The relationship between different dimensions of alcohol use and the burden of disease—an update

作者：Jürgen Rehm, Gerhard Gmel, Gerrit Gmel, Omer S. M. Hasan, Sameer Imtiaz, Svetlana Popova, Charlotte Probst, Michael Roerecke, Robin Room, Andriy V. Samokhvalov, Kevin D. Shield, Paul A. Shuper · 发表于：Addiction · 年份：2017 · DOI：10.1111/add.13757 · 被引用次数：1237 · 研究领域：Alcohol Consumption and Health Effects、Substance Abuse Treatment and Outcomes、Alcoholism and Thiamine Deficiency

BACKGROUND AND AIMS: Alcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs). METHODS: Systematic review of reviews and meta-analyses on alcohol consumption and health outcomes attributable to alcohol use. For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others. RESULTS: In total, 255 reviews and meta-analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD-10 three-digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on addit...