How does alcohol use impact morbidity and mortality of liver cirrhosis? A systematic review and dose-response meta-analysis.
Details
Request a copy Under embargo until 28/02/2025.
UNIL restricted access
State: Public
Version: Author's accepted manuscript
License: All rights reserved
UNIL restricted access
State: Public
Version: Author's accepted manuscript
License: All rights reserved
Serval ID
serval:BIB_3635D762B17D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
How does alcohol use impact morbidity and mortality of liver cirrhosis? A systematic review and dose-response meta-analysis.
Journal
Hepatology international
ISSN
1936-0541 (Electronic)
ISSN-L
1936-0533
Publication state
Published
Issued date
02/2024
Peer-reviewed
Oui
Volume
18
Number
1
Pages
216-224
Language
english
Notes
Publication types: Systematic Review ; Meta-Analysis ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Alcohol consumption is the most important risk factor responsible for the disease burden of liver cirrhosis (LC). Estimates of risk relationships available usually neither distinguish between different causes such as alcohol-related LC or hepatitis-related LC, nor differentiate between morbidity and mortality as outcome. We aimed to address this research gap and identify dose-response relationships between alcohol consumption and LC, by cause and outcome.
A systematic review using PubMed/Medline and Embase was conducted, identifying studies that reported an association between level of alcohol use and LC. Meta-regression models were used to estimate the dose-response relationships and control for heterogeneity.
Totally, 44 studies, and 1 secondary data source, with a total of 5,122,534 participants and 15,150 cases were included. Non-linear dose-response relationships were identified, attenuated for higher levels of consumption. For morbidity, drinking 25 g/day was associated with a RR of 1.81 (95% CI 1.68-1.94) compared to lifetime abstention; 50 g/day and 100 g/day corresponded to 3.54 (95% CI 3.29-3.81) and 8.15 (95% CI 7.46-8.91), respectively. For mortality, for 25 g/day, a RR of 2.65 (95% CI 2.22-3.16); for 50 g/day, a RR of 6.83 (95% CI 5.84-7.97); for 100 g/day, a RR of 16.38 (95% CI 13.81-19.42) were identified. A higher risk for alcohol-related and all-cause LC as compared to hepatitis C-related LC was found.
Our results demonstrated higher acceleration for mortality compared to morbidity. The current findings will inform the way we quantify the burden due to LC attributable to alcohol use.
A systematic review using PubMed/Medline and Embase was conducted, identifying studies that reported an association between level of alcohol use and LC. Meta-regression models were used to estimate the dose-response relationships and control for heterogeneity.
Totally, 44 studies, and 1 secondary data source, with a total of 5,122,534 participants and 15,150 cases were included. Non-linear dose-response relationships were identified, attenuated for higher levels of consumption. For morbidity, drinking 25 g/day was associated with a RR of 1.81 (95% CI 1.68-1.94) compared to lifetime abstention; 50 g/day and 100 g/day corresponded to 3.54 (95% CI 3.29-3.81) and 8.15 (95% CI 7.46-8.91), respectively. For mortality, for 25 g/day, a RR of 2.65 (95% CI 2.22-3.16); for 50 g/day, a RR of 6.83 (95% CI 5.84-7.97); for 100 g/day, a RR of 16.38 (95% CI 13.81-19.42) were identified. A higher risk for alcohol-related and all-cause LC as compared to hepatitis C-related LC was found.
Our results demonstrated higher acceleration for mortality compared to morbidity. The current findings will inform the way we quantify the burden due to LC attributable to alcohol use.
Keywords
Humans, Alcohol Drinking/adverse effects, Alcohol Drinking/epidemiology, Risk Factors, Liver Cirrhosis/etiology, Morbidity, Liver Cirrhosis, Alcoholic, Alcohol, Dose–response, Epidemiology, Liver cirrhosis, Liver disease, Meta-analysis, Mortality, Public health, Systematic review
Pubmed
Web of science
Funding(s)
Swiss National Science Foundation / Careers / P2LAP3_191273
Create date
25/09/2023 16:04
Last modification date
18/07/2024 7:07