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Meta-Analysis
. 2009 Jul 6;10(4):387-92.

Alcohol as a risk factor for pancreatitis. A systematic review and meta-analysis

Hyacinth M Irving  1 , Andriy V Samokhvalov, Jürgen Rehm
Affiliations
Meta-Analysis

Alcohol as a risk factor for pancreatitis. A systematic review and meta-analysis

Hyacinth M Irving et al. JOP. .

Abstract

Context: Epidemiologic studies have suggested an association between alcohol consumption and pancreatitis, although the exact dose-response relationship is unknown. It also remains uncertain whether a threshold effect exists.

Objective: To conduct a systematic review and meta-analysis of epidemiologic studies on the association between alcohol consumption and the risk of pancreatitis.

Methods: We searched Ovid MEDLINE, EMBASE, CINAHL, Web of Science, ETOH and AIM. Studies were included if they reported quantifiable information on risk and related confidence intervals with respect to at least three different levels of alcohol intake.

Results: Six studies, including 146,517 individuals with 1,671 cases of pancreatitis, met the inclusion criteria. We found a monotonic and approximately exponential dose-response relationship between average volume of alcohol consumption and pancreatitis. However, in a categorical analysis the lower drinking categories were not significantly elevated, with an apparent threshold of 4 drinks daily.

Conclusions: As the available evidence also indicates that the relationship is biologically plausible, these results support the existence of a link between alcohol consumption and the risk of pancreatitis.

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Figures

Figure 1
Figure 1
Forest plot of individual studies based on one drink (12 grams) daily.
Figure 2
Figure 2
Dose-response relationship between alcohol consumption and risk of pancreatitis (continuous analysis using fractional polynomials). Reference category is non-drinkers; solid line represents the estimated relative risks and the dotted lines represent the 95% confidence intervals.
Figure 3
Figure 3
Relative risk of pancreatitis by alcohol exposure category (categorical analysis). Horizontal line represents the relative risk for the reference group, non-drinkers; vertical bars represent 95% confidence intervals; 1 drink = 12 grams.
Figure 4
Figure 4
Begg's funnel plot with pseudo 95% confidence limits. Funnel plot shows the relative risks (for 12 g/day) on a natural logarithm scale on its standard error for the six studies included in the meta-analysis. The horizontal line represents the summary estimate of relative risks and the diagonal lines indicate the expected 95% confidence intervals for a given standard error.
See this image and copyright information in PMC

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