摘要目的 探讨饮酒与中老年男性2型糖尿病(T2DM)发病风险的关联性.方法 研究人群来源于东风同济队列,该队列于2008年在湖北省招募了27009名东风汽车公司离、退休职工,基线调查采用半结构化问卷收集饮酒信息和相关协变量,并进行了体格检查、血糖和血脂等测定.从队列中选取男性并排除基线调查时已患糖尿病、冠心病、卒中和恶性肿瘤者,最终纳入6784名男性.2013年进行随访,通过研究对象的医疗保险号收集其疾病或死亡结局.应用COX比例风险模型分析不同饮酒特征和模式与T2DM的关联性.结果 6784名研究对象中,3541名从不饮酒者共随访15852.2人年,新发T2DM 270例,发病密度为1703.2/10万人年;3243名饮酒者共随访14509.8人年,新发T2DM 258例,发病密度为1778.1/10万人年.多因素COX比例风险模型显示:与不饮酒人群相比,饮酒人群T2DM发生风险总体上未升高[HR(95%CI):1.09(0.91~1.30)],但平均乙醇摄入量>20 g/d和饮酒频率高于7次/周的饮酒者T2DM发生风险均升高[HR(95%CI)值分别为1.27(1.02~1.58)和1.35(1.00~1.83)];饮酒频率>7次/周的人群中,单次乙醇摄入量为0.01~40和>40 g者发生T2DM的HR(95%CI)值分别为1.48(1.05~2.09)和1.27(0.80~2.01).结论 总体上饮酒与T2DM发生风险无关,但平均乙醇摄入量>20 g/d或饮酒频率>7次/周会增加T2DM发生风险.

abstractsObjective To investigate the association between alcohol use and incidence of type 2 diabetes mellitus (T2DM) in the middle-aged and elderly male population. Methods All participants were from Dongfeng-Tongji cohort, 27009 retired employees from Dongfeng Motor Corporation in Hubei Province were enrolled in the Dongfeng-Tongji cohort baseline survey in 2008. In baseline study, information of alcohol use and other covariates were collected by semi-structured questionnaire and all participants completed physical examination including the test of fasting glucose and blood lipid levels. A total of 6784 male participants from Dongfeng-Tongji cohort who were without diagnosis of diabetes, coronary heart disease, stroke, or cancer in baseline study were enrolled in this study. We completed the first follow-up in 2013 and the outcome of disease or death was retrieved based on health-care medical records according to the unique medical insurance ID. Cox proportional hazard regression model was used to estimate the association between alcohol use and incidence of type 2 diabetes mellitus (T2DM), by drinking features and patterns. Results Out of the 6784 participants, 3541 participant were defined as non-alcohol drinkers and there were 15852.2 person-years of follow-up;among which 270 new cases of T2DM were diagnosed withthe crude incidence density of non-alcohol drinkers at 1703.2/100000 person-years. The other 3243 subjects were classified as alcohol drinkers and there were 14509.8 person-years of follow-up;and among which 258 new cases of T2DM were diagnosed, with the crude incidence density of T2DM at 1778.1/100000 person-years. Multivariate COX proportional hazard regression model indicated that there was no significantly increased risk of T2DM incidence between alcohol drinkers and non-alcohol drinkers(HR(95%CI): 1.09 (0.91-1.30)). However, participants who averagely consumed >20 g/d or>7 times/week had a significantly increased risk of T2DM compared with non-alcohol drinkers, and the value of HR(95%CI) was 1.27 (1.02-1.58) and 1.35 (1.00-1.83), respectively. Among men who consumed alcoholic beverages more than 7 times/week, HR (95%CI) for T2DM incidence in the subjects who consumed 0.01 to 40 g and>40 g once a time were 1.48 (1.05-2.09) and 1.27 (0.80-2.10), respectively. Conclusion Although we found no relationship between alcohol use and T2DM incidence overall, alcohol use more than 20 g/d or more than 7 times/week would increase the risk of T2DM.