Chong Elaine W-T, Kreis Andreas J, Wong Tien Y, Simpson Julie A, Guymer Robyn H
Centre for Eye Research Australia, The University of Melbourne, Victoria, Australia.
Am J Ophthalmol. 2008 Apr;145(4):707-715. doi: 10.1016/j.ajo.2007.12.005. Epub 2008 Feb 1.
To review systematically the evidence currently available on alcohol consumption and the risk of age-related macular degeneration (AMD).
Systematic review and meta-analysis of observational studies.
Seven databases were searched systematically with no limits on the year or language of publication for prospective cohort studies. References identified from pertinent reviews and articles also were retrieved. Two reviewers independently searched the above databases and selected the studies using prespecified standardized criteria. These criteria included appropriate adjustment for age and smoking in the analysis. Of the 441 studies identified initially, five cohort studies met the selection criteria. Data extraction and study quality evaluation were performed independently by two reviewers and results were pooled quantitatively using meta-analytic methods.
The five cohort studies included 136,946 people, among whom AMD developed in 1923 (1,513 early and 410 late). Pooled results showed that heavy alcohol consumption was associated with an increased risk of early AMD (pooled odds ratio, 1.47; 95% confidence interval, 1.10 to 1.95), whereas the association between heavy alcohol consumption and risk of late AMD was inconclusive. There were insufficient data to evaluate a dose-response association between alcohol consumption and AMD or the association between moderate alcohol consumption and AMD.
Heavy alcohol consumption (more than three standard drinks per day) is associated with an increased risk of early AMD. Although this association seems to be independent of smoking, residual confounding effects from smoking cannot be excluded completely.
系统回顾目前关于饮酒与年龄相关性黄斑变性（AMD）风险的现有证据。
对观察性研究进行系统回顾和荟萃分析。
系统检索七个数据库，对前瞻性队列研究的发表年份和语言无限制。还检索了从相关综述和文章中识别出的参考文献。两名评审员独立检索上述数据库，并使用预先指定的标准化标准选择研究。这些标准包括在分析中对年龄和吸烟进行适当调整。在最初识别出的441项研究中，五项队列研究符合选择标准。两名评审员独立进行数据提取和研究质量评估，并使用荟萃分析方法对结果进行定量汇总。
五项队列研究共纳入136,946人，其中1923人发生AMD（1513例早期和410例晚期）。汇总结果显示，大量饮酒与早期AMD风险增加相关（汇总比值比，1.47；95%置信区间，1.10至1.95），而大量饮酒与晚期AMD风险之间的关联尚无定论。没有足够的数据来评估饮酒与AMD之间的剂量反应关系或适度饮酒与AMD之间的关系。
大量饮酒（每天超过三杯标准饮品）与早期AMD风险增加相关。尽管这种关联似乎独立于吸烟，但不能完全排除吸烟的残余混杂效应。
