近年来，人们在了解饮酒对不良健康结果的影响方面取得了重大进展。然而，证据的质量仍然有限。我们的目标是进行一项前瞻性研究，探讨不同类型的酒精饮料与全因死亡率、心血管疾病 (CVD) 和慢性肾病 (CKD) 风险之间的关系，并确定按性别分层的安全剂量阈值使用英国生物银行的数据。共有 502,490 名参与者报名。这些参与者在2006年至2010年期间进行了初步登记，并在2012年至2013年期间进行了重新评估。所有参与者都完成了一份关于其饮酒量的详细调查问卷，包括昨天的总饮酒量、每周的红酒、香槟加白酒、啤酒、烈酒消费量、和加强酒。全因死亡率以及 CVD 和 CKD 的发生率被视为主要结局。 2852 名参与者在中位随访期间 11.94 年报告了 CKD，而 79,958 名参与者在中位随访期间 11.35 年报告了 CVD。此外，在中位随访期 11.89 年中，有 18,923 名参与者死亡。在调整了年龄、性别、教育水平、吸烟状况、饮食评分和运动评分等变量后，总饮酒量与心血管疾病风险和全因死亡率呈 U 形关系，但与CKD 的风险。对酒精饮料进一步分类后，我们的分析显示，红酒、香槟加白葡萄酒、啤酒、烈酒和强化酒与全因死亡率和慢性肾病的风险呈 U 形关系。然而，烈酒与CVD风险呈正相关，只有红酒、香槟加白葡萄酒、啤酒和加强型葡萄酒与CVD风险呈U形关系。饮酒总量的安全剂量应为男性 < 11 克/天，女性 < 10克/天，红酒摄入量男性应为 < 7杯/周，女性 < 6杯/周，香槟加白葡萄酒摄入量应为 < 5杯每周，强化葡萄酒的消费量应为 < 4 杯/周。在我们的分析中，低于相应安全剂量阈值的红酒、香槟加白葡萄酒、啤酒和强化葡萄酒与全因死亡率、CVD 和 CKD 风险降低显着相关。这些安全剂量的酒精饮料对糖尿病、抑郁症、痴呆、癫痫、肝硬化和其他消化系统疾病等疾病具有保护作用，同时不会增加患癌症的风险。版权所有 © 2024 作者。由 Wolters Kluwer Health, Inc. 出版

In recent years, significant progress has been achieved in comprehending the impact of alcohol consumption on adverse health outcomes. However, the quality of evidence remains limited. Our objective was to conduct a prospective study examining the relationship between different types of alcoholic beverages and the risk of all-cause mortality, cardiovascular disease (CVD), and chronic kidney disease (CKD), and identifying the thresholds of safe dose stratified by sex using data from the UK Biobank. 502,490 participants were enrolled. These participants were initially registered between 2006 and 2010, and underwent reassessment between 2012 and 2013. All participants completed a detailed questionnaire on their alcohol consumption, including total alcohol consumption yesterday, weekly consumption of red wine, champagne plus white wine, beer, spirits, and fortified wine. All-cause mortality and the incidence of CVD and CKD were considered as the primary outcomes. 2852 participants reported CKD during a median follow-up period of 11.94 years, while 79,958 participants reported CVD over a median follow-up period of 11.35 years. Additionally, 18,923 participants died over a median follow-up period of 11.89 years. After adjusting for variables such as age, sex, education level, smoking status, diet score, and exercise score, total alcohol consumption showed a U-shaped relationship with the risk of CVD and all-cause mortality, but showed an inverse association with the risk of CKD. Upon further classification of alcoholic beverages, our analysis revealed that red wine, champagne plus white wine, beer, spirits, and fortified wine presented a U-shaped relationship with the risk of all-cause mortality and CKD. However, spirits were positively associated with the risk of CVD, only red wine, champagne plus white wine, beer, and fortified wine showed a U-shaped relationship with the risk of CVD. The safe doses of total alcohol consumption should be < 11 g/d for males and < 10 for females, red wine consumption should be < 7 glasses/week for males and < 6 for females, champagne plus white wine consumption should be < 5 glasses/week, and fortified wine consumption should be < 4 glasses/week. Red wine, champagne plus white wine, beer, and fortified wine below the corresponding thresholds of safe dose in our analysis were significantly associated with a lower risk of all-cause mortality, CVD, and CKD. And these alcoholic beverages under safe doses exhibited a protective effect against conditions like diabetes, depression, dementia, epilepsy, liver cirrhosis, and other digestive diseases, while didn't increase the risk of cancer.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.