Meta-analysis of alcohol and all-cause mortality: A validation of NHMRC recommendations
Meta-analysis of alcohol and all-cause mortality: A validation of NHMRC recommendations
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DOI：
10.5694/j.1326-5377.1996.tb122011.x
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发表时间：
1996-02-05
影响因子：
11.4
通讯作者：
Winter, MG
中科院分区：
文献类型：
--
作者：
Holman, CDJ;English, DR;Winter, MG
目的：比较国家卫生与医学研究委员会(NHMRC)关于负责任、危险和有害饮酒的建议与其对男性和女性全因死亡率的影响以及对10种特定肿瘤、心血管和消化系统疾病的发生的影响。设计：从16项队列研究(主要是35岁以上的成年人)收集的16项队列研究(主要是35岁以上的成年人)和132项流行病学研究中的酒精和特定疾病的相对死亡风险进行荟萃分析。作者报告的结果被分配到由NHMRC基于酒精摄入量中位数定义的性别特定暴露类别。使用基于精度的权重计算相对风险的汇集估计。设置：该评估是为国家药物战略进行的流行病学研究的综合荟萃分析的一部分。结果：与戒酒者相比，男性饮酒者全因死亡的相对风险在每天1.0-1.9标准饮酒时下降到0.84，在3.0-3.9饮酒时恢复到1.01，在6种或更多饮酒时增加到1.37。女性饮酒者的相对风险最低(0.88)，每天喝0-0.9杯酒，喝2.0-2.9杯酒的风险比戒酒者高1.13倍；喝6杯酒的相对风险为1.58。根据NHMRC分类，负责任饮酒者死亡的相对风险为0.93(0.93-0.94)，危险饮酒者为1.24(1.22-1.27)，有害饮酒者为1.37(1.35-1.49)。口咽癌、食道癌、肝癌、喉癌和女性乳腺癌以及肝硬变的风险随着酒精摄入量的增加而增加。结论：符合NHMRC推荐的日常饮酒模式将赋予与戒酒者相似或更低的死亡风险。酒精对女性死亡率的生物有效剂量大约是每天比男性少两杯标准饮酒量。我们的认证最可靠的是年龄在35岁或以上的饮酒者。
Objective: To compare the National Health and Medical Research Council (NHMRC) recommendations on responsible, hazardous and harmful alcohol intake with their effects on all-cause mortality in men and women and on the occurrence of 10 specific neoplastic, cardiovascular and alimentary diseases.Design: Meta-analyses of relative risks of mortality in relation to usual level of alcohol intake pooled from 16 cohort studies (mostly of adults over 35 years), and alcohol and selected conditions from a further 132 epidemiological studies. Results reported by authors were assigned to sex-specific exposure categories defined by the NHMRC based on median alcohol intakes. Pooled estimates of relative risk were calculated using precision-based weighting.Setting: The assessment was part of a comprehensive meta-analysis of epidemiological research undertaken for the National Drug Strategy.Results: Relative risk of all-cause mortality in male drinkers compared with abstainers fell to 0.84 at 1.0-1.9 standard drinks per day, returned to 1.01 by 3.0-3.9 drinks, and increased to 1.37 at six or more drinks. In female drinkers the lowest relative risk (of 0.88) was at 0-0.9 drinks per day, and by 2.0-2.9 drinks the risk exceeded that in abstainers by 1.13; at six drinks the relative risk was 1.58. Based on NHMRC categories, the relative risks of mortality were 0.93 (0.93-0.94) in responsible drinkers, 1.24 (1.22-1.27) in hazardous drinkers and 1.37 (1.35-1.49) in harmful drinkers. Risk of cancers of the oropharynx, oesophagus, liver, larynx and female breast and of cirrhosis of the liver increased with increasing alcohol intake level.Conclusions: A pattern of usual alcohol intake consistent with the NHMRC recommendations will confer a mortality risk similar to or less than that observed in abstainers. The biologically effective dose of alcohol on mortality in women is approximately two standard drinks per day less than in men. Our validation is most reliable for drinkers aged 35 years or older.