这项分析中，研究者构建了22种健康结局的负担加权剂量反应相对风险曲线，以估计不同地区、年龄和性别饮酒的理论最小风险暴露水平（TMREL，即整体人群的健康损失降至最低水平的饮酒量），以及非饮酒者等效水平（NDE，饮酒者健康损失风险等同于非饮酒者的饮酒量）。

不同年龄人群饮酒的TMREL和NDE有明显差异，年轻人的TMREL和NDE水平明显低于年龄更大的人：2020年，在15-39岁的人中，TMREL范围为0-0.603杯/天；≥40岁的人中，TMREL范围为0.114-1.87杯/天。15-39岁的人中，NDE范围为0.002-1.75杯/天；≥40岁的人中，NDE范围为0.193-6.94杯/天。

本研究结果支持基于年龄来作出不同的饮酒建议。鉴于TMREL和NDE没有性别差异，无需针对性别作出各自的饮酒推荐。超量饮酒人群主要为青壮年，且主要为年轻男性，为了最大限度地减少饮酒造成的健康损失，必须优先考虑针对这类人群的干预措施。

Background

The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year.

Methods

For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol.

Findings

The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male.

Interpretation

There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol.

文章连接：

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00847-9/fulltext

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