A Prospective Study of Alcohol Consumption and Smoking and the Risk of Major Gastrointestinal Bleeding in Men

Background and AimsData regarding smoking and alcohol consumption and risk of gastrointestinal bleeding (GIB) are sparse and conflicting. We assessed the risk of major GIB associated with smoking and alcohol consumption in a large, prospective cohort.MethodsWe prospectively studied 48,000 men in the Health Professional follow-up Study (HPFS) who were aged 40–75 years at baseline in 1986. We identified men with major GIB requiring hospitalization and/or blood transfusion via biennial questionnaires and chart review.ResultsWe documented 305 episodes of major GIB during 26 years of follow-up. Men who consumed >30 g/day of alcohol had a multivariable relative risk (RR) of 1.43 (95% confidence interval (CI), 0.88–2.35; P for trend 0.006) for major GIB when compared with nondrinkers. Alcohol consumption appeared to be primarily related to upper GIB (multivariable RR for >30 g/day vs. nondrinkers was 1.35; 95% CI, 0.66–2.77; P for trend 0.02). Men who consumed ≥ 5 drinks/week vs. P for trend ConclusionsAlcohol consumption, but not smoking, was associated with an increased risk of major GIB. Associations were most notable for upper GIB associated with liquor intake. Alcohol appeared to potentiate the risk of NSAID-associated GIB.

研究背景与目的 目前关于吸烟、饮酒与胃肠道出血（GIB）风险相关性的数据较为匮乏且结论相悖。本研究依托一项大型前瞻性队列，评估吸烟与饮酒相关的重度胃肠道出血风险。
研究方法 本研究纳入1986年基线时年龄为40~75岁的健康专业人员随访研究（HPFS）中的48000名男性，通过两年一次的问卷随访与病历审查，识别出需要住院和/或输血的重度胃肠道出血病例。
研究结果 在26年的随访期间，共记录到305例重度胃肠道出血事件。与不饮酒者相比，每日饮酒量＞30g的男性发生重度胃肠道出血的多变量相对危险度（RR）为1.43（95%置信区间（CI）：0.88~2.35；趋势检验P=0.006）。饮酒主要与上消化道出血相关：每日饮酒量＞30g者的多变量相对危险度为1.35（95%CI：0.66~2.77；趋势检验P=0.02）。与每周饮酒≥5杯者相比，（原文此处表述不完整）趋势检验P值。
研究结论 饮酒而非吸烟与重度胃肠道出血风险升高相关，该关联在烈性酒摄入相关的上消化道出血中最为显著。酒精可增强非甾体抗炎药（NSAID）相关胃肠道出血的风险。