Department of Health Statistics, Second Military Medical University, Shanghai, China.
Department of Rheumatology and Immunology, Changhai Hospital, Shanghai, China.
Ann Rheum Dis. 2014 Nov;73(11):1962-7. doi: 10.1136/annrheumdis-2013-203323. Epub 2013 Jul 29.
To summarise the evidence regarding the dose-response association between alcohol consumption and risk of rheumatoid arthritis (RA).
Studies were identified from search of MEDLINE, Embase and Web of Science databases between 1 January 1946 and 10 April 2013, and from review of the conference abstracts and the reference lists of retrieved articles. Prospective studies that reported relative risks (RRs) with 95% CIs for the association between alcohol consumption and the risk of RA were included. Results from individual studies were pooled using a dose-response meta-analysis.
Up to 10 April 2013, 8 prospective studies contained 195 029 participants and 1878 RA cases were included. The results indicated that low to moderate alcohol consumption yielded a preventive effect on RA development (RR: 0.86; 95% CI 0.78 to 0.94), and provided some evidence of a non-linear relationship between alcohol consumption and risk of RA. Dose-response meta-analysis of the study data revealed that compared with that for no alcohol consumption, the adjusted RR was 0.93 (95% CI 0.88 to 0.98) for 3 g/day of alcohol consumption, 0.86 (95% CI 0.76 to 0.97) for 9 g/day, 0.88 (95% CI 0.78 to 0.99) for 12 g/day, 0.91 (95% CI 0.81 to 1.03) for 15 g/day, and 1.28 (95% CI 0.94 to 1.73) for 30 g/day. Subgroup analysis indicated that women who had low to moderate alcohol consumption had a 19% reduction in RA risk. Regardless of sex, a consistent low to moderate alcohol consumption for a period of at least 10 years was found to have a 17% reduction in RA risk.
Low to moderate alcohol consumption inversely associated with the development of RA in a manner that appears to be dose-dependent, time-dependent and sex-dependent. Large prospective studies that investigate gene-environment interactions are required to further clarify the aetiology of RA.
总结酒精摄入量与类风湿关节炎（RA）风险之间的剂量-反应关系的证据。
检索 1946 年 1 月 1 日至 2013 年 4 月 10 日 MEDLINE、Embase 和 Web of Science 数据库，以及会议摘要和检索文章的参考文献，以确定研究。纳入报告酒精摄入与 RA 风险之间关联的相对风险（RR）及其 95%置信区间的前瞻性研究。使用剂量-反应荟萃分析汇总来自个别研究的结果。
截至 2013 年 4 月 10 日，8 项前瞻性研究纳入了 195029 名参与者和 1878 例 RA 病例。结果表明，低至中度饮酒对 RA 发展具有预防作用（RR：0.86；95%CI 0.78 至 0.94），并且表明酒精摄入与 RA 风险之间存在非线性关系。对研究数据的剂量-反应荟萃分析显示，与不饮酒相比，酒精摄入量为 3g/d 时，调整后的 RR 为 0.93（95%CI 0.88 至 0.98），9g/d 时为 0.86（95%CI 0.76 至 0.97），12g/d 时为 0.88（95%CI 0.78 至 0.99），15g/d 时为 0.91（95%CI 0.81 至 1.03），30g/d 时为 1.28（95%CI 0.94 至 1.73）。亚组分析表明，低至中度饮酒的女性患 RA 的风险降低了 19%。无论性别如何，至少 10 年持续低至中度饮酒可使 RA 风险降低 17%。
低至中度饮酒与 RA 的发生呈负相关，这种相关性似乎呈剂量依赖性、时间依赖性和性别依赖性。需要进行大型前瞻性研究来探讨基因-环境相互作用，以进一步阐明 RA 的病因。
