학술논문

Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data
Document Type
Academic Journal
Author
Holmes, Michael VDale, Caroline EZuccolo, LuisaSilverwood, Richard JGuo, YiranYe, ZhengPrieto-Merino, DavidDehghan, AbbasTrompet, StellaWong, AndrewCavadino, AlanaDrogan, DagmarPadmanabhan, SandoshLi, ShanshanYesupriya, AjayLeusink, MaartenSundstrom, JohanHubacek, Jaroslav APikhart, HynekSwerdlow, Daniel IPanayiotou, Andrie GBorinskaya, Svetlana AFinan, ChrisShah, SoniaKuchenbaecker, Karoline BShah, TinaEngmann, JorgenFolkersen, LasseEriksson, PerRicceri, FulvioMelander, OlleSacerdote, CarlottaGamble, Dale MRayaprolu, SrutiRoss, Owen AMcLachlan, StelaVikhireva, OlgaSluijs, IvonneScott, Robert AAdamkova, VeraFlicker, LeonBockxmeer, Frank M vanPower, ChristineMarques-Vidal, PedroMeade, TomMarmot, Michael GFerro, Jose MPaulos-Pinheiro, SofiaHumphries, Steve ETalmud, Philippa JLeach, Irene MateoVerweij, NiekLinneberg, AllanSkaaby, TeaDoevendans, Pieter ACramer, Maarten Jvan der Harst, PimKlungel, Olaf HDowling, Nicole FDominiczak, Anna FKumari, MeenaNicolaides, Andrew NWeikert, CorneliaBoeing, HeinerEbrahim, ShahGaunt, Tom RPrice, Jackie FLannfelt, LarsPeasey, AnneKubinova, RuzenaPajak, AndrzejMalyutina, SofiaVoevoda, Mikhail ITamosiunas, AbdonasMaitland-van der Zee, Anke HNorman, Paul EHankey, Graeme JBergmann, Manuela MHofman, AlbertFranco, Oscar HCooper, JackiePalmen, JuttaSpiering, Wilkode Jong, Pim AKuh, DianaHardy, RebeccaUitterlinden, Andre GIkram, Arfan MFord, IanHyppönen, ElinaAlmeida, Osvaldo PWareham, Nicholas JKhaw, Kay-TeeHamsten, AndersHusemoen, Lise Lotte NTjønneland, AnneTolstrup, Janne SRimm, EricBeulens, Joline W JVerschuren, Monique MWOnland-Moret, Charlotte NHofker, Marten HWannamethee, Goya SWhincup, Peter HMorris, RichardVicente, Astrid MWatkins, HughFarrall, MartinJukema, Wouter JMeschia, JamesCupples, Adrienne LSharp, Stephen JFornage, MyriamKooperberg, CharlesLaCroix, Andrea ZDai, James YLanktree, Matthew BSiscovick, David SJorgenson, EricSpring, BonnieCoresh, JosefLi, Yun RBuxbaum, Sarah GSchreiner, Pamela JEllison, Curtis RTsai, Michael YPatel, Sanjay RRedline, SusanJohnson, Andrew DHoogeveen, Ron CHakonarson, HakonRotter, Jerome IBoerwinkle, Ericde Bakker, Paul I WKivimaki, MikaAsselbergs, Folkert WSattar, NaveedLawlor, Debbie AWhittaker, JohnDavey Smith, GeorgeMukamal, KennethPsaty, Bruce MWilson, James GLange, Leslie AHamidovic, AjnaHingorani, Aroon DNordestgaard, Børge GBobak, MartinLeon, David ALangenberg, ClaudiaPalmer, Tom MReiner, Alex PKeating, Brendan JDudbridge, FrankCasas, Juan P
Source
BMJ. Jul 12, 2014 349:g4164-g4164
Subject
Language
English
ISSN
0959-8138
Abstract
OBJECTIVE: To use the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B) as an instrument to investigate the causal role of alcohol in cardiovascular disease. DESIGN: Mendelian randomisation meta-analysis of 56 epidemiological studies. PARTICIPANTS: 261 991 individuals of European descent, including 20 259 coronary heart disease cases and 10 164 stroke events. Data were available on ADH1B rs1229984 variant, alcohol phenotypes, and cardiovascular biomarkers. MAIN OUTCOME MEASURES: Odds ratio for coronary heart disease and stroke associated with the ADH1B variant in all individuals and by categories of alcohol consumption. RESULTS: Carriers of the A-allele of ADH1B rs1229984 consumed 17.2% fewer units of alcohol per week (95% confidence interval 15.6% to 18.9%), had a lower prevalence of binge drinking (odds ratio 0.78 (95% CI 0.73 to 0.84)), and had higher abstention (odds ratio 1.27 (1.21 to 1.34)) than non-carriers. Rs1229984 A-allele carriers had lower systolic blood pressure (-0.88 (-1.19 to -0.56) mm Hg), interleukin-6 levels (-5.2% (-7.8 to -2.4%)), waist circumference (-0.3 (-0.6 to -0.1) cm), and body mass index (-0.17 (-0.24 to -0.10) kg/m). Rs1229984 A-allele carriers had lower odds of coronary heart disease (odds ratio 0.90 (0.84 to 0.96)). The protective association of the ADH1B rs1229984 A-allele variant remained the same across all categories of alcohol consumption (P=0.83 for heterogeneity). Although no association of rs1229984 was identified with the combined subtypes of stroke, carriers of the A-allele had lower odds of ischaemic stroke (odds ratio 0.83 (0.72 to 0.95)). CONCLUSIONS: Individuals with a genetic variant associated with non-drinking and lower alcohol consumption had a more favourable cardiovascular profile and a reduced risk of coronary heart disease than those without the genetic variant. This suggests that reduction of alcohol consumption, even for light to moderate drinkers, is beneficial for cardiovascular health.