By:Rehm, J (Rehm, Juergen)^{[ 1,2,3,4 ]} ; Taylor, B (Taylor, Benjamin)^{[ 1,2 ]} ; Mohapatra, S (Mohapatra, Satya)^{[ 1 ]} ; Irving, H (Irving, Hyacinth)^{[ 1 ]} ; Baliunas, D (Baliunas, Dolly)^{[ 1,2 ]} ; Patra, J (Patra, Jayadeep)^{[ 1 ]} ; Roerecke, M (Roerecke, Michael)^{[ 1,2 ]}

Introduction and Aims. Alcohol is an established risk factor for liver cirrhosis. It remains unclear, however, whether this relationship follows a continuous dose-response pattern or has a threshold. Also, the influences of sex and end-point (i.e. mortality vs. morbidity) on the association are not known. To address these questions and to provide a quantitative assessment of the association between alcohol intake and risk of liver cirrhosis, we conducted a systematic review and meta-analysis of cohort and case-control studies. Design and Methods. Studies were identified by a literature search of Ovid MEDLINE, EMBASE, Web of Science, CINAHL, PsychINFO, ETOH and Google Scholar from January 1980 to January 2008 and by searching the references of retrieved articles. Studies were included if quantifiable information on risk and related confidence intervals with respect to at least three different levels of average alcohol intake were reported. Both categorical and continuous meta-analytic techniques were used to model the dose-response relationship. Results. Seventeen studies met the inclusion criteria. We found some indications for threshold effects. Alcohol consumption had a significantly larger impact on mortality of liver cirrhosis compared with morbidity. Also, the same amount of average consumption was related to a higher risk of liver cirrhosis in women than in men. Discussion and Conclusions. Overall, end-point was an important source of heterogeneity among study results. This result has important implications not only for studies in which the burden of disease attributable to alcohol consumption is estimated, but also for prevention. [Rehm J, Taylor B, Mohapatra S, Irving H, Baliunas D, Patra J, Roerecke M. Alcohol as a risk factor for liver cirrhosis: A systematic review and meta-analysis. Drug Alcohol Rev 2010].

Author Keywords:alcohol; liver cirrhosis; mortality; morbidity; meta-analysis

KeyWords Plus:DOSE-RESPONSE DATA; DRINKING PATTERNS; ASCITIC CIRRHOSIS; TREND ESTIMATION; GLOBAL BURDEN; HARDLY EVER; CONSUMPTION; MORTALITY; DISEASE; WINE

Reprint Address: Rehm, J (reprint author)

Ctr Addict & Mental Hlth, 33 Russell St,Room 2035, Toronto, ON M5S 2S1, Canada.   Organization-Enhanced Name(s)     Centre for Addiction & Mental Health - Canada     University of Toronto

Addresses:

	[ 1 ] Ctr Addict & Mental Hlth, Toronto, ON M5S 2S1, Canada   Organization-Enhanced Name(s)     Centre for Addiction & Mental Health - Canada     University of Toronto
	[ 2 ] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada   Organization-Enhanced Name(s)     University of Toronto
	[ 3 ] Tech Univ Dresden, Dresden, Germany   Organization-Enhanced Name(s)     Dresden University of Technology
	[ 4 ] Univ Toronto, Dept Psychiat, Toronto, ON, Canada   Organization-Enhanced Name(s)     University of Toronto

E-mail Addresses:jtrehm@aol.com

WILEY-BLACKWELL, COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA

Research Areas:Substance Abuse

Web of Science Categories:Substance Abuse

Document Type:Review

Language:English

Accession Number: WOS:000279531600014

PubMed ID: 20636661

ISSN: 0959-5236

IDS Number: 620WH

Times Cited in Web of Science Core Collection: 111