Department of Gastroenterology, Division of Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE.
Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Gut Liver. 2019 Jan 15;13(1):114-131. doi: 10.5009/gnl18278.
BACKGROUND/AIMS: Gallstone disease (GSD) is a common gastrointestinal disorder. Clinical epidemiological studies revealed that alcohol consumption has a preventive effect on the development of GSD. This study aimed to evaluate the relative risks of drinking for GSD development and investigate the dose-response relationships.
A systematic search of the MEDLINE, EMBASE, and Cochrane Library databases for studies published up to 2018 was performed. All studies that satisfied the following eligibility criteria were included: patients with GSD with or without cholecystitis; and cohort or case-control studies investigating the association between alcohol consumption and GSD development.
Sixteen case-control studies including 24,401 gallstone cases and 76,185 controls, and eight cohort studies with 14,693 GSD cases among 2,432,471 person-years were enrolled. Alcohol consumption presented a decreased overall risk of GSD (pooled relative ratio [RR], 0.84; 95% confidence interval [CI], 0.79 to 0.89; p=0.02). Subgroup analyses according to drinking levels indicated a gradual risk reduction for GSD compared to nondrinkers (light: RR, 0.96; 95% CI, 0.94 to 0.99; p=0.75; moderate: RR, 0.80; 95% CI, 0.75 to 0.85; p=0.27; high: RR, 0.66; 95% CI, 0.56 to 0.79; p＜0.01). A nonlinear risk reduction was observed in a dose-response meta-analysis of all the studies (n=14, p＜0.01 for nonlinearity).
In this systematic review with meta-analysis, alcohol consumption could decrease the risk of GSD, and the dose-response analysis revealed a dose-dependent linear risk reduction and a weakened linear trend between alcohol consumption levels less than and greater than 28 g/day.
背景/目的：胆石病（GSD）是一种常见的胃肠道疾病。临床流行病学研究表明，饮酒对 GSD 的发生具有预防作用。本研究旨在评估饮酒对 GSD 发展的相对风险，并探讨剂量-反应关系。
系统检索 MEDLINE、EMBASE 和 Cochrane Library 数据库，检索截至 2018 年发表的研究。所有符合以下纳入标准的研究均被纳入：患有或不伴有胆囊炎的 GSD 患者；以及队列或病例对照研究，调查饮酒与 GSD 发展之间的关系。
共纳入 16 项病例对照研究（24401 例胆石症病例和 76185 例对照）和 8 项队列研究（2432471 人年中有 14693 例 GSD 病例）。饮酒总体上降低了 GSD 的风险（汇总相对比值 [RR]，0.84；95%置信区间 [CI]，0.79 至 0.89；p=0.02）。根据饮酒水平进行的亚组分析表明，与不饮酒者相比，GSD 的风险逐渐降低（轻度：RR，0.96；95%CI，0.94 至 0.99；p=0.75；中度：RR，0.80；95%CI，0.75 至 0.85；p=0.27；重度：RR，0.66；95%CI，0.56 至 0.79；p＜0.01）。对所有研究进行的剂量-反应meta 分析显示呈非线性风险降低（n=14，p＜0.01 表示非线性）。
在这项系统评价和荟萃分析中，饮酒可以降低 GSD 的风险，剂量-反应分析显示出剂量依赖性的线性风险降低，以及饮酒水平小于和大于 28g/天之间线性趋势的减弱。
