A meta-analysis of alcohol consumption and the risk of 15 diseases
A meta-analysis of alcohol consumption and the risk of 15 diseases
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DOI：
10.1016/j.ypmed.2003.11.027
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发表时间：
2004-05-01
影响因子：
5.1
通讯作者：
La Vecchia, C
中科院分区：
文献类型：
--
作者：
Corrao, G;Bagnardi, V;La Vecchia, C
背景资料。比较流行病学文献提供的关于饮酒与14种与酒精相关的主要肿瘤和非肿瘤疾病以及伤害的风险之间关系的证据的强度。通过几个书目数据库检索1966~1998年的流行病学文献。考虑酒精摄入量的固定和随机效应模型以及线性和非线性效应，建立了Meta回归模型。考虑了研究的某些特征的影响，包括研究质量的指标。在最初审查的561项研究中，156项被选为荟萃分析，因为他们的先验定义质量更高，总共包括116,702名受试者。观察到口腔癌、食道癌和喉癌、高血压、肝硬变、慢性胰腺炎以及伤害和暴力的风险有很大的趋势。结肠癌、直肠癌、肝癌和乳腺癌的直接关联度较低。在所有这些情况下，每天摄入25克乙醇的风险也显著增加。观察缺血性和出血性卒中的阈值。对于冠心病，观察到J型关系，20g/d的相对危险度最小为0.80，72g/d的保护作用显著，89g/d的风险显著增加。结论胃十二指肠溃疡与胃十二指肠溃疡无明显关系。这项荟萃分析没有证据表明肿瘤和几种非肿瘤疾病都有阈值效应。J形关系仅在冠心病患者中观察到。(C)2004年癌症预防研究所和爱思唯尔公司。保留所有权利。
Background. To compare the strength of evidence provided by the epidemiological literature on the association between alcohol consumption and the risk of 14 major alcohol-related neoplasms and non-neoplastic diseases, plus injuries.Methods. A search of the epidemiological literature from 1966 to 1998 was performed by several bibliographic databases. Meta-regression models were fitted considering fixed and random effect models and linear and nonlinear effects of alcohol intake. The effects of some characteristics of the studies, including an index of their quality, were considered.Results. Of the 561 initially reviewed studies, 156 were selected for meta-analysis because of their a priori defined higher quality, including a total of 116,702 subjects. Strong trends in risk were observed for cancers of the oral cavity, esophagus and larynx, hypertension, liver cirrhosis, chronic pancreatitis, and injuries and violence. Less strong direct relations were observed for cancers of the colon, rectum, liver, and breast. For all these conditions, significant increased risks were also found for ethanol intake of 25 g per day. Threshold values were observed for ischemic and hemorrhagic strokes. For coronary heart disease, a J-shaped relation was observed with a minimum relative risk of 0.80 at 20 g/day, a significant protective effect up to 72 g/day, and a significant increased risk at 89 g/day. No clear relation was observed for gastroduodenal ulcer.Conclusions. This meta-analysis shows no evidence of a threshold effect for both neoplasms and several non-neoplastic diseases. J-shaped relations were observed only for coronary heart disease. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.