INTRODUCTION AND AIMS: Alcohol is an established risk factor for liver cirrhosis. It remains unclear, however, whether this relationship follows a continuous dose-response pattern or has a threshold. Also, the influences of sex and end-point (i.e. mortality vs. morbidity) on the association are not known. To address these questions and to provide a quantitative assessment of the association between alcohol intake and risk of liver cirrhosis, we conducted a systematic review and meta-analysis of cohort and case-control studies. DESIGN AND METHODS: Studies were identified by a literature search of Ovid MEDLINE, EMBASE, Web of Science, CINAHL, PsychINFO, ETOH and Google Scholar from January 1980 to January 2008 and by searching the references of retrieved articles. Studies were included if quantifiable information on risk and related confidence intervals with respect to at least three different levels of average alcohol intake were reported. Both categorical and continuous meta-analytic techniques were used to model the dose-response relationship. RESULTS: Seventeen studies met the inclusion criteria. We found some indications for threshold effects. Alcohol consumption had a significantly larger impact on mortality of liver cirrhosis compared with morbidity. Also, the same amount of average consumption was related to a higher risk of liver cirrhosis in women than in men. DISCUSSION AND CONCLUSIONS: Overall, end-point was an important source of heterogeneity among study results. This result has important implications not only for studies in which the burden of disease attributable to alcohol consumption is estimated, but also for prevention.
INTRODUCTION AND AIMS: Alcohol is an established risk factor for liver cirrhosis. It remains unclear, however, whether this relationship follows a continuous dose-response pattern or has a threshold. Also, the influences of sex and end-point (i.e. mortality vs. morbidity) on the association are not known. To address these questions and to provide a quantitative assessment of the association between alcohol intake and risk of liver cirrhosis, we conducted a systematic review and meta-analysis of cohort and case-control studies. DESIGN AND METHODS: Studies were identified by a literature search of Ovid MEDLINE, EMBASE, Web of Science, CINAHL, PsychINFO, ETOH and Google Scholar from January 1980 to January 2008 and by searching the references of retrieved articles. Studies were included if quantifiable information on risk and related confidence intervals with respect to at least three different levels of average alcohol intake were reported. Both categorical and continuous meta-analytic techniques were used to model the dose-response relationship. RESULTS: Seventeen studies met the inclusion criteria. We found some indications for threshold effects. Alcohol consumption had a significantly larger impact on mortality of liver cirrhosis compared with morbidity. Also, the same amount of average consumption was related to a higher risk of liver cirrhosis in women than in men. DISCUSSION AND CONCLUSIONS: Overall, end-point was an important source of heterogeneity among study results. This result has important implications not only for studies in which the burden of disease attributable to alcohol consumption is estimated, but also for prevention.
Authors: Anam Khan; Aylin Tansel; Donna L White; Waleed Tallat Kayani; Shah Bano; Jan Lindsay; Hashem B El-Serag; Fasiha Kanwal Journal: Clin Gastroenterol Hepatol Date: 2015-08-06 Impact factor: 11.382
Authors: Jürgen Rehm; Dolly Baliunas; Guilherme L G Borges; Kathryn Graham; Hyacinth Irving; Tara Kehoe; Charles D Parry; Jayadeep Patra; Svetlana Popova; Vladimir Poznyak; Michael Roerecke; Robin Room; Andriy V Samokhvalov; Benjamin Taylor Journal: Addiction Date: 2010-03-15 Impact factor: 6.526
Authors: Jayadeep Patra; Benjamin Taylor; Hyacinth Irving; Michael Roerecke; Dolly Baliunas; Satya Mohapatra; Jürgen Rehm Journal: BMC Public Health Date: 2010-05-18 Impact factor: 3.295