35万人研究：空腹喝酒，胃癌、肝癌和直肠癌风险大增！

　　在全球范围内，胃肠道(GI)癌症约占新诊断癌症病例的27%，占癌症死亡的37%。有趣的是，在过去的几十年里，年龄在50岁或55岁以下的成年人中，几种胃肠道癌症(非贲门癌、胰腺癌和结直肠癌)的发病率呈上升趋势。

　　2023年11月15日，华盛顿大学曹崟团队在Gastroenterology 在线发表题为“Alcohol Drinking Without Meals Is Associated with Risk of Gastrointestinal Cancers, Including Early-Onset Cases”的研究论文，与吃饭喝酒相比，该研究发现喝酒不吃饭与整体胃肠道癌症和几种亚型(胃癌、肝癌和直肠癌)的更高风险相关，与早发癌症的相关性更强。这些发现为喝酒不吃饭对胃肠道癌症风险的影响提供了初步的见解，并强调了迫切需要了解最近几代人出现的饮酒模式对致癌的影响。

　　研究者们分析了来自英国生物库的347591名参与者的数据，44%的参与者在吃饭时喝酒，36%表示要看情况，20%选择空腹喝酒。在总计3636677人年的随访期间，发生了6813例胃肠道癌症事件。

　　调整其他变量和酒精摄入量之后，研究者发现，与随餐饮酒的人相比，空腹喝酒的人患胃肠道癌症的风险增加了10%。按照癌症亚型进一步分析，胃癌风险增加了56%，肝癌风险增加了42%，直肠癌风险增加了17%。

　　进一步分析还发现，空腹喝酒与早发性癌症关联更强（早发性癌症指50岁以前确诊的癌症）。空腹喝酒的人，早发性胃肠道癌症风险增加30%，胃癌、肝癌、直肠癌风险增加48%；相对而言，迟发性胃肠道癌症风险增加8%，胃癌、肝癌、直肠癌风险增加26%。也就是说，年纪越轻，空腹喝酒导致的患癌风险越高。

　　有一些生物学机制可以解释这些观察。食物会延迟胃排空，减少酒精吸收；空腹状态下ADH水平较低，会导致酒精清除率降低，在此状态下，酒精代谢物会通过刺激肠道炎症，形成促癌的环境。

　　其实，除了胃肠道癌症，空腹喝酒和心血管疾病死亡以及全因死亡之间都存在关联。有研究发现，空腹喝酒与女性肝硬化风险增加44%有关，这和肝癌风险的增加也是一致的。

　　无论饮酒量如何，是偶尔浅酌一口还是资深酒鬼，空腹喝酒的人患癌风险都要更高！

　　以下为研究报告英文原文：

Alcohol Drinking Without Meals Is Associated With Risk of Gastrointestinal Cancers, Including Early-Onset Cases

　　Globally, gastrointestinal (GI) cancers account for about 27% of newly diagnosed cancer cases and 37% of cancer deaths. 1 Intriguingly, there has been an upward trend in the incidence of several GI cancers (gastric noncardia, pancreatic, and colorectal cancer) among adults younger than 50 or 55 years over the past several decades. 2 Alcohol drinking, a pervasive behavior across the globe and a causal risk factor for esophageal squamous cell carcinoma, liver cancer, and colorectal cancer, is also gaining recognition as a potential risk factor for gastric, pancreatic, and gallbladder cancers. 3 Most studies have focused on the amount of alcohol, often highlighting the dose–response relationship 4 ; there are scarce data exploring the effect of timing of drinking on GI cancer. Recently, skipping meals before drinking has been gaining popularity among young adults to save calories and avoid weight gain. However, the independent impact of such contemporary drinking patterns on the risk of GI cancers, especially those of early onset, has not been investigated.

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