Sex-specific association between alcohol consumption and liver cirrhosis: An updated systematic review and meta-analysis - PubMed (original) (raw)

Sex-specific association between alcohol consumption and liver cirrhosis: An updated systematic review and meta-analysis

Laura Llamosas-Falcón et al. Front Gastroenterol (Lausanne). 2022.

Abstract

Different studies have shown that females develop liver diseases at lower levels of alcohol consumption than males. Our aim was to quantify the dose-response relationship between alcohol consumption and the risk of liver cirrhosis by sex and identify the differences between females and males. A systematic review was conducted using PubMed/Medline and Embase to identify longitudinal and case-control studies that analyzed the relationship between the level of alcohol use and liver cirrhosis (LC) incidence, and mortality (ICD-8 and ICD-9 codes 571 and ICD-10 codes K70, K73, K74). Pooled relative risks (RR) were calculated by random effects models. Restricted cubic splines were used to model the dose-response relationship. A total of 24 studies were included in the analysis. There were collectively 2,112,476 females and 924,853 males, and a total of 4,301 and 4,231 cases of LC for females and males, respectively. We identified a non-linear dose-response relationship. Females showed a higher risk for LC compared to males with the same amount of alcohol consumed daily. For instance, drinking 40 g/day showed RRs of 9.35 (95% CI 7.64-11.45) in females and 2.82 (95% CI 2.53-3.14) in males, while drinking 80 g/day presented RRs of 23.32 (95% CI 18.24-29.82) in females and 7.93 (95% CI 7.12-8.83) in males. Additional analyses showed that a higher risk for females was found for morbidity and for mortality. Understanding the influence of sex on the association of alcohol consumption and the risk of LC is needed to develop recommendations and clinical guidelines for prevention and treatment.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display\_record.php?ID=CRD42022299680, identifier CRD42022299680.

Keywords: alcohol; epidemiology; liver cirrhosis; meta-analysis; systematic review.

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Conflict of interest statement

Conflict of interest Author AL reported grants from Swiss National Science Foundation (SNSF) during the conduct of the study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1

FIGURE 1

Flow-chart of the study selection process.

FIGURE 2

FIGURE 2

Dose-response curve between alcohol intake in grams per day and the risk of liver cirrhosis by sex.

FIGURE 3

FIGURE 3

Dose-response curve between alcohol intake in grams per day and the risk of liver cirrhosis by outcome (A. Liver cirrhosis morbidity, B. Liver cirrhosis mortality) and by sex.

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