BACKGROUND Non-linear associations have been reported between baseline measures of alcohol consumption and type 2 diabetes (T2DM). However, given that drinking varies over the adult life course, we investigated whether differences existed in the longitudinal trajectory of alcohol consumption according to T2DM status. METHODS For a case-cohort (916 incident cases; 7376 controls) of British civil servants nested within the Whitehall II cohort, the self-reported weekly volume of alcohol consumption was traced backwards from the date of diagnosis or censoring to the beginning of the study, covering a period of up to 28 years. Mean trajectories of alcohol intake were estimated separately by diagnosis status using random-effects models. RESULTS Drinking increased linearly among male cases before diagnosis, but declined among male non-cases prior to censoring. At the time of diagnosis or censoring, consumption among those who developed T2DM was 33.4 g/week greater on average. These patterns were not apparent among women. Here, alcohol intake among female cases was consistently below that of non-cases, with the difference in consumption most pronounced around 15 years prior to diagnosis or censoring, at ∼28.0 g/week. Disparities by diagnosis status were attenuated following adjustment for potential confounders, including the frequency of consumption and metabolic factors. Drinking among male and female cases declined following diagnosis. CONCLUSIONS Differences in the weekly volume of alcohol consumption are reported in the years leading up to diagnosis or censoring. Although male and female cases predominantly consumed alcohol at volumes lower than or equal to those who were not diagnosed, these disparities appear to be largely explained by a range of socio-demographic and lifestyle factors. Where disparities are observed between cases and non-cases, adjusted absolute differences are small in magnitude. The decision to drink alcohol should not be motivated by a perceived benefit to T2DM risk.

中文翻译：

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在诊断2型糖尿病之前饮酒的轨迹：一项纵向病例队列研究。

背景技术已经报道了在饮酒的基线量度和2型糖尿病（T2DM）之间的非线性关联。但是，考虑到饮酒在成年人的生活过程中会有所不同，我们根据T2DM状况调查了饮酒的纵向轨迹是否存在差异。方法对于在白厅II队列中筑巢的英国公务员的病例队列（916个事件案例； 7376个控件），自我报告的每周饮酒量是从诊断或检查日期算起，一直追溯到研究开始。 ，有效期最长为28年。使用随机效应模型通过诊断状态分别估计酒精摄入的平均轨迹。结果男性确诊前饮酒呈线性增加，但是在审查前，男性非病例数下降了。在诊断或检查时，发展为T2DM的人群的平均消费量为33.4 g /周。这些模式在女性中并不明显。在这里，女性病例中的酒精摄入量始终低于非病例，在诊断或检查前15年左右，饮酒差异最为明显，约为28.0克/周。通过对潜在混杂因素进行调整（包括食用频率和代谢因子），诊断状态的差异得到了缓解。诊断后，男性和女性病例中的饮酒量下降。结论在诊断或检查之前的几年中，每周饮酒量有差异。尽管男性和女性病例主要以低于或等于未被诊断者的比例饮酒，但这些差异似乎在很大程度上是由一系列社会人口统计学和生活方式因素引起的。在案例与非案例之间发现差异的情况下，调整后的绝对差异幅度很小。饮酒的决定不应出于对T2DM风险的感知收益的动机。