Soo Joo Lee1, Yong-Jin Cho1, Jae Guk Kim1, Youngchai Ko1, Keun-Sik Hong1, Jong-Moo Park1, Kyusik Kang1, Tai Hwan Park1, Sang-Soon Park1, Kyung Bok Lee1, Jae Kwan Cha1, Dae-Hyun Kim1, Jun Lee1, Joon-Tae Kim1, Juneyoung Lee1, Ji Sung Lee1, Myung Suk Jang1, Moon-Ku Han1, Philip B Gorelick1, Hee-Joon Bae. 1. From the Department of Neurology (S.J.L., J.G.K., Y.K.), Eulji University Hospital, Daejeon; Department of Neurology (Y.-J.C., K.-S.H.), Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Seoul; Department of Neurology (T.H.P., S.-S.P.), Seoul Medical Center; Department of Neurology (K.B.L.), Soonchunhyang University Hospital Seoul; Department of Neurology (J.K.C., D.-H.K.), Dong-A University Hospital, Busan; Department of Neurology (Jun Lee), Yeungnam University Medical Center, Daegu; Department of Neurology (J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul; Clinical Research Center (J.S.L.), Asan Medical Center, Seoul; Department of Neurology and Cerebrovascular Center (M.S.J., M.-K.H., H.-J.B.), Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea; and Department of Translational Science & Molecular Medicine (P.B.G.), Michigan State University College of Human Medicine and Medical Director, Mercy Health Hauenstein Neurosciences, Grand Rapids, MI.
Abstract
OBJECTIVE: We undertook a population-based, case-control study to examine a dose-response relationship between alcohol intake and risk of ischemic stroke in Koreans who had different alcoholic beverage type preferences than Western populations and to examine the effect modifications by sex and ischemic stroke subtypes. METHODS: Cases (n = 1,848) were recruited from patients aged 20 years or older with first-ever ischemic stroke. Stroke-free controls (n = 3,589) were from the fourth and fifth Korean National Health and Nutrition Examination Survey and were matched to the cases by age (±3 years), sex, and education level. All participants completed an interview using a structured questionnaire about alcohol intake. RESULTS: Light to moderate alcohol intake, 3 or 4 drinks (1 drink = 10 g ethanol) per day, was significantly associated with a lower odds of ischemic stroke after adjusting for potential confounders (no drinks: reference; <1 drink: odds ratio 0.38, 95% confidence interval 0.32-0.45; 1-2 drinks: 0.45, 0.36-0.57; and 3-4 drinks: 0.54, 0.39-0.74). The threshold of alcohol effect in women was slightly lower than that in men (up to 1-2 drinks in women vs up to 3-4 drinks in men), but this difference was not statistically significant. There was no statistical interaction between alcohol intake and the subtypes of ischemic stroke (p = 0.50). The most frequently used alcoholic beverage was one native to Korea, soju (78% of the cases), a distilled beverage with 20% ethanol by volume. CONCLUSIONS: Our findings suggest that light to moderate distilled alcohol consumption may reduce the risk of ischemic stroke in Koreans.
OBJECTIVE: We undertook a population-based, case-control study to examine a dose-response relationship between alcohol intake and risk of ischemic stroke in Koreans who had different alcoholic beverage type preferences than Western populations and to examine the effect modifications by sex and ischemic stroke subtypes. METHODS: Cases (n = 1,848) were recruited from patients aged 20 years or older with first-ever ischemic stroke. Stroke-free controls (n = 3,589) were from the fourth and fifth Korean National Health and Nutrition Examination Survey and were matched to the cases by age (±3 years), sex, and education level. All participants completed an interview using a structured questionnaire about alcohol intake. RESULTS: Light to moderate alcohol intake, 3 or 4 drinks (1 drink = 10 g ethanol) per day, was significantly associated with a lower odds of ischemic stroke after adjusting for potential confounders (no drinks: reference; <1 drink: odds ratio 0.38, 95% confidence interval 0.32-0.45; 1-2 drinks: 0.45, 0.36-0.57; and 3-4 drinks: 0.54, 0.39-0.74). The threshold of alcohol effect in women was slightly lower than that in men (up to 1-2 drinks in women vs up to 3-4 drinks in men), but this difference was not statistically significant. There was no statistical interaction between alcohol intake and the subtypes of ischemic stroke (p = 0.50). The most frequently used alcoholic beverage was one native to Korea, soju (78% of the cases), a distilled beverage with 20% ethanol by volume. CONCLUSIONS: Our findings suggest that light to moderate distilled alcohol consumption may reduce the risk of ischemic stroke in Koreans.
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