Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Addiction. 2021 Aug;116(8):2026-2038. doi: 10.1111/add.15413. Epub 2021 Feb 3.
To compare systematically the alcohol-attributable mortality and burden of disease estimates for 2016 from a recent study by Shield and colleagues and the Global Burden of Disease study 2017 (GBD).
This study compared estimates of alcohol-attributable mortality and disability adjusted life years (DALYs) lost for 2016 with regards to absolute and relative differences, by region and by cause of disease or injury. Relative differences between the two studies are reported herein as percentage (%) differences. A difference of 10% or more was considered meaningful.
The studies estimated similar global levels of overall alcohol-attributable mortality for 2016 (Shield and colleagues estimated 5.1% more alcohol-attributable mortality than the GBD study) but not alcohol-attributable DALYs lost (18.3% difference). There were marked differences by region and cause of disease or injury. Compared with the results from Shield and colleagues, the GBD study estimated a lower alcohol-attributable burden in Eastern Europe by 252 770 alcohol-attributable deaths (45.2% difference) and 6.1 million alcohol-attributable DALYs lost (32.9% difference) and in Western sub-Saharan Africa by 124 200 alcohol-attributable deaths (55.7% difference) and 7.0 million alcohol-attributable DALYs lost (63.4% difference), and estimated a higher alcohol-attributable burden in East Asia by 227 100 alcohol-attributable deaths (48.0% difference) and 2.2 million DALYs lost (11.0% difference). With regard to the cause of disease or injury, Shield and colleagues attributed an overall detrimental effect to alcohol on ischaemic heart disease mortality, whereas the GBD study attributed a net beneficial effect. The GBD study, as compared with Shield and colleagues' study, estimated a lower alcohol-attributable mortality because of liver cirrhosis and injuries by 262 500 (44.6% difference) and 398 800 (46.2% difference), respectively.
Differences in estimates of the alcohol-attributable burden of disease in two recent studies indicate the need to improve the accuracy of underlying data and risk relations to obtain more consistent estimates and to formulate, advocate for, and implement alcohol policies more effectively.
系统比较 Shield 及其同事在最近的研究中对 2016 年归因于酒精的死亡率和疾病负担的估计，以及 2017 年全球疾病负担研究（GBD）的结果。
本研究比较了 2016 年归因于酒精的死亡率和残疾调整生命年（DALY）损失的估计值，比较了绝对差异和相对差异、区域差异以及疾病或伤害原因的差异。本研究报告了两个研究之间的相对差异为百分比（%）差异。差异超过 10%被认为是有意义的。
这两项研究估计了 2016 年全球范围内总体归因于酒精的死亡率水平相似（Shield 及其同事估计的归因于酒精的死亡率比 GBD 研究高 5.1%），但归因于酒精的 DALY 损失不同（相差 18.3%）。区域和疾病或伤害原因存在明显差异。与 Shield 及其同事的结果相比，GBD 研究估计东欧的酒精负担较低，归因于酒精的死亡人数减少 252770 人（相差 45.2%），归因于酒精的 DALY 损失减少 610 万人（相差 32.9%），在西非撒哈拉以南地区减少 124200 人（相差 55.7%）和 700 万人归因于酒精的 DALY 损失（相差 63.4%），东亚归因于酒精的死亡人数增加 227100 人（相差 48.0%）和 220 万人归因于酒精的 DALY 损失（相差 11.0%）。就疾病或伤害的原因而言，Shield 及其同事认为酒精对缺血性心脏病死亡率有总体的不利影响，而 GBD 研究则认为有净有利影响。与 Shield 和同事的研究相比，GBD 研究估计由于肝硬化和损伤导致的归因于酒精的死亡率分别减少了 262500 人（相差 44.6%）和 398800 人（相差 46.2%）。
两项最近研究中对与酒精相关的疾病负担的估计差异表明，需要提高基础数据和风险关系的准确性，以获得更一致的估计值，并更有效地制定、倡导和实施酒精政策。
