Alcohol Consumption and the Risk of Type 2 Diabetes Mellitus: Effect Modification by Hypercholesterolemia: The Third Korea National Health and Nutrition Examination Survey (2005)

酒精攝取與第2型糖尿病罹患風險：高膽固醇血症之效應修飾：第三次韓國國民健康與營養調查（2005）

Hyeon-Gap Jang ； Won-Mo Jang ； Jong-Heon Park ； Juh-Wan Oh ； Mu-Kyung Oh ； Soo-Hee Hwang ； Yong-Ik Kim ； Jin-Seok Lee

《Asia Pacific Journal of Clinical Nutrition》 21卷4期 (2012/12) Pp. 588-593

https://doi.org/10.6133/apjcn.2012.21.4.14

摘要

目的：已知適量飲酒對於糖尿病具有保護作用，但仍有報告指出不一致的結果，造成此差異的原因可能來自於效應修飾因子之間互相影響。本研究目的為檢視酒精攝取對第2型糖尿病影響之潛在效應修飾因子。方法：本研究資料來自第三次韓國國民健康與營養調查，納入之研究對象共有3982位，條件為30歲以上未被診斷為糖尿病者。在多元邏輯斯迴歸模式下，以Breslow-Day檢定和Wald檢定來分析高膽固醇血症與飲酒之間的效應修飾作用。結果：利用Breslow-Day檢定來檢測同質性，在不同飲酒狀況之糖尿病勝算比（OR）指出，高膽固醇血症並不是一項顯著干擾因子（p=0.01）。然而，由較保守之效應修飾分析方法-Wald檢定的結果顯示，兩者之間具有顯著之交互作用（p=0.03）。結論：由結果指出，對於有高膽固醇血症者，適量飲酒對第2型糖尿病風險不一定具有保護作用。因此高膽固醇血症患者應對飲酒相關風險有所警覺，此風險與適量飲酒對糖尿病之保護作用卻是相對立的。

關鍵字

糖尿病 ； 酒精攝取 ； 高膽固醇血症 ； 血脂異常 ； 效應修飾 ； 交互作用

並列摘要

OBJECTIVE: While the protective nature of moderate alcohol consumption against diabetes mellitus is well known, inconsistent findings continue to be reported. The possibility of different mixes of effect modifiers has been raised as a reason for those inconsistent findings. Our study aim was to examine potential effect modifiers that can change the effect of alcohol consumption on type 2 diabetes. METHODS: From data in the third Korea National Health and Nutrition Examination Survey, 3,982 individuals over the age of 30 years who had not been diagnosed with diabetes were selected for inclusion in the study population. Breslow and Day's test and the Wald test between hypercholesterolemia and alcohol consumption in a multiple logistic regression model were used to assess effect modification. RESULTS: Odds ratios for diabetes stratified by alcohol consumption strata and assessed using Breslow and Day's tests for homogeneity indicated that hypercholesterolemia was not a significant confounding factor (p=0.01). However, the Wald test for interaction terms, which is a conservative method of effect modification, was significant (p=0.03). CONCLUSIONS: The results indicate that moderate alcohol consumption is not necessarily protective for type 2 diabetes mellitus, if a person has hypercholesterolemia. People who have hypercholesterolemia should be aware of the risk associated with alcohol consumption, a risk that contrasts with the reported protective effect of moderate alcohol consumption on diabetes.

並列關鍵字

diabetes ； alcohol consumption ； hypercholesterolemia ； dyslipidemia ； effect modification ； interaction