Alcohol consumption and risk of stroke - A meta-analysis
Alcohol consumption and risk of stroke - A meta-analysis
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DOI：
10.1001/jama.289.5.579
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发表时间：
2003-02-05
影响因子：
120.7
通讯作者：
He, J
中科院分区：
文献类型：
--
作者：
Reynolds, K;Lewis, LB;He, J
资料来源：应用计算机检索英文期刊MEDLINE(1966-2002-04)，检索词分别为：酒精、酒精、脑血管意外、脑血管疾病、颅内血栓和脑血管疾病，关键词为中风；论文摘要以中风和酒精为关键词；检索文章的参考文献。以总卒中、缺血性卒中或出血性卒中(脑内或全部)为终点的队列或病例对照；报告与饮酒相关的卒中的相对风险或相对优势及其方差(或计算它们的数据)；饮酒被量化；戒酒者作为参考组。研究设计、参与者特征、饮酒水平、卒中结局、潜在混杂因素的控制和风险估计由3名研究人员使用标准化方案独立提取数据提取信息。数据综合采用随机效应模型和元回归分析从单个研究中汇集数据。与戒酒者相比，每天饮酒超过60克与总中风的相对风险增加相关，1.64(95%可信区间，1.39-1.93)；缺血性中风，1.69。(95%CI，1.34~2.15)；出血性卒中，2.18(95%CI，1.48~3.20)，而每天摄入低于12g与总卒中和缺血性卒中的相对危险度降低相关，0.83(95%，CI，0.75~0.91)和0.80(95%CI，0.67~0.96)，12~24 g/d与缺血性卒中的相对危险度降低相关，0.72(95%，CI，0.57~0.91)。Meta回归分析显示，饮酒与总卒中和缺血性卒中之间存在显著的非线性关系，而与出血性卒中之间存在线性关系。结论大量饮酒增加了卒中的相对危险性，而轻度和中度饮酒可能对完全卒中和缺血性卒中具有保护作用。
Context Observational studies suggest that heavy alcohol consumption may increase the risk of stroke while moderate consumption may decrease the risk.Objective To examine the association between alcohol consumption and relative risk of stroke.Data Sources Studies published in English-language journals were retrieved by searching MEDLINE (1966-April 2002) using Medical Subject Headings alcohol drinking, ethanol, cerebrovascular accident, cerebrovascular disorders, and intracranial embolism and thrombosis and the key word stroke; Dissertation Abstracts Online using the keywords stroke and alcohol; and bibliographies of retrieved articles.Study Selection From 122 relevant retrieved reports, 35 observational studies. (cohort or case control) in which total stroke, ischemic stroke, or hemorrhagic (intracerebral or total) stroke was an end point; the relative risk or relative odds and their variance (or data to calculate them) of stroke associated with alcohol consumption were reported; alcohol consumption was quantified; and abstainers served as the reference group.Data Extraction Information on study design, participant characteristics, level of alcohol consumption, stroke outcome, control for potential confounding factors, and risk estimates was abstracted independently by 3 investigators using a standardized protocol.Data Synthesis A random-effects model and meta-regression analysis were used to pool data from individual studies. Compared with abstainers, consumption of more than 60 g of alcohol per day was associated with an increased relative risk of total stroke, 1.64 (95% confidence interval [CI], 1.39-1.93); ischemic stroke, 1.69. (95% CI, 1.34-2.15); and hemorrhagic stroke, 2.18 (95% CI, 1.48-3.20), while consumption of less than 12 g/d was associated with a reduced relative risk of total stroke, 0.83 (95%, CI, 0.75-0.91) and ischemic stroke, 0.80 (95% CI, 0.67-0.96), and consumption of 12 to 24 g/d was associated with a reduced relative risk of ischemic stroke, 0.72 (95%, CI, 0.57-0.91). The meta-regression analysis revealed a significant nonlinear relationship between alcohol consumption and total and ischemic stroke and a linear relationship between alcohol consumption and hemorrhagic stroke.Conclusions These results indicate that heavy alcohol consumption increases the relative risk of stroke while light or moderate alcohol consumption may be protective against total and ischemic stroke.