Institute of Medical Science, University of Toronto, Toronto, ON, Canada
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Eur Respir J. 2017 Jul 13;50(1). doi: 10.1183/13993003.00216-2017. Print 2017 Jul.
Meta-analyses of alcohol use, alcohol dosage and alcohol-related problems as risk factors for tuberculosis incidence were undertaken. The global alcohol-attributable tuberculosis burden of disease was also re-estimated.Systematic searches were conducted, reference lists were reviewed and expert consultations were held to identify studies. Cohort and case-control studies were included if there were no temporal violations of exposure and outcome. Risk relations (RRs) were pooled by using categorical and dose-response meta-analyses. The alcohol-attributable tuberculosis burden of disease was estimated by using alcohol-attributable fractions.36 of 1108 studies were included. RRs for alcohol use and alcohol-related problems were 1.35 (95% CI 1.09-1.68; I: 83%) and 3.33 (95% CI 2.14-5.19; 87%), respectively. Concerning alcohol dosage, tuberculosis risk rose as ethanol intake increased, with evidence of a threshold effect. Alcohol consumption caused 22.02 incident cases (95% CI 19.70-40.77) and 2.35 deaths (95% CI 2.05-4.79) per 100 000 people from tuberculosis in 2014. Alcohol-attributable tuberculosis incidence increased between 2000 and 2014 in most high tuberculosis burden countries, whereas mortality decreased.Alcohol consumption was associated with an increased risk of tuberculosis in all meta-analyses. It was consequently a major contributor to the tuberculosis burden of disease.
对饮酒、酒精剂量和与酒精相关问题作为结核病发病风险因素的荟萃分析进行了研究。还重新估计了全球由酒精引起的结核病疾病负担。系统地进行了搜索，查阅了参考文献，并进行了专家咨询，以确定研究。如果暴露和结果没有时间上的冲突，则纳入队列和病例对照研究。使用分类和剂量反应荟萃分析来汇总风险比（RR）。通过使用归因于酒精的分数来估计归因于酒精的结核病疾病负担。在 1108 项研究中，有 36 项被纳入。饮酒和与酒精相关问题的 RR 分别为 1.35（95%CI 1.09-1.68；I：83%）和 3.33（95%CI 2.14-5.19；87%）。关于酒精剂量，随着乙醇摄入量的增加，结核病风险上升，存在阈值效应的证据。在 2014 年，酒精消费导致每 100000 人中有 22.02 例（95%CI 19.70-40.77）结核病新发病例和 2.35 例（95%CI 2.05-4.79）死亡。在大多数结核病负担重的国家，2000 年至 2014 年间，归因于酒精的结核病发病率增加，而死亡率下降。在所有荟萃分析中，饮酒均与结核病风险增加相关。因此，它是结核病疾病负担的主要原因之一。
