中国全科医学2024，Vol.27Issue(26) ：3304-3311.DOI:10.12114/j.issn.1007-9572.2024.0043

酒精摄入与脑卒中发病风险的剂量反应Meta分析

Alcohol Intake and Risk of Stroke:a Dose-response Meta-analysis

韩雪梅 赵春善 梅春丽 陈丹
中国全科医学2024，Vol.27Issue(26) ：3304-3311.DOI:10.12114/j.issn.1007-9572.2024.0043
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酒精摄入与脑卒中发病风险的剂量反应Meta分析

Alcohol Intake and Risk of Stroke:a Dose-response Meta-analysis

韩雪梅 1赵春善 1梅春丽 1陈丹2
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作者信息

  • 1. 132013 吉林省吉林市,北华大学护理学院
  • 2. 132011 吉林省吉林市中心医院神经内科
  • 折叠

摘要

背景 脑卒中作为一种重大慢性非传染性疾病严重影响国民健康,给患者、家庭和社会造成沉重负担.饮酒现象在我国普遍存在,酒精摄入与脑卒中发病之间存在密切关系,但酒精摄入剂量和脑卒中发病关系仍存有争议.目的 探讨酒精摄入量与脑卒中发病风险的关系.方法 计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、维普网、万方数据知识服务平台和中国生物医学文献数据库,收集关于酒精与脑卒中发病风险的前瞻性队列研究,检索时限均为建库至 2023 年 12 月.文献筛选、数据提取、文献质量评价由 2 位研究者独立进行.应用Stata/MP 17.0软件进行剂量反应Meta分析.结果 共纳入16篇文献,共548 595例研究对象.Meta分析结果显示,酒精摄入与脑卒中发病风险相关(RR=1.17,95%CI=1.10～1.26,P＜0.05).亚组分析结果,每天酒精摄入＜20 g脑卒中发病风险降低 10%(RR=0.90,95%CI=0.85～0.95,P＜0.05);酒精摄入＞40 g脑卒中发病风险增加 35%(RR=1.35,95%CI=1.23～1.49,P＜0.05);酒精摄入出血性脑卒中风险增加 49%(RR=1.49,95%CI=1.14～1.95,P＜0.05),酒精摄入缺血性脑卒中风险增加 20%(RR=1.20,95%CI=1.00～1.43,P＜0.05);亚洲人群酒精摄入脑卒中发病风险增加27%(RR=1.27,95%CI=1.14～1.40,P＜0.05);男性酒精摄入脑卒中风险增加 19%(RR=1.19,95%CI=1.09～1.29,P＜0.05).剂量反应Meta分析结果,酒精摄入与脑卒中发病风险之间呈J型非线性关系(P=0.018),与从不饮酒者相比,饮酒者摄入酒精剂量的脑卒中相对风险比分别为1 g/d:RR=0.97,95%CI=0.96～0.98;2 g/d:RR=0.96,95%CI=0.94～0.97;3 g/d:RR=0.95,95%CI=0.93～0.97;4 g/d:RR=0.94,95%CI=0.91～0.96;5 g/d:RR=0.91,95%CI=0.88～0.94;6 g/d:RR=0.90,95%CI=0.86～0.93;7 g/d:RR=0.88,95%CI=0.84～0.92;8 g/d:RR=0.88,95%CI=0.83～0.92;9 g/d:RR=0.88,95%CI=0.83～0.92;10 g/d:RR=0.88,95%CI=0.83～0.93;11 g/d:RR=0.88,95%CI=0.83～0.93;12 g/d:RR=0.90,95%CI=0.85～0.95;13 g/d:RR=0.91,95%CI=0.85～0.95;14 g/d:RR=0.92,95%CI=0.86～0.95;15 g/d:RR=0.93,95%CI=0.86～0.96;16 g/d:RR=0.95,95%CI=0.88～0.96;17 g/d:RR=0.96,95%CI=0.88～0.97;18 g/d:RR=0.98,95%CI=0.89～0.97;19 g/d:RR=0.98,95%CI=0.89～0.98;20 g/d:RR=0.99,95%CI=0.90～0.99.饮酒者平均每天酒精摄入量＜20 g表现为脑卒中发病风险降低(P＜0.001).结论 酒精摄入量与脑卒中风险间具有J型非线性的剂量反应关系,适量酒精摄入与脑卒中风险呈负相关,平均每天酒精摄入7～11 g时脑卒中风险最低.

Abstract

Background Stroke,as a major chronic non-communicable disease,seriously affects the health of the nation and imposes a heavy burden on patients,families and society.Alcohol consumption is common in China,and there is a close relationship between alcohol intake and stroke incidence,but the relationship between alcohol intake and stroke incidence is still controversial.Objective To investigate the relationship between alcohol intake and risk of stroke.Methods PubMed,Web of Science,Cochrane Library,Embase,CNKI,VIP,Wanfang Data,and SinoMed were searched for prospective cohort studies on the relationship between alcohol intake and risk of stroke from inception to December 2023.Literature screening,data extraction,and literature quality evaluation were performed independently by 2 researchers.Stata/MP 17.0 was used for dose-response meta-analysis.Results A total of 16 papers with 548 595 study subjects were included.Meta-analysis results showed that alcohol intake was associated with the risk of stroke(RR=1.17,95%CI=1.10-1.26,P＜0.05).The results of the subgroup analysis showed that the risk of stroke was increased by 10%for alcohol intake＜20 g per day(RR=0.90,95%CI=0.85-0.95,P＜0.05);alcohol intake＞40 g increased the risk of stroke by 35%(RR=1.35,95%CI=1.23-1.49,P＜0.05);alcohol intake increased the risk of hemorrhagic stroke by 49%(RR=1.49,95%CI=1.14-1.95,P＜0.05),alcohol intake ischemic stroke risk increased by 20%(RR=1.20,95%CI=1.00-1.43,P＜0.05);alcohol intake in Asian populations increased the risk of stroke incidence by 27%(RR=1.27,95%CI=1.14-1.40,P＜0.05);intake alcohol in men increased the risk of stroke by 19%(RR=1.19,95%CI=1.09-1.29,P＜0.05).Dose-response Meta-analysis showed a J-shaped nonlinear relationship between alcohol intake and risk of stroke(P=0.018),and the relative risk ratios of stroke for alcohol intake in drinkers compared with never-drinkers were 1 g/d:RR=0.97,95%CI=0.96-0.98;2 g/d:RR=0.96,95%CI=0.94-0.97;3 g/d:RR=0.95,95%CI=0.93-0.97;4 g/d:RR=0.94,95%CI=0.91-0.96;5 g/d:RR=0.91,95%CI=0.88-0.94;6 g/d:RR=0.90,95%CI=0.86-0.93;7 g/d:RR=0.88,95%CI=0.84-0.92;8 g/d:RR=0.88,95%CI=0.83-0.92;9 g/d:RR=0.88,95%CI=0.83-0.92;10 g/d:RR=0.88,95%CI=0.83-0.93;11 g/d:RR=0.88,95%CI=0.83-0.93;12 g/d:RR=0.90,95%CI=0.85-0.95;13 g/d:RR=0.91,95%CI=0.85-0.95;14 g/d:RR=0.92,95%CI=0.86-0.95;15 g/d:RR=0.93,95%CI=0.86-0.96;16 g/d:RR=0.95,95%CI=0.88-0.96;17 g/d:RR=0.96,95%CI=0.88-0.97;18 g/d:RR=0.98,95%CI=0.89-0.97;19 g/d:RR=0.98,95%CI=0.89-0.98;20 g/d:RR=0.99,95%CI=0.90-0.99,and drinkers with an average alcohol intake of＜20 g per day showed a reduced risk of stroke(P＜0.001).Conclusion There is a J-shaped nonlinear dose-response relationship between alcohol intake and the stroke risk,with moderate alcohol intake negatively associated with stroke risk.The risk of stroke is lowest with an average alcohol intake of 7-11 grams per day.

关键词

脑卒中/酒精/Meta分析/剂量反应/前瞻性研究

Key words

Stroke/Alcohol/Meta-analysis/Dose-response/Prospective study

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基金项目

吉林省科技发展计划(20190303171SF)

吉林市科技发展计划(20230406138)

出版年

2024
中国全科医学
中国医院协会

中国全科医学

CSTPCD北大核心
影响因子：2.04
ISSN：1007-9572
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