-
摘要:
目的 定量估计2018年山东省居民酒精摄入与归因死亡数的关系,为制定饮酒防控策略提供依据。 方法 利用2018年山东省死因登记系统数据和2018年中国成人慢性病及其危险因素调查获得山东省人群死亡和日均饮酒量数据,基于2019年全球疾病负担研究(GBD2019)获得饮酒与相关疾病死亡的相对危险度(RR值),通过比较风险评估理论定量估计2018年山东省居民归因于酒精摄入的人群归因分值(PAF)及死亡数。 结果 2018年山东省居民死亡中可归因于酒精摄入的百分比为2.80%,男性为4.93%,女性为0.02%。 2018年山东省19 399例可能由于饮酒死亡,男性归因死亡人数(19 349例)高于女性(50例)。 饮酒造成死亡最多的疾病为脑出血、高血压性心脏病、缺血性卒中,分别为7 073例、3 114例、2 983例,PAF分别为6.73%、6.98%、2.41%。 酒精摄入归因死亡分值最大的疾病为其他咽癌(34.41%),其次为鼻咽癌(26.40%)、口腔癌(25.67%)。 饮酒共造成伤害类死亡2 180例,其中道路伤害死亡1 109例,自杀及后遗症521例,意外伤害535例。 结论 酒精摄入对山东省居民死亡造成了较大影响,建议开展控制饮酒的相关应对措施以减少酒精摄入造成的死亡。 Abstract:Objective To quantitatively evaluate the relationship between alcohol use and itsattributable deaths in residents in Shandong province in 2018 and provide data for the development of the strategies to control harmful drinking. Methods We collected the death data from the cause of death registration system in Shandong in 2018 and obtained alcohol consumption data in Shandong from Chinese Chronic Disease and Risk Factors Surveillance in 2018. Based on these data, we estimated the population attributable fraction (PAF) and the number of deaths due to alcohol consumption in 2018 by comparative risk assessment theory using relative risks (RRs) from 2019 Global Burden of Disease (GBD2019). Results In 2018, the percentage of deaths attributed to alcohol use was 2.80%. In men the PAF was 4.93% and in women the PAF was 0.02%. The number of deaths caused by alcohol use was 19 399, including 19 349 deaths in men and 50 deaths in women. The leading causes of alcohol-related deaths were hemorrhagic stroke, hypertensive heart disease, and ischemic stroke, causing 7 073, 3 114 and 2 983 deaths respectively. The PAFs were 6.73%, 6.98% and 2.41% respectively. Other pharyngeal cancers (34.41%) had the highest score of death attributed to alcohol use, followed by nasopharynx cancer (26.40%) and oral cavity cancer (25.67%). Alcohol use caused 2 180 injury deaths, including 1 109 traffic accident deaths, 521 suicide deaths, and 535 unintentional injury deaths. Conclusion Alcohol use has a significant impact on the mortality of residents in Shandong. It is suggested to take effective measures to control alcohol use in order to reduce the mortality caused by alcohol use. -
Key words:
- Alcohol use /
- Population attributable fraction /
- Attributable death
-
表 1 不同饮酒等级造成相关疾病的相对危险度
Table 1. Relative risks of related diseases caused by drinking at different levels
病种 饮酒量(g/d) 0~ 12~ 24~ 36~ 48~ 60~ 72~ 暴力 1.000 1.129 1.256 1.345 1.396 1.452 1.516 鼻咽癌 1.000 1.371 1.839 2.385 3.062 3.803 4.545 道路伤害 1.000 1.163 1.220 1.288 1.366 1.456 1.552 癫痫症 1.000 1.177 1.353 1.585 1.872 2.186 2.480 房颤和颤振 1.000 1.066 1.131 1.214 1.312 1.411 1.535 高血压性心脏病 1.000 1.046 1.315 1.479 1.614 1.705 1.860 喉癌 1.000 1.120 1.304 1.531 1.813 2.144 2.461 结核病 1.000 1.101 1.531 2.058 2.535 2.994 3.507 结直肠癌 1.000 1.078 1.156 1.237 1.323 1.468 1.616 酒精肝硬化 1.000 1.243 2.055 3.274 4.673 6.274 9.427 酒精性肝癌 1.000 1.067 1.140 1.225 1.310 1.372 1.424 口腔癌 1.000 1.293 1.738 2.311 2.991 3.766 4.858 脑出血(男性) 1.000 1.068 1.162 1.31 1.458 1.705 1.971 脑出血(女性) 1.000 1.031 1.110 1.337 1.614 1.964 2.276 其他咽癌 1.000 1.472 1.943 2.519 3.199 3.972 4.764 缺血性脑卒中(男性) 1.000 0.938 0.970 1.057 1.159 1.312 1.451 缺血性脑卒中(女性) 1.000 0.824 0.850 0.985 1.145 1.300 1.430 缺血性心脏病(男性) 1.000 0.865 0.857 0.871 0.906 0.993 1.091 缺血性心脏病(女性) 1.000 0.823 0.846 0.882 0.932 1.012 1.107 乳腺癌 1.000 1.170 1.329 1.433 1.443 1.452 1.476 食道癌 1.000 1.212 1.466 1.815 2.202 2.452 2.669 糖尿病 1.000 0.921 0.932 1.000 1.084 1.165 1.198 下呼吸道感染 1.000 1.013 1.026 1.064 1.127 1.226 1.357 胰腺炎 1.000 1.073 1.228 1.471 1.717 2.217 3.298 意外伤害 1.000 1.090 1.154 1.168 1.182 1.221 1.266 自杀及后遗症 1.000 1.107 1.230 1.376 1.545 1.734 1.927 注:数据来源于GBD2019;其他咽癌(国际疾病分类:C09~C10.9, C12~C13.9) 表 2 2018年山东省各年龄组调查对象饮酒量分布
Table 2. Distribution of drinking levels in residents in Shandong, 2018
年龄组
(岁)性别 饮酒量(g/d) 总计 0~ 12~ 24~ 36~ 48~ 60~ 72~ 18~ 男性 412(82.07) 46(9.16) 14(2.79) 8(1.59) 9(1.79) 6(1.21) 7(1.39) 502 女性 503(100.00) 0(0.00) 0(0.00) 0(0.00) 0(0.00) 0(0.00) 0(0.00) 503 30~ 男性 775(71.49) 89(8.21) 68(6.27) 38(3.51) 16(1.48) 27(2.49) 71(6.55) 1 084 女性 1 248(99.68) 3(0.24) 0(0.00) 0(0.00) 0(0.00) 1(0.08) 0(0.00) 1 252 45~ 男性 769(57.26) 142(10.57) 84(6.25) 88(6.55) 35(2.61) 44(3.28) 181(13.48) 1 343 女性 1 522(99.02) 9(0.59) 2(0.13) 2(0.13) 0(0.00) 0(0.00) 2(0.13) 1 537 60~ 男性 694(62.13) 86(7.70) 64(5.73) 77(6.89) 17(1.52) 50(4.48) 129(11.55) 1 117 女性 1 110(98.58) 12(1.06) 1(0.09) 1(0.09) 0(0.00) 1(0.09) 1(0.09) 1 126 合计 男性 2 650(65.50) 363(8.97) 230(5.68) 211(5.22) 77(1.90) 127(3.14) 388(9.59) 4 046 女性 4 383(99.21) 24(0.53) 3(0.07) 3(0.07) 0(0.00) 2(0.05) 3(0.07) 4 418 7 033(83.09) 387(4.57) 233(2.75) 214(2.53) 77(0.92) 129(1.52) 391(4.62) 8 464 注:括号内数据为构成比(%),括号外数据为人数 表 3 2018年山东省居民饮酒相关疾病结局归因分值及归因死亡数
Table 3. Population attributable fraction and number of deaths attributed to alcohol use, 2018
疾病 人群归因分值(%) 归因死亡数(人) 男性 女性 合计 男性 女性 合计 全死因 4.93 0.02 2.80 19 349 50 19 399 其他咽癌 39.74 0.86 34.41 139 0 139 鼻咽癌 37.87 0.77 26.40 159 1 160 口腔癌 38.32 0.72 25.67 152 1 153 结核病 29.51 0.46 22.33 179 1 180 食道癌 23.69 0.41 18.13 2 685 15 2 700 喉癌 19.56 0.29 17.03 173 0 173 胰腺炎 23.82 0.29 14.51 83 1 84 癫痫症 20.49 0.34 12.54 74 1 75 暴力 10.13 0.18 9.93 15 0 15 自杀及后遗症 13.92 0.21 7.89 515 6 521 道路伤害 10.25 0.19 7.45 1 101 8 1 109 高血压性心脏病 13.77 0.19 6.98 3 072 42 3 114 脑出血 13.27 0.19 6.73 6 975 98 7 073 结直肠癌 9.61 0.14 5.78 621 6 627 酒精性肝癌 7.60 0.12 5.53 1 470 9 1 479 房颤和颤振 8.52 0.12 4.55 8 0 8 意外伤害 5.68 0.11 3.97 531 4 535 下呼吸道感染 4.70 0.05 2.52 44 0 44 缺血性脑卒中 4.89 −0.07 2.41 3 026 −43 2 983 糖尿病 1.47 −0.17 0.57 56 −8 48 乳腺癌 10.84 0.21 0.48 14 10 24 酒精肝硬化 55.09 1.18 3.80 0 0 0 缺血性心脏病 −1.95 −0.12 −1.04 −1 743 −102 −1 845 -
[1] Griswold MG, Fullman N, Hawley C, et al. Alcohol use and burden for 195 countries and territories, 1990−2016: a systematic analysis for the Global Burden of Disease Study 2016[J]. Lancet, 2018, 392(10152): 1015–1035. DOI: 10.1016/S0140−6736(18)31310−2. [2] Murray CJL, Aravkin AY, Zheng P, et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396(10258): 1223–1249. DOI: 10.1016/S0140−6736(20)30752−2. [3] 姜莹莹, 刘世炜, 吉宁, 等. 中国居民2013年酒精归因死亡及对期望寿命影响的分析[J]. 中华流行病学杂志,2018,39(1):27–31. DOI:10.3760/cma.j.issn.0254−6450.2018.01.005.Jiang YY, Liu SW, Ji N, et al. Deaths attributable to alcohol use and its impact on life expectancy in China, 2013[J]. Chin J Epidemiol, 2018, 39(1): 27–31. DOI: 10.3760/cma.j.issn.0254−6450.2018.01.005. [4] World Health Organization. Global status report on alcohol and health 2018[R]. Geneva: World Health Organization, 2018. [5] Manthey J, Shield KD, Rylett M, et al. Global alcohol exposure between 1990 and 2017 and forecasts until 2030: a modelling study[J]. Lancet, 2019, 393(10190): 2493–2502. DOI: 10.1016/S0140−6736(18)32744−2. [6] 张高辉, 鹿子龙, 郭晓雷, 等. 2013年山东省18岁及以上居民饮酒现状调查分析[J]. 中华预防医学杂志,2017,51(5):450–452. DOI:10.3760/cma.j.issn.0253−9624.2017.05.016.Zhang GH, Lu ZL, Guo XL, et al. Cross-sectional survey on drinking among residents aged 18 and older in Shandong province during 2013[J]. Chin J Prev Med, 2017, 51(5): 450–452. DOI: 10.3760/cma.j.issn.0253−9624.2017.05.016. [7] Murray CJ, Ezzati M, Lopez AD, et al. Comparative quantification of health risks: conceptual framework and methodological issues[J]. Popul Health Metrics, 2003, 1(1): 1. DOI: 10.1186/1478−7954−1−1. [8] 北京协和医院世界卫生组织国际分类家族合作中心, 董景五. 疾病和有关健康问题的国际统计分类: 第十次修订本[M]. 3版. 北京: 人民卫生出版社, 2008.Dong JW. International statistical classification of diseasesand related health problems: the tenth revision[M]. 3rd ed. Beijing: People's Medical Publishing House, 2008. [9] Biddinger KJ, Emdin CA, Haas ME, et al. Association of habitual alcohol intake with risk of cardiovascular disease[J]. JAMA Netw Open, 2022, 5(3): e223849. DOI: 10.1001/jamanetworkopen.2022.3849. [10] Mostofsky E, Chahal HS, Mukamal KJ, et al. Alcohol and immediate risk of cardiovascular events: A systematic review and dose-response meta-analysis[J]. Circulation, 2016, 133(10): 979–987. DOI: 10.1161/CIRCULATIONAHA.115.019743. [11] Polsky S, Akturk HK. Alcohol consumption, diabetes risk, and cardiovascular disease within diabetes[J]. Curr Diab Rep, 2017, 17(12): 136. DOI: 10.1007/s11892−017−0950−8. [12] 施倩雯, 戴宁彬, 盛红艳, 等. 饮酒频率与心血管病高危风险的关联分析[J]. 中国慢性病预防与控制,2019,27(3):171–175. DOI:10.16386/j.cjpccd.issn.1004−6194.2019.03.003.Shi QW, Dai NB, Sheng HY, et al. Correlation between drinking frequency and the high-risk of cardiovascular disease[J]. Chin J Prev Control Chron Dis, 2019, 27(3): 171–175. DOI: 10.16386/j.cjpccd.issn.1004−6194.2019.03.003. [13] Millwood IY, Walters RG, Mei XW, et al. Conventional and genetic evidence on alcohol and vascular disease aetiology: a prospective study of 500 000 men and women in China[J]. Lancet, 2019, 393(10183): 1831–1842. DOI: 10.1016/S0140−6736(18)31772−0. [14] Akinyemiju T, Abera S, Ahmed M, et al. The burden of primary liver cancer and underlying etiologies from 1990 to 2015 at the global, regional, and national level: Results from the global burden of disease study 2015[J]. JAMA Oncol, 2017, 3(12): 1683–1691. DOI: 10.1001/jamaoncol.2017.3055. [15] 付振涛, 王洪涛, 鹿子龙, 等. 山东省1970-2013年肝癌死亡率空间聚集性分析及其变化趋势[J]. 中华流行病学杂志,2020,41(11):1865–1870. DOI:10.3760/cma.j.cn112338−20200604−00807.Fu ZT, Wang HT, Lu ZL, et al. Spatial clustering analysis and trend of liver cancer death rate in Shandong province, 1970−2013[J]. Chin J Epidemiol, 2020, 41(11): 1865–1870. DOI: 10.3760/cma.j.cn112338−20200604−00807. [16] 王黎君, 殷鹏, 刘韫宁, 等. 1990年与2013年中国人群肝癌疾病负担研究[J]. 中华流行病学杂志,2016,37(6):758–762. DOI:10.3760/cma.j.issn.0254−6450.2016.06.003.Wang LJ, Yin P, Liu YN, et al. Disease burden of liver cancer in the Chinese population, in 1990 and 2013[J]. Chin J Epidemiol, 2016, 37(6): 758–762. DOI: 10.3760/cma.j.issn.0254−6450.2016.06.003. [17] 戚文威. 中国人群饮酒与代谢综合征发病关系的前瞻性研究[D]. 北京: 北京协和医学院, 2012.Qi WW. Alcohol consumption and the incidence of metabolic syndrome in Chinese cohort study[D]. Beijing: Peking Union Medical College, 2012. [18] 王增武, 范国辉, 张林峰, 等. 北方农村地区男性代谢综合征与饮酒关系研究[J]. 中华疾病控制杂志,2015,19(4):348–351. DOI: 10.16462/j.cnki.zhjbkz.2015.04.008.Wang ZW, Fan GH, Zhang LF, et al. Association study between metabolic syndrome and alcohol consumption among rural male residents in northern China[J]. Chin J Dis Control Prev, 2015, 19(4): 348–351. DOI: 10.16462/j.cnki.zhjbkz.2015.04.008. [19] 胡彩红, 张梅, 李纯, 等. 我国成年居民饮酒行为与血脂异常关系研究[J]. 疾病监测,2020,35(8):697–705. DOI:10.3784/j.issn.1003−9961.2020.08.007.Hu CH, Zhang M, Li C, et al. Relationship between drinking behavior and dyslipidemia in adults in China[J]. Dis Surveill, 2020, 35(8): 697–705. DOI: 10.3784/j.issn.1003−9961.2020.08.007. [20] Rehm J, Gmel GE Sr, Gmel G, et al. The relationship between different dimensions of alcohol use and the burden of disease—an update[J]. Addiction, 2017, 112(6): 968–1001. DOI: 10.1111/add.13757. [21] Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis[J]. Br J Cancer, 2015, 112(3): 580–593. DOI: 10.1038/bjc.2014.579. [22] 崔芳芳. 湖北省主要危险因素归因疾病负担研究[D]. 武汉: 武汉大学, 2017.Cui FF. Research on the disease burden attributable to main risk factors in Hubei province, China[D]. Wuhan: Wuhan University, 2017. [23] 徐爱强, 孙建东, 鹿子龙, 等. 山东省主要危险因素的归因死亡和疾病负担分析[J]. 中华流行病学杂志,2008,29(10):959–964. DOI:10.3321/j.issn:0254−6450.2008.10.002.Xu AQ, Sun JD, Lu ZL, et al. Estimation on the mortality and disease burden attributed to selected risk factors in Shandong province[J]. Chin J Epidemiol, 2008, 29(10): 959–964. DOI: 10.3321/j.issn:0254−6450.2008.10.002. -

计量
- 文章访问数: 213
- HTML全文浏览量: 73
- PDF下载量: 19
- 被引次数: 0