研究背景 飲用酒精所導致的健康與社會問題一直都是臨床醫學與公共衛生領域所關注的議題，有鑒於飲酒行為與心血管疾病(Cardiovascular Diseases-CVD)之間的關係是複雜且有具有爭議的，而抽菸、飲酒與嚼食檳榔是台灣文化的死角，所造成的社會問題繁多。在學術界與醫學界，已經對飲酒行為、酒精的攝取量與心血管疾病之間的關聯進行多次的系統性評價，越來越多的研究皆顯示適度飲酒對於心血管疾病具有一定的保護作用，而國內已完成的相關研究中，飲用酒精的探討大致仍偏向於飲酒盛行率的調查。
目的 本研究欲利用行政院衛生福利部國民健康署之國民營養健康狀況變遷調查(NAHSIT,Nutrition and Health Survey in Taiwan)，探討國人飲酒行為與心血管疾病代謝相關危險因子之風險，並分析不同的飲酒行為與心血管疾病代謝相關危險因子之關聯。
研究材料與方法 為了解國人的飲酒行為與心血管疾病代謝相關危險因子之關聯，本研究將使用行政院衛生福利部國民健康署之國民營養健康狀況變遷調查(NAHSIT)，進行橫斷式研究設計(Cross-sectional study design)，以邏輯式迴歸模型(Logistic regression model)分析不同飲酒行為的飲酒類別與其心血管疾病代謝相關危險因子的關係 ; 再以多變量迴歸模式調整影響飲酒行為與心血管疾病的相關干擾因子，並了解飲酒行為及其酒精攝取量與心血管疾病風險是否有劑量效應。
研究結果 本研究發現全樣本的男女分佈平均，被歸類至戒酒者的平均年齡為全樣本最高(64.6歲)，同時戒菸、戒檳榔與目前有抽菸和嚼食檳榔的比例亦較全樣本高出許多，且其三高藥物使用狀態與三高共病狀態相對較高，此族群可能為研究樣本中相對比較不健康的人群 ; 而隨著飲酒次數的增加，目前有抽菸與嚼食檳榔的比例也著增加，亦呼應研究背景所提及之抽菸、飲酒與嚼食檳榔為台灣社會文化上的死角。探討全樣本之不同飲酒類別與心血管疾病代謝相關危險因子風險部分，在調整所有社會人口學變項與健康相關變項後，絕大部分的數值皆未達到統計上顯著之差異，而高密度脂蛋白膽固醇(HDL-C)異常之戒酒者(OR=1.84)、目前重度飲酒者(OR=0.64)，有達到統計上顯著之意義，意即戒酒者相較於滴酒不沾者而言，有多出84%的高密度脂蛋白膽固醇(HDL-C)異常風險，以及目前重度飲酒者相較於滴酒不沾者則有少36%異常的風險。再進一步對不同飲酒類別與心血管疾病危險因子之風險進行性別與年齡的分層分析後發現，男性戒酒者的高密度脂蛋白膽固醇(HDL-C)異常(OR=2.29)、不常飲酒者(OR=1.46)、目前輕度(OR=1.52)、中度飲酒者(OR=1.67)的低密度脂蛋白膽固醇(LDL-C)異常和目前輕度(OR=1.53)、中度飲酒者(OR=2.12)的總膽固醇(TC)異常以及目前中度飲酒者的代謝症候群(MS)異常(OR=1.68)都有達到統計上顯著之差異 ; 女性戒酒者的收縮壓(SBP)異常(OR=2.12)、舒張壓(DBP)異常(OR=3.31)和目前輕度飲酒者的收縮壓(SBP)異常(OR=0.58)、高密度脂蛋白膽固醇(HDL-C)異常(OR=0.56)、代謝症候群(MS)異常(OR=0.45)以及目前重度飲酒者的高密度脂蛋白膽固醇(HDL-C)異常(OR=0.39)皆有達到統計上顯著之差異。年齡分層分析部分，45-64歲輕度飲酒者的低密度脂蛋白膽固醇(LDL-C)異常(OR=1.69)、總膽固醇(TC)異常(OR=1.87)、代謝症候群(MS)異常(OR=0.58)以及65歲以上重度飲酒者的高密度脂蛋白膽固醇(HDL-C)異常(OR=0.57)、總膽固醇(TC)異常(OR=1.56)，亦有達到統計上顯著之差異。
結論 本研究針對年齡30歲以上的族群，探討利用性別與年齡分層後不同飲酒行為與心血管疾病代謝相關危險因子之關係，研究結果顯示在目前輕度和中度飲酒的人群中，有些心血管疾病代謝相關危險因子確實有較低的異常風險，像是收縮壓(SBP)、高密度脂蛋白膽固醇(HDL-C)和代謝症候群(MS)，且達到統計上顯著之差異 ; 但在進行飲酒類別分類後，被分類至戒酒者的女性(n=10)與30-44歲的(n=7)樣本數不足，進而使得推論性統計之Odds Ratio數值較大、95%信賴區間較寬，此代表性之問題也導致對於研究結果的精確度可能稍嫌不足 ; 而酒精之於心血管系統的生理機轉確實能夠預防部分的心血管疾病、對於延緩老化也有一定程度的作用，但問題飲酒與較高風險的不當飲酒行為都會是導致死亡、失能和社會問題的主要原因之一，且因酒精使用所累積的傷害、疾病問題、心理健康等後端併發症以及衍生的醫療費用和收入損失，往往更為嚴重且複雜，更會對醫藥衛生領域產生相當大的負面影響。

The health and social problems caused by drinking behavior have always been a issue of concern in the fields of clinical medicine and public health. In Taiwan,the related studies have been completed, the discussion of alcohol drinking is still generally squint towards the survey of prevalence for drinking. The purpose to explore the risk of drinking behaviors and cardiometabolic risk factors in Taiwan and to analyze the association of drinking behavior with cardiometabolic risk factors for different drinking category. The research database was retrieved from Nutrition and Health Survey in Taiwan(NAHSIT) of Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan). Using logistic regression model to analyse the relationship between the categories of different drinking behaviors and their cardiometabolic risk factors, and then adjust the relevant confounding that affect drinking behaviors and cardiovascular disease with multiple logistic regression analysis.People were selected as the study subjects in age over 30. There were more people use the drugs of hypertension,hyperlipidemia and hyperglycemia, so these people may be a relatively unhealthy group in the study sample. With the increase in the number of alcohol consumption, the proportion of currently smoking and chewing betel nut has also increased, echoing that the smoking, drinking, and chewing betel nut mentioned in the research background are the blind spots in Taiwan's culture. The results show that among the current light drinker and moderate drinker, some cardiometabolic risk factors do have lower abnormal risks, such as systolic blood pressure(SBP), high-density lipoprotein cholesterol(HDL-C), and metabolic syndrome(MS),also significant differences exist on above.

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