purpose is to provide a scientific reference for control blood viscosity of hemoglobin and red blood cell volume in the drinking population.Methods:Based on the data of GBCS,29419 participants in the baseline who aged ?50 years and both one of them,16456 participants who had data for both baseline and follow-up examinations as the research objects.The survry included age,bmi,educational level,occupation and income,physical activity and smoking,alcohol consumption,etc,and data from physical examination and laboratory tests including blood pressure.Multivariate factors covariance analysis was used to analyse the association of baseline alcohol consumption with the MCV?HCT?MCH?HGB in the cross-sectional study,and analyse the association of alcohol consumption changes with the change of MCV?HCT?MCH?HGB in the longitudinal study.Multivariate logistic regression was used to analyse the association of alcohol consumption with the risk of macrocytosis,elevated MCH,HCT,HGB.Results: In the baseline,After adjusted age,bmi,educational level,occupation,income,physical activity and smoking,multiple factors covariance analysis show that,in women who wihtout thalassemia,MCV,MCH level in occasional,moderate,heavy drinkers were significantly higher than the non-drinkers,MCV,HCT level in abstainers were significantly higher than the non-drinkers,MCH level in abstainers were significantly lower than heavy drinkers(P<0.05);there was a dose-response relationship between alcohol intake and the MCV,HCT,MCH level,an increase with the increase of alcohol intake(P<0.05).In men who wihtout thalassemia,MCV,HCT,MCH,HGB level in heavy drinkers were significantly higher than the non-drinkers,(P<0.05),and MCV,HCT,MCH level in moderate drinkers were significantly higher than the non-drinkers,MCV,HCT,MCH,HGB level in abstainers were significantly lower than heavy drinkers(P<0.05),and there was a dose-response relationship between alcohol intake and the MCV?HCT?MCH?HGB level,an increase with the increase of alcohol intake(P<0.05).There was no significant correlation between alcohol use and MCV,HCT,MCH,HGB level in thalassemia people.The moderate and heavy drinkers showed higher risk of macrocytosis compared to non-drinkers in men after adjustment OR(95CI%)were 1.95(1.23,3.09),2.79(1.87,4.16)respectively,abstainers showed lower risk of macrocytosis compared to heavy drinkers(P<0.05),increases with the increased incidence of macrocytosis with alcohol(P<0.001).The heavy drinkers showed higher risk of elevated MCH compared to non-drinkers in men OR(95CI%)was 3.16(2.35,4.26),abstainers showed lower risk of elevated MCH compared to heavy drinkers(P<0.05),increases with the increased incidence of elevated MCH with alcohol(P<0.001).The heavy drinkers showed higher risk of elevated HCT compared to non-drinkers in men OR(95CI%)was 1.81(1.30,2.52),abstainers showed lower risk of elevated HCT compared to heavy drinkers(P<0.05),increases with the increased incidence of elevated HCT with alcohol(P<0.001).The heavy drinkers showed higher risk of elevated HGB compared to non-drinkers in men OR(95CI%)was 2.50(1.78,3.51),abstainers showed lower risk of elevated HGB compared to heavy drinkers(P<0.05),increases with the increased incidence of elevated HGB with alcohol(P<0.001).In the follow-up,after adjustment,in women who wihtout thalassemia,and in the non-drinkers at baseline,MCV,HCT,MCH,HGB change level in who change to occasional or moderate drinkers were significantly higher than the non-drinkers(P<0.05),and there was a dose-response relationship between alcohol comsumption in the follow-up and the MCV,HCT,MCH,HGB change level,an increase with the increase of alcohol intake.In the occasional drinkers at baseline,HCT change level in who change to moderate or heavy drinkers were significantly higher than the non-drinkers(P<0.05),and there was a dose-response relationship between alcohol comsumption in the follow-up and the HCT change level,an increase with the increase of alcohol intake.In the moderate drinkers at baseline,HCT,MCH change level in who still be moderate drinkers were significantly higher than the non-drinkers,MCH change level in who change to occasional drinkers were significantly higher than the non-drinkers(P<0.05),and there was an dose-response relationship between alcohol comsumption in the follow-up and the MCH change level,a increase with the increase of alcohol intake.In men who wihtout thalassemia,and in the non-drinkers at baseline,HCT,HGB change level in who change to occasional drinkers were significantly higher than the non-drinkers,MCV,HCT,MCH,HGB change level in who change to moderate drinkers were significantly higher than the non-drinkers(P<0.05),and there was a dose-response relationship between alcohol comsumption in the follow-up and the MCV,HCT,MCH,HGB change level,an increase with the increase of alcohol intake.In the occasional drinkers at baseline,MCV change level in who change to heavy drinkers was significantly higher than the non-drinkers,MCH change level in who change to moderate drinkers was significantly higher than the non-drinkers(P<0.05),and there was a dose-response relationship between alcohol comsumption in the follow-up and the MCV,MCH,HGB change level,an increase with the increase of alcohol intake.In the moderate drinkers at baseline,MCV,HCT change level in who still be moderate drinkers was significantly higher than the non-drinkers(P<0.05),and there was a dose-response relationship between alcohol comsumption in the follow-up and the MCV,HCT,HGB change level,an increase with the increase of alcohol intake.In the heavy drinkers at baseline,MCV,HCT,MCH,HGB change level in who change to moderate drinkers or still be heavy drinkers was significantly higher than the non-drinkers(P<0.05),and there was a dose-response relationship between alcohol comsumption in the follow-up and the MCV,HCT,MCH,HGB change level,an increase with the increase of alcohol intake.Conclusion: Alcohol use associated with elevated MCV,HCT,MCH,HGB in people who wihtout thalassemia,limit alcohol intake or abstinence can reduce the above index level.Men alcohol consumption may increase the risk of macrocytosis and elevated of MCH,HCT,HGB.Suggesting alcohol restriction should be advocated as soon as possible to reduce the risk of blood viscosity and cardiovascular disease attributed elevated red blood cell volume,hemoglobin fromPart 2: A study on the association between alcohol consumption and hypertensionBackground: The related studies showed that alcohol consumption had dose-response relationship and hypertension.But type of dose-response relationship is not sure.Some results show that alcohol consumption and hypertension prevalence relationship is linear.And some other results show the relationship is J curve,it has not been determined.To learn the relationship between drinking and hypertension.We therefore to implement such research base on the baseline data of Guangzhou Biobank Cohort Study(GBCS).Purpose is to provide a scientific reference for control Blood pressure in the drinking population.Methods:Based on the baseline data of GBCS,29419 participants aged 50 years or older were selected.The survry included general demographic information(age,sex),socioeconomic status(educational level,occupation and income),life-style(physical activity and Smoking,alcohol consumption,etc),and hypertension history,the usage of antihypertensive drugs,and physical examination and static blood pressure test also collected.Multivariate factors covariance analysis was used to analyse the association of alcohol consumption with the blood pressure(SBP,DBP,PP,MAP).Multivariate logistic regression was used to analyse the association of alcohol consumption with the risk of hypertensionResults: After adjusted age,bmi,educational level,occupation,income,physical activity and smoking,multiple factors covariance analysis show that,wihtout people who taking blood pressure medication in the past two weeks,in women,SBP,DBP,MAP level in occasional drinkers and SBP,DBP,PP,MAP level in moderate drinkers were significantly lower than the non-drinkers,SBP,MAP level in abstainers were significantly higher than the non-drinkers(P<0.05),and there was a dose-response relationship between alcohol intake and the SBP,DBP,PP,MAP level,a decrease with the increase of alcohol intake(P<0.05).In men,SBP,DBP,PP,MAP level in heavy drinkers were significantly higher than the non-drinkers,DBP,MAP level in moderate drinkers were significantly higher than the non-drinkers(P<0.05),and there was a dose-response relationship between alcohol intake and the SBP,DBP,PP,MAP level,an increase with the increase of alcohol intake(P<0.001).In the condition wihtout people who have hypertension and taking blood pressure medication,for the women,SBP,DBP,PP,MAP level in moderate drinkers were significantly lower than the non-drinkers,SBP,MAP level in abstainers were significantly higher than the non-drinkers(P<0.05),and there was a dose-response relationship between alcohol intake and the SBP,DBP,PP,MAP level,a decrease with the increase of alcohol intake(P<0.05).For the men,SBP,DBP,PP,MAP level in heavy drinkers were significantly higher than the non-drinkers,DBP,MAP level in moderate drinkers were significantly higher than the non-drinkers(P<0.05),and there was a dose-response relationship between alcohol intake and the SBP,DBP,PP,MAP level,an increase with the increase of alcohol intake(P<0.001).Ater adjustment multivariate logistic regression analysis show that,the occasional and moderate and heavy drinkers all showed lower risk of hypertension to non-drinkers in women,OR(95CI%)were 0.70(0.60,0.83),0.59(0.48,0.72),0.58(0.40,0.84)respectively(P<0.05).For the men,the occasional drinkers showed lower risk of hypertension to non-drinkers,OR(95CI%)was 0.77(0.64,0.93),heavy drinkers and abstainers showed higher risk of hypertension to non-drinkers,OR(95CI%)were 1.52(1.29,1.80),1.25(1.02,1.54)(P<0.05).In the condition wihtout people who have hypertension and taking blood pressure medication,the moderate drinkers showed lower risk of hypertension to non-drinkers in women,OR(95CI%)was 0.67(0.49,0.91)(P<0.01).The heavy drinkers showed higher risk of hypertension to non-drinkers in men,OR(95CI%)was 2.12(1.73,2.59)(P<0.05).Conclusion: The association of alcohol consumption and blood pressure is J curve correlation in women,moderate drinking have protective effect on hypertension.The association of alcohol consumption and blood pressure is linear correlation in men,moderate drinking can increase the risk of hypertension.Part 3:A study on the mediating effect of hemoglobin and hematocrit in the relationship between alcohol consumption and blood pressureBackground: To explore the mediating effect of hemoglobin(HGB)and hematocrit(HCT)on the association between alcohol consumption and blood pressure,and provide evidence for the alcohol-attributed hypertension prevention and control.Methods:1091 male participants of the Guangzhou biobank cohort study(GBCS)were included.All participants were aged 50+ years and drank weekly.Mediation analysis was used to calculate the mediating effect of HGB and HCT on the association of alcohol consumption(unit/day)with systolic blood pressure(SBP),diastolic blood pressure(DBP),pulse pressure(PP)and mean arterial pressure(MAP).Results: After adjusting for age,body mass index,education,personal annual income,smoking,occupation and physical activity,the associations of alcohol consumption with SBP,DBP,PP and MAP were partly mediated by HGB,with the proportion of mediating effect being 11.8%(95%CI: 4.8%-24.7%),15.2%(6.7%-31.6%),8.4%(2.2%-21.6%)and 13.5%(5.7%-27.2%),respectively,and also partly mediated by HCT,with the proportion of mediating effect being 6.3%(0.9%-16.3%),8.7%(1.1%-21.6%),4.0(0.2%-15.2%),7.5%(1.3%-18.1%),respectively.Conclusion: The adverse effect of alcohol consumption on blood pressure was partly due to higher HGB and HCT.For monitoring and prevention of alcohol-related hypertension,besides efforts on alcohol control,potential benefits from interventions on HGB and HCT need to be further explored.