OBJECTIVE To investigate the association between alcohol consumption and type 2 diabetes, and determine whether this is modified by sex, body mass index (BMI) and beverage type. DESIGN Multicentre prospective case-cohort study. SETTING Eight countries from the European Prospective Investigation into Cancer and Nutrition cohort. SUBJECTS A representative baseline sample of 16 154 participants and 12 403 incident cases of type 2 diabetes. INTERVENTIONS Alcohol consumption assessed using validated dietary questionnaires. MAIN OUTCOME MEASURES Occurrence of type 2 diabetes based on multiple sources (mainly self-reports), verified against medical information. RESULTS Amongst men, moderate alcohol consumption was nonsignificantly associated with a lower incidence of diabetes with a hazard ratio (HR) of 0.90 (95% CI: 0.78-1.05) for 6.1-12.0 versus 0.1-6.0 g day(-1) , adjusted for dietary and diabetes risk factors. However, the lowest risk was observed at higher intakes of 24.1-96.0 g day(-1) with an HR of 0.86 (95% CI: 0.75-0.98). Amongst women, moderate alcohol consumption was associated with a lower incidence of diabetes with a hazard ratio of 0.82 (95% CI: 0.72-0.92) for 6.1-12.0 g day(-1) (P interaction gender <0.01). The inverse association between alcohol consumption and diabetes was more pronounced amongst overweight (BMI ≥ 25 kg m(-2) ) than normal-weight men and women (P interaction < 0.05). Adjusting for waist and hip circumference did not alter the results for men, but attenuated the association for women (HR=0.90, 95% CI: 0.79-1.03 for 6.1-12.0 g day(-1) ). Wine consumption for men and fortified wine consumption for women were most strongly associated with a reduced risk of diabetes. CONCLUSIONS The results of this study show that moderate alcohol consumption is associated with a lower risk of type 2 diabetes amongst women only. However, this risk reduction is in part explained by fat distribution. The relation between alcohol consumption and type 2 diabetes was stronger for overweight than normal-weight women and men.

中文翻译：

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欧洲男性和女性的酒精消费和 2 型糖尿病风险：饮料类型和体型的影响 EPIC-InterAct 研究。

目的 调查饮酒与 2 型糖尿病之间的关联，并确定这是否受到性别、体重指数 (BMI) 和饮料类型的影响。设计多中心前瞻性病例队列研究。设置来自欧洲癌症和营养队列前瞻性调查的八个国家。受试者 16 154 名参与者和 12 403 例 2 型糖尿病事件的代表性基线样本。干预 使用经过验证的饮食问卷评估酒精消耗量。主要结果测量 2 型糖尿病的发生基于多个来源（主要是自我报告），并根据医学信息进行验证。结果 在男性中，适度饮酒与糖尿病发病率降低无显着相关性，6.1-12 的风险比 (HR) 为 0.90 (95% CI: 0.78-1.05)。0 对 0.1-6.0 g 天 (-1) ，根据饮食和糖尿病风险因素进行调整。然而，在 24.1-96.0 g 天 (-1) 的较高摄入量下观察到最低风险，HR 为 0.86（95% CI：0.75-0.98）。在女性中，适度饮酒与较低的糖尿病发病率相关，每天 6.1-12.0 g (-1) 的风险比为 0.82（95% CI：0.72-0.92）（P 交互性别 <0.01）。与正常体重男性和女性相比，超重（BMI ≥ 25 kg m(-2)）饮酒与糖尿病之间的负相关更为明显（P 交互作用 < 0.05）。调整腰围和臀围并没有改变男性的结果，但减弱了女性的相关性（HR=0.90，95% CI：0.79-1.03，每天 6.1-12.0 g(-1)）。男性饮用葡萄酒和女性饮用强化葡萄酒与降低患糖尿病的风险最密切相关。结论 本研究结果表明，适度饮酒仅与女性患 2 型糖尿病的风险降低有关。然而，这种风险降低部分可以通过脂肪分布来解释。与正常体重的女性和男性相比，超重的饮酒与 2 型糖尿病之间的相关性更强。