Xu Qin, Guo Wei, Shi Xingang, Zhang Wei, Zhang Tianyi, Wu Cheng, Lu Jian, Wang Rui, Zhao Yanfang, Ma Xiuqiang, He Jia
From the Department of Health Statistics (QX, WG, TZ, CW, JL, RW, YZ, XM, JH), Second Military Medical University; Department of Gastroenterology (XS), Changhai Hospital, Second Military Medical University; and Department of Heath Services Management (WZ), Second Military Medical University, Shanghai, China.
Medicine (Baltimore). 2015 Aug;94(32):e1244. doi: 10.1097/MD.0000000000001244.
The association between alcohol consumption and Barrett's esophagus (BE) remained uncertain and controversial in the previous studies. We performed a meta-analysis of observational studies to clarify the association.We searched PubMed, Web of Science, and Embase for studies on alcohol consumption and risk of BE published before February 2015. A total of 20 studies reporting the association between alcohol consumption and the risk of BE were identified. Subgroup analyses, meta-regression analyses, sensitivity analyses, and publication bias tests were also performed. Several results from individual studies were pooled using a dose-response meta-analysis.A total of 20 studies involving 45,181 participants and 4432 patients of BE were included in the meta-analysis. No association was found between alcohol consumption and BE (relative risk [RR] = 1.10, 95% confidence interval [CI] 0.96-1.27, I = 48.60%) in our study. In subgroup analysis, alcohol consumption was associated with an increased risk of BE in men (RR = 1.35, 95% CI 1.13-1.61, I = 0.00%) and Asian population (RR = 1.60, 95% CI 1.03-2.49, I = 60.60%). In beverage-specific consumption analysis, liquor was associated with an increased risk of BE (RR = 1.16, 95% CI 1.02-1.32, I = 0.00%). Multivariate meta-regression analysis suggested that geographic area, and adjusted age, sex, body mass index, and smoke, might explain 70.75% of the heterogeneity between the studies. We also found the inverse association (RR = 0.84, 95% CI 0.72-0.98, I = 0.00%) between alcohol consumption and BE among subjects when compared with population controls.Overall, there was no significant association between alcohol consumption and BE. Alcohol consumption may be a risk factor of BE in men and Asian population, and liquor consumption may also increase the risk of BE. Significant inverse association was observed between alcohol consumption and BE, for comparisons with population controls.
在以往的研究中,饮酒与巴雷特食管(BE)之间的关联仍不明确且存在争议。我们进行了一项观察性研究的荟萃分析以阐明这种关联。我们在PubMed、科学网和Embase中检索了2015年2月之前发表的关于饮酒与BE风险的研究。共确定了20项报告饮酒与BE风险之间关联的研究。还进行了亚组分析、元回归分析、敏感性分析和发表偏倚检验。使用剂量反应荟萃分析汇总了个体研究的若干结果。
荟萃分析共纳入了20项研究,涉及45181名参与者和4432例BE患者。在我们的研究中,未发现饮酒与BE之间存在关联(相对风险[RR]=1.10,95%置信区间[CI]0.96 - 1.27,I=48.60%)。在亚组分析中,饮酒与男性BE风险增加相关(RR=1.35,95%CI 1.13 - 1.6l,I=0.00%)以及与亚洲人群相关(RR=1.60,95%CI 1.03 - 2.49,I=60.60%)。在特定饮料消费分析中,白酒与BE风险增加相关(RR=1.16,95%CI 1.02 - 1.32,I=0.00%)。多变量元回归分析表明,地理区域以及调整后的年龄、性别、体重指数和吸烟情况,可能解释了研究之间70.75%的异质性。与人群对照相比,我们还发现饮酒与BE之间存在负相关(RR=0.84,95%CI 0.72 - 0.98,I=0.00%)。
总体而言,饮酒与BE之间无显著关联。饮酒可能是男性和亚洲人群患BE的危险因素,饮用白酒也可能增加BE风险。与人群对照相比,观察到饮酒与BE之间存在显著负相关。