广州地区中老年男性血红蛋白和红细胞压积在饮酒与血压间的中介效应

Mediating effect of hemoglobin and hematocrit on the association between alcohol consumption and blood pressure among middle-aged and elderly male residents in Guangzhou

目的 探讨血红蛋白（Hb）和红细胞压积（HCT）在饮酒与血压间的中介效应.方法本研究为横断面调查.基于广州生物库队列研究（GBCS）平台的基线资料,选取经常饮酒的男性1091人,年龄（64.2±6.9）岁.采用中介效应分析方法分析Hb和HCT在饮酒（单位/d）与收缩压、舒张压、脉压差和平均动脉压间的中介效应.结果调整年龄、体重指数、文化程度、个人年收入、吸烟、职业、体力活动后,中介效应分析结果显示,Hb在饮酒对收缩压、舒张压、脉压差和平均动脉压的影响中具有部分中介效应,中介效应占其总效应的比例分别是11.8％（95％CI 4.8％～24.7％）、15.3％（95％CI 6.5％～32.0％）、8.4％（95％CI 2.2％～22.5％）和13.5％（95％CI 5.9％～27.2％）;HCT在饮酒对收缩压、舒张压、平均动脉压的影响中也具有部分中介效应,中介效应占其总效应的比例分别是6.3％（95％CI 1.0％～16.0％）、8.7％（95％CI 1.4％～21.4％）和7.5％（1.0％～18.6％）.结论Hb和HCT在饮酒对血压的影响中均具有部分中介效应,在酒精相关高血压的监测及预防中,除了考虑酒精本身的影响外,还需适当考虑饮酒致Hb、HCT升高及随之而来的高血压效应.

Objective To explore the mediating effect of hemoglobin （Hb） and hematocrit （HCT） on the association between alcohol consumption and blood pressure, and provide evidence for the prevention and control of alcohol-attributed hypertension. Methods 1091 male （age〉50 years old） participants with drinking habit were selected from the Guangzhou biobank cohort study （GBCS）. Mediation analysis was used to evaluate the mediating effect of Hb and HCT on the association of alcohol consumption （unit/day） with systolic blood pressure （SBP）, diastolic blood pressure（DBP）, pulse pressure（PP） and mean arterial pressure （MAP）. Results After adjusting for age, body mass index, education level, personal annual income, smoking, occupation and physical activity, the associations of alcohol consumption with SBP, DBP, PP and MAP were partly mediated by Hb, the proportion of mediating effect was 11.8％ （95％CI 4.8％-24.7％）, 15.3％（95％CI 6.5％-32.0％）, 8.4％（95％CI 2.2％-22.5％） and 13.5％（95％CI 5.9％-27.5％）, respectively. The associations of alcohol consumption with SBP, DBP, and MAP were also partly mediated by HCT, the proportion of mediating effect was 6.3％ （95％CI 1.0％-16.0％）, 8.7％ （95％CI 1.4％-21.4％）, and 7.5％（95％CI 1.0％-18.6％）, respectively. Conclusion There is a significant mediating effect of Hb and HCT on the association between alcohol consumption and blood pressure. Besides efforts on alcohol control, the potential effects of alcohol-induced increase on Hb and HCT, which might also increase the blood pressure, need to be considered to achieve optimal monitoring and prevention of alcohol-related hypertension.