绝经后女性因体重指数、酒精及其相互作用导致慢性肝病的风险：英国卵巢癌筛查协作试验（UKCTOCS）中的一项前瞻性巢式队列研究。
Risk of chronic liver disease in post-menopausal women due to body mass index, alcohol and their interaction: a prospective nested cohort study within the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).
作者信息
Trembling Paul M, Apostolidou Sophia, Gentry-Maharaj Aleksandra, Parkes Julie, Ryan Andy, Tanwar Sudeep, Burnell Matthew, Jacobs Ian, Menon Usha, Rosenberg William M
机构信息
Institute for Liver and Digestive Health, Division of Medicine, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.
Gynaecological Cancer Research Centre, University College London Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.
出版信息
BMC Public Health. 2017 Jun 28;17(1):603. doi: 10.1186/s12889-017-4518-y.
BACKGROUND
We investigated the risk of chronic liver disease (CLD) due to alcohol consumption and body mass index (BMI) and the effects of their interaction in a prospective cohort study of women recruited to the UKCTOCS trial.
METHODS
95,126 post-menopausal women without documented CLD were stratified into 12 groups defined by combinations of BMI (normal, overweight, obese) and alcohol consumption (none, <1-15, 16-20 and ≥21 units/week), and followed for an average of 5.1 years. Hazard ratios (HR) were calculated for incident liver-related events (LRE).
RESULTS
First LREs were reported in 325 (0.34%) participants. Compared to women with normal BMI, HR = 1.44 (95% CI; 1.10-1.87) in the overweight group and HR = 2.25 (95% CI; 1.70-2.97) in the obese group, adjusted for alcohol and potential confounders. Compared to those abstinent from alcohol, HR = 0.70 (95% CI; 0.55-0.88) for <1-15 units/week, 0.93 (95% CI; 0.50-1.73) for 16-20 units/week and 1.82 (95% CI; 0.97-3.39) for ≥21 units/week adjusted for BMI and potential confounders. Compared to women with normal BMI drinking no alcohol, HR for LRE in obese women consuming ≥21 units/week was 2.86 (95% CI; 0.67-12.42), 1.58 (95% CI; 0.96-2.61) for obese women drinking <1-15 units/week and 1.93 (95% CI; 0.66-5.62) in those with normal BMI consuming ≥21 units/week after adjustment for potential confounders. We found no significant interaction between BMI and alcohol.
CONCLUSION
High BMI and alcohol consumption and abstinence are risk factors for CLD in post-menopausal women. However, BMI and alcohol do not demonstrate significant interaction in this group.
TRIAL REGISTRATION
UKCTOCS is registered as an International Standard Randomised Controlled Trial, number ISRCTN22488978 . Registered 06/04/2000.
背景
在一项针对参加英国癌症预防研究（UKCTOCS）试验的女性的前瞻性队列研究中，我们调查了饮酒和体重指数（BMI）导致慢性肝病（CLD）的风险及其相互作用的影响。
方法
95126名无CLD记录的绝经后女性按BMI（正常、超重、肥胖）和饮酒量（无、每周<1至15、16至20以及≥21单位）的组合分为12组，并平均随访5.1年。计算了肝脏相关事件（LRE）的风险比（HR）。
结果
325名（0.34%）参与者报告了首次LRE。与BMI正常的女性相比，超重组调整饮酒和潜在混杂因素后的HR = 1.44（95%CI；1.10 - 1.87），肥胖组为HR = 2.25（95%CI；1.70 - 2.97）。与戒酒者相比，每周<1至15单位调整BMI和潜在混杂因素后的HR = 0.70（95%CI；0.55 - 0.88），每周16至20单位为0.93（95%CI；0.50 - 1.73），每周≥21单位为1.82（95%CI；0.97 - 3.39）。调整潜在混杂因素后，与BMI正常且不饮酒的女性相比，每周饮酒≥21单位的肥胖女性发生LRE的HR为2.86（95%CI；0.67 - 12.42），每周饮酒<1至15单位的肥胖女性为1.58（95%CI；0.96 - 2.61），BMI正常且每周饮酒≥21单位的女性为1.93（95%CI；0.66 - 5.62）。我们发现BMI与酒精之间无显著相互作用。
结论
高BMI、饮酒和戒酒是绝经后女性CLD的危险因素。然而，BMI与酒精在该组中未显示出显著相互作用。
试验注册
UKCTOCS注册为国际标准随机对照试验，编号ISRCTN22488978。于2000年4月6日注册。
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