How stable is the risk curve between alcohol and all-cause mortality and what factors influence the shape? A precision-weighted hierarchical meta-analysis

被引:126
作者
Gmel, G
Gutjahr, E
Rehm, J
机构
[1] Swiss Inst Prevent Alcohol & Drug Problems, CH-1003 Lausanne, Switzerland
[2] Res Inst Addict, Zurich, Switzerland
[3] Ctr Addict & Mental Hlth, Toronto, ON, Canada
[4] Univ Toronto, Dept Publ Hlth Sci, Toronto, ON, Canada
关键词
alcohol; all-cause mortality; average consumption; ex-drinker; gender; heavy drinking occasions; hierarchical meta-analysis; pooled analysis;
D O I
10.1023/A:1024805021504
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective: To determine the influence of six determining variables on the shape of the risk curve between alcohol and all-cause mortality. Methods: Data: Based on a systematic search with clear inclusion criteria, all articles on alcohol and all-cause mortality until 2000 were included. Statistical methods: Precision-weighted pooling of relative risks (RRs); precision-weighted hierarchical analysis. Variables: For pooling: RRs for different categories of average volume of drinking, lifetime abstainers and ex-drinkers. For hierarchical analysis: on first level: consumption in grams of pure alcohol per day; on second level: length of follow-up time in months; per capita consumption; average age, proportion of abstainers, average volume of drinking, and variability of average volume of drinking at baseline. Outcomes measures: RR of former and current drinkers for all-cause mortality compared to abstainers. Results: The main hypotheses could be confirmed for males: Ex-drinkers had a higher mortality risk than lifetime abstainers; the higher and the more diverse the average volume of alcohol consumption, the wider the dip of the curve; the older the persons at baseline, the more pronounced the protective effect; and the longer the follow-up time, the less pronounced the protective effect. Except for average volume of drinking effects for females went in the same direction but with one exception did not reach significance. Conclusions: There are systematic influences on the shape of the risk curve between alcohol and all-cause mortality. The overall beneficial effect of light to moderate drinking remained under all scenarios, indicating a high validity of the overall shape despite the heterogeneity between studies.
引用
收藏
页码:631 / 642
页数:12
相关论文
共 85 条
[1]  
Andreasson S, 1997, ALCOHOL ALCOHOLISM, V32, P173
[2]  
[Anonymous], 2000, International guide for monitoring alcohol consumption and related harm
[3]  
[Anonymous], 1999, GLOB STAT REP ALC
[4]  
[Anonymous], SUBSTANCE ABUSE, DOI DOI 10.1080/08897070109511443
[5]  
ASHLEY MJ, 2000, 10 US DEP HLTH HUM S
[6]   ALCOHOL AND MORTALITY - HONOLULU HEART-STUDY [J].
BLACKWELDER, WC ;
YANO, K ;
RHOADS, GG ;
KAGAN, A ;
GORDON, T ;
PALESCH, Y .
AMERICAN JOURNAL OF MEDICINE, 1980, 68 (02) :164-169
[7]  
Boffetta P, 1990, Epidemiology, V1, P342, DOI 10.1097/00001648-199009000-00003
[8]   The association between alcohol consumption and all-cause mortality in a cohort of male employees in the German construction industry [J].
Brenner, H ;
Arndt, V ;
Rothenbacher, D ;
Schuberth, S ;
Fraisse, E ;
Fliedner, TM .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 1997, 26 (01) :85-91
[9]  
Byrk A, 1992, HIERARCHICAL LINEAR
[10]   ALCOHOL-CONSUMPTION AND MORTALITY IN ALAMEDA COUNTY [J].
CAMACHO, TC ;
KAPLAN, GA ;
COHEN, RD .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (03) :229-236