与戒酒有因有关论文参考文献

生活中或多或少我们都会喝点酒，特别是“久旱遇甘露”“他乡遇故知”“洞房花烛夜”“金榜题名时”，这种喜庆的日子里，少了酒，总感觉就少了那么点喜庆的味道。这就是中国历经千年的“酒文化”！

现代医学研究下，喝酒被越来越多的人认为是“百害而不一利”的事情，喝酒不但损伤肝脏，导致酒精性肝损害，甚至出现酒精中毒现象；还会对血管有慢性的损伤，导致动脉粥样硬化，心脑血管方面的风险加重，高血压、高血脂的风险加重。

这样看来喝酒确实是危害太大了。口说无凭，让我们一起看一下现实世界关于酒的研究。

国内外关于饮酒的研究

1. 张秋依等人通过对江苏省常熟市的10246名2型糖尿病患者展开2年的横断面研究，研究发现饮酒不仅是发生糖尿病的危险因素，饮酒的2型糖尿病患者空腹血糖水平较高，血糖控制效果较差，而血糖控制水平是影响糖尿病患者预后的主要因素。而戒酒可以改善2型糖尿病患者的血糖控制， 进一步减少糖尿病并发症的发生。

2. 岳峰在研究中发现无论饮酒剂量大小，与不饮酒者相比，饮酒者的胰岛β细胞功能均减退；与少量饮酒相比，不仅大量饮酒， 适量饮酒也会显著升高空腹血糖。

从这两个研究上看，饮酒可以造成胰岛β细胞功能，还会显著提高空腹血糖，影响糖尿病患者的预后，对2型糖尿病患者影响不良。

3. 根据2018年版的《Lifestyle Management：Standards of Medical Care in Diabetes》（类似于中国的糖尿病指南）显示：适量饮酒对长期血糖控制没有明显的不利影响，与饮酒有关的风险包括低血糖(尤其是那些使用了胰岛素或胰岛素促分泌治疗的人)、体重增加和高血糖(那些酗酒，喝了太多的人)，糖尿病患者如果选择饮酒，可以遵循与非糖尿病患者相同的指导方针。女性每天不超过一杯，男性每天不超过两杯(一杯相当于12盎司啤酒、5盎司葡萄酒或1.5盎司乙醇)。

从国内外的研究来看：对2型糖尿病患者的作用更多是损害性的，不利于血糖的控制。

结合目前国内外对于饮酒与糖尿病之间的关联性的研究，我们发现很多研究认为饮酒对2型糖尿病无益处，会导致控制血糖能力下降，空腹血糖水平升高。

因此，不推荐2型糖尿病患者去饮酒，以免糖代谢水平进一步下降，如果饮酒的话，请按照2017年版《中国2型糖尿病防治指南》的建议：

1. 不推荐糖尿病患者饮酒，若饮酒需计算酒精中含有的总能量；

2. 女性每天饮酒的酒精量不超过15克，男性不超过25克（15克酒精相当于350毫升啤酒、150毫升葡萄酒或45毫升蒸馏酒），且每周不超过2次。

3. 应警惕酒精可能诱发的低血糖，避免空腹饮酒。

参考文献：

[1]朱亚莉,李社莉.饮酒与糖尿病相关性的研究进展[J].广西医学,2018,40(15):1729-1731.

[2]张秋伊,盛红艳,顾淑君.饮酒与2型糖尿病患者血糖控制之间的关系[J].中国慢性病预防与控制,2017,25(12):905-907.

[3]岳峰.乙醇摄入与男性胰岛功能的相关性研究[D].济南:山东大学博士论文集, 2012:1-56.

[4]Avogaro A, Watanabe RM, Gottardo L, et al.Glucose tolerance during moderate alcohol intake:insights on insulin action from glucose/lactate dynamics[J].J Clin Endocrinol Metab, 2002, 87 (3):1233-1238.

[5]Bell RA, Mayer-Davis EJ, Martin MA, et al.Associations between alcohol consumption and insulin sensitivity and cardiovascular disease risk factors:the Insulin Resistance and Atherosclerosis Study[J].Diabetes care, 2000, 23 (11) :1630-1636.

[6]Joosten MM, Chiuve SE, Mukamal KJ, et al.Changes in alcohol consumption and subsequent risk of type 2 diabetes in men[J].Diabetes, 2011, 60 (1) :74-79.

作者：Belly zheng

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