适量饮酒有益降低糖尿病风险
转自丁香园lisuxizh编译
事实再次证明凡事都有两面性。
October 7, 2009 — Moderate daily alcohol intake (1 - 3 drinks per day) is linked to a reduced risk for incident diabetes and to lower insulin secretion in patients assigned to metformin or lifestyle modification for diabetes prevention, according to the results of a study reported in the October issue of the American Journal of Clinical Nutrition.
2009年10月7日新闻-根据10月份美国临床营养杂志刊登的一项研究报告，每天适量饮酒（每天1 – 3杯）可以降低发生糖尿病的风险，和减少接受二甲双胍药物治疗或是采取生活方式改善疗法的糖尿病患者的胰岛素分泌。
"Moderate alcohol consumption is associated with a decreased risk of type 2 diabetes in the general population, but little is known about the effects in individuals at high risk of diabetes," write Jill P. Crandall, MD, from the Albert Einstein College of Medicine, Bronx, New York, and colleagues from the Diabetes Prevention Program Research Group. "The objectives were to determine associations between alcohol consumption and diabetes risk factors and whether alcohol consumption was a predictor of incident diabetes in individuals enrolled in the Diabetes Prevention Program (DPP)."
“适量饮酒对一般人群来说可降低发生II型糖尿病的风险，但对那些糖尿病高危人群来说，饮酒的作用究竟如何我们还知之甚少。”来自阿尔伯特爱因斯坦医学院，糖尿病预防计划研究小组的Jill P. Crandall博士在文章中指出， 研究的目的是确定饮酒和糖尿病的风险因素之间的联系，以及对糖尿病预防计划（DPP）参与者们来说饮酒是否是发生糖尿病的一个预测因素。
The study cohort in the Diabetes Prevention Program consisted of 3175 participants with impaired glucose tolerance (2-hour glucose: 7.8 - 11.1 mmol/L), elevated fasting glucose (5.3 - 7.0 mmol/L), and a body mass index of 24 kg/m2 or greater. Participants were randomly assigned to receive placebo, metformin, or lifestyle modification. With use of a semiquantitative food-frequency questionnaire, alcohol intake was evaluated at baseline and at 1 year. During follow-up (mean duration, 3.2 years), incident diabetes was diagnosed by annual oral-glucose-tolerance testing and semiannual fasting plasma glucose measurement.
该项研究共包括3175例患者（糖耐量受损（2小时血糖7.8 - 11.1 mmol/L）和空腹血糖升高（5.3 - 7.0 mmol / L），体重指数在24 kg/m2以上），随机分为三组：安慰剂组，二甲双胍治疗组以及生活方式改善组。在研究伊始和1年后采用半定量食物频率问卷调查法评估饮酒量。随访期间（平均为3.2年），根据年口服葡萄糖耐受测试和半年度空腹血糖测量进行糖尿病的诊断。
Self-reported alcohol consumption tended to be higher in participants who were men, older, white, and less obese, with higher energy intake and a higher high-density lipoprotein cholesterol concentration. At any level of insulin sensitivity, higher consumption of alcohol was associated with lower insulin secretion. In the metformin and lifestyle modification groups, higher alcohol consumption was associated with lower incidence rates of diabetes (P < .01 and P = .02 for trend, respectively). These associations remained significant after adjustment for multiple baseline covariates but were not observed in the placebo group.
参与研究者中，男性，较年长，白色人种，较瘦，较高能量摄取和有较高水平的高密度脂蛋白的人自报的饮酒量往往偏高一些。而无论胰岛素敏感程度如何，较高的饮酒量都与较低水平的胰岛素分泌有相关。而在二甲双胍治疗组和生活方式改善组观察到较高的酒精摄入量与糖尿病低发病率有相关（两组P值分别为P < .01 ，P= .02）。在进行了多因素调整后，以上两组中这种相关性仍然显著存在，但在安慰剂组则没有观察到有相关。
"Despite overall low rates of alcohol consumption, there was a reduced risk of incident diabetes in those who reported modest daily alcohol intake and were assigned to metformin or lifestyle modification," the study authors write. "Moderate daily alcohol intake is associated with lower insulin secretion — an effect that warrants further investigation."
尽管总体饮酒率低，但那些报告每日有适量饮酒的二甲双胍组或生活方式组的患者患糖尿病风险更低，作者写道，每天适度的饮酒与较低水平的胰岛素分泌之间的联系还需要进一步的研究。
Limitations of this study include baseline differences in diabetes risk factors among the alcohol consumption categories, possible unmeasured confounders, reliance on self-report to assess alcohol consumption, overall low alcohol consumption, and limited generalizability.
这项研究也存局限性，如在饮用酒种类，不可测量的混淆变相，依赖自我报告评估饮酒量，整体饮用量低和概化程度有限等风险因素相关的基线差异。
"The potential benefits of alcohol use in preventing diabetes may be limited to those who are actively pursuing other therapies to reduce risk," the study authors conclude. "Moderate alcohol intake was associated with decreased insulin secretion, independent of insulin sensitivity. The effect of chronic alcohol consumption on glucose metabolism, especially b cell function, warrants further investigation."
对积极寻求其他疗法降低患病风险的人来说，饮酒在预防糖尿病方面潜在的益处可能是有限的，作者总结说，适度饮酒是胰岛素敏感之外减少胰岛素分泌的一个独立因素。长期的适量饮酒对糖代谢的影响，特别是B细胞功能，还需要深入研究。
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