Craig Knott1, Steven Bell2, Annie Britton2. 1. Research Department of Epidemiology and Public Health, University College London, London, U.K. craig.knott.10@ucl.ac.uk. 2. Research Department of Epidemiology and Public Health, University College London, London, U.K.
Abstract
OBJECTIVE: Observational studies indicate that moderate levels of alcohol consumption may reduce the risk of type 2 diabetes. In addition to providing an updated summary of the existing literature, this meta-analysis explored whether reductions in risk may be the product of misclassification bias. RESEARCH DESIGN AND METHODS: A systematic search was undertaken, identifying studies that reported a temporal association between alcohol consumption and the risk of type 2 diabetes. No restrictions were placed upon the language or date of publication. Non-English publications were, where necessary, translated using online translation tools. Models were constructed using fractional polynomial regression to determine the best-fitting dose-response relationship between alcohol intake and type 2 diabetes, with a priori testing of sex and referent group interactions. RESULTS: Thirty-eight studies met the selection criteria, representing 1,902,605 participants and 125,926 cases of type 2 diabetes. A conventional noncurrent drinking category was reported by 33 studies, while five reported a never-drinking category. Relative to combined abstainers, reductions in the risk of type 2 diabetes were present at all levels of alcohol intake <63 g/day, with risks increasing above this threshold. Peak risk reduction was present between 10-14 g/day at an 18% decrease in hazards. Stratification of available data revealed that reductions in risk may be specific to women only and absent in studies that adopted a never-drinking abstention category or sampled an Asian population region. CONCLUSIONS: Reductions in risk among moderate alcohol drinkers may be confined to women and non-Asian populations. Although based on a minority of studies, there is also the possibility that reductions in risk may have been overestimated by studies using a referent group contaminated by less healthy former drinkers.
OBJECTIVE: Observational studies indicate that moderate levels of alcohol consumption may reduce the risk of type 2 diabetes. In addition to providing an updated summary of the existing literature, this meta-analysis explored whether reductions in risk may be the product of misclassification bias. RESEARCH DESIGN AND METHODS: A systematic search was undertaken, identifying studies that reported a temporal association between alcohol consumption and the risk of type 2 diabetes. No restrictions were placed upon the language or date of publication. Non-English publications were, where necessary, translated using online translation tools. Models were constructed using fractional polynomial regression to determine the best-fitting dose-response relationship between alcohol intake and type 2 diabetes, with a priori testing of sex and referent group interactions. RESULTS: Thirty-eight studies met the selection criteria, representing 1,902,605 participants and 125,926 cases of type 2 diabetes. A conventional noncurrent drinking category was reported by 33 studies, while five reported a never-drinking category. Relative to combined abstainers, reductions in the risk of type 2 diabetes were present at all levels of alcohol intake <63 g/day, with risks increasing above this threshold. Peak risk reduction was present between 10-14 g/day at an 18% decrease in hazards. Stratification of available data revealed that reductions in risk may be specific to women only and absent in studies that adopted a never-drinking abstention category or sampled an Asian population region. CONCLUSIONS: Reductions in risk among moderate alcohol drinkers may be confined to women and non-Asian populations. Although based on a minority of studies, there is also the possibility that reductions in risk may have been overestimated by studies using a referent group contaminated by less healthy former drinkers.
Authors: Natalie E Kelso-Chichetto; Michael Plankey; Alison G Abraham; Nicole Ennis; Xinguang Chen; Robert Bolan; Robert L Cook Journal: Am J Drug Alcohol Abuse Date: 2017-06-16 Impact factor: 3.829
Authors: William C Kerr; Edwina Williams; Libo Li; Camillia K Lui; Yu Ye; Thomas K Greenfield; E Anne Lown Journal: Prev Med Date: 2018-02-03 Impact factor: 4.018
Authors: Emily A Hu; Mariana Lazo; Sarah D Rosenberg; Morgan E Grams; Lyn M Steffen; Josef Coresh; Casey M Rebholz Journal: J Ren Nutr Date: 2019-03-06 Impact factor: 3.655
Authors: William C Kerr; Yu Ye; Edwina Williams; Camillia K Lui; Thomas K Greenfield; E Anne Lown Journal: Alcohol Clin Exp Res Date: 2018-12-10 Impact factor: 3.455
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