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Sankaranarayanan R, Saxlin T, Ylöstalo P, Khan S, Knuuttila M, Suominen AL. Alcohol use and periodontal pocket development: findings from a 4‐yr longitudinal study. Eur J Oral Sci 2019; 127:232-240. [DOI: 10.1111/eos.12610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Tuomas Saxlin
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
- Research Unit of Oral Health Sciences Medical Research Centre Oulu (MRC Oulu) University of Oulu Oulu Finland
| | - Pekka Ylöstalo
- Research Unit of Oral Health Sciences Medical Research Centre Oulu (MRC Oulu) University of Oulu Oulu Finland
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
| | - Sohaib Khan
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
| | - Anna L. Suominen
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
- Unit of Public Health Evaluation and Projection National Institute for Health and Welfare (THL) Helsinki Finland
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Singhrao SK, Olsen I. Assessing the role of Porphyromonas gingivalis in periodontitis to determine a causative relationship with Alzheimer's disease. J Oral Microbiol 2019; 11:1563405. [PMID: 30728914 PMCID: PMC6352933 DOI: 10.1080/20002297.2018.1563405] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/05/2018] [Accepted: 12/13/2018] [Indexed: 01/14/2023] Open
Abstract
Chronic periodontitis of 10 years' duration is reported to become a twofold risk factor for the development of Alzheimer's disease (AD). Periodontitis is modifiable, and this fits with the current action plan for preventing AD. However, until periodontitis, becomes acknowledged as a firm risk factor for AD, this risk will continue. Here, we put forward our own argument based on the current literature for in vivo infection-mediated periodontal disease models supporting the antimicrobial protection hypothesis of AD and interventional studies supporting the causal links. Oral infections with Porphyromonas gingivalis, or introduction of its lipopolysaccharide (LPS), in various mouse models has demonstrated the development of key neuropathological hallmark lesions defining AD. These are extracellular amyloid-beta plaques, phosphorylated tau, neurofibrillary tangles, widespread acute and chronic inflammation, blood-brain barrier defects together with the clinical phenotype showing impaired learning and spatial memory. Live P. gingivalis and its LPS (commercial or from 'microbullets') are powerful peripheral and intracerebral inflammatory signalling initiators, and this has direct implications on memory and lesion development. Maintaining a healthy oral microbiome and managing periodontal disease with regular surveillance and good oral hygiene throughout life is likely to reduce the unnecessary burden of AD in some individuals.
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Affiliation(s)
- Sim K Singhrao
- Dementia and Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Ingar Olsen
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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TEIXEIRA FCF, MARÍN-LEÓN L, GOMES EP, PEDRÃO AMN, PEREIRA ADC, FRANCISCO PMSB. Perda de inserção periodontal e associações com indicadores de risco sociodemográficos e comportamentais. REVISTA DE ODONTOLOGIA DA UNESP 2019. [DOI: 10.1590/1807-2577.09519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Introdução A perda de inserção clínica periodontal (PIP) tem sido indicada como parâmetro determinante para o estudo de indicadores de risco de periodontite crônica. Objetivo Descrever a prevalência, severidade e extensão de PIP em um grupo populacional que se abstém de álcool e tabaco, além de avaliar associações com características sociodemográficas e comportamentais dos participantes. Método Uma amostra de 420 indivíduos adultos, participantes do Estudo Advento (São Paulo), foi submetida ao exame periodontal de seis sítios por dente e respondeu um questionário estruturado. As associações foram verificadas por meio de análise de regressão logística múltipla. Resultado A prevalência de periodontite foi de 20,7% e de gengivite, 38,8%; a PIP média foi de 1,38 mm (± 0,5) e a perda dental, 5,4 (± 9,0). A prevalência de PIP ≥ 3 mm, ≥ 4 mm e ≥ 6 mm foi de 69,7%, 31,7% e 9,6% dos indivíduos, e 11,4%, 4,4% e 1,2% dos dentes por indivíduo, respectivamente. Houve associação significativa de PIP ≥ 4 mm com sexo masculino, idade superior a 55 anos, baixa escolaridade, placa visível, autocuidado irregular, falta de orientação em higiene bucal e doença sistêmica referida. Para PIP ≥ 6 mm, foi observada maior razão de chances para as variáveis idade e doença sistêmica. Conclusão O grupo populacional estudado apresentou baixa extensão e severidade de PIP, possivelmente pelas características da amostra. As associações de risco encontradas confirmam a necessidade de atenção integral ao paciente, incluindo o incentivo à prevenção e ao controle de doenças crônicas, ao lado de orientações específicas para higiene bucal.
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Bonner M, Fresno M, Gironès N, Guillén N, Santi-Rocca J. Reassessing the Role of Entamoeba gingivalis in Periodontitis. Front Cell Infect Microbiol 2018; 8:379. [PMID: 30420943 PMCID: PMC6215854 DOI: 10.3389/fcimb.2018.00379] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/08/2018] [Indexed: 12/19/2022] Open
Abstract
The protozoan Entamoeba gingivalis resides in the oral cavity and is frequently observed in the periodontal pockets of humans and pets. This species of Entamoeba is closely related to the human pathogen Entamoeba histolytica, the agent of amoebiasis. Although E. gingivalis is highly enriched in people with periodontitis (a disease in which inflammation and bone loss correlate with changes in the microbial flora), the potential role of this protozoan in oral infectious diseases is not known. Periodontitis affects half the adult population in the world, eventually leads to edentulism, and has been linked to other pathologies, like diabetes and cardiovascular diseases. As aging is a risk factor for the disorder, it is considered an inevitable physiological process, even though it can be prevented and cured. However, the impact of periodontitis on the patient's health and quality of life, as well as its economic burden, are underestimated. Commonly accepted models explain the progression from health to gingivitis and then periodontitis by a gradual change in the identity and proportion of bacterial microorganisms in the gingival crevices. Though not pathognomonic, inflammation is always present in periodontitis. The recruitment of leukocytes to inflamed gums and their passage to the periodontal pocket lumen are speculated to fuel both tissue destruction and the development of the flora. The individual contribution to the disease of each bacterial species is difficult to establish and the eventual role of protozoa in the fate of this disease has been ignored. Following recent scientific findings, we discuss the relevance of these data and propose that the status of E. gingivalis be reconsidered as a potential pathogen contributing to periodontitis.
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Affiliation(s)
- Mark Bonner
- International Institute of Periodontology Victoriaville, QC, Canada
| | - Manuel Fresno
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Madrid, Spain
| | - Núria Gironès
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Madrid, Spain
| | - Nancy Guillén
- Institut Pasteur, Paris, France.,Centre National de la Recherche Scientifique, CNRS-ERL9195, Paris, France
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Ryder MI, Couch ET, Chaffee BW. Personalized periodontal treatment for the tobacco- and alcohol-using patient. Periodontol 2000 2018; 78:30-46. [PMID: 30198132 PMCID: PMC6132065 DOI: 10.1111/prd.12229] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The use of various forms of tobacco is one of the most important preventable risk factors for the incidence and progression of periodontal disease. Tobacco use negatively affects treatment outcomes for both periodontal diseases and conditions, and for dental implants. Tobacco-cessation programs can mitigate these adverse dental treatment outcomes and may be the most effective component of a personalized periodontal treatment approach. In addition, heavy alcohol consumption may exacerbate the adverse effects of tobacco use. In this review, the microbiology, host/inflammatory responses and genetic characteristics of the tobacco-using patient are presented as a framework to aid the practitioner in developing personalized treatment strategies for these patients. These personalized approaches can be used for patients who use a variety of tobacco products, including cigarettes, cigars, pipes, smokeless tobacco products, e-cigarettes and other tobacco forms, as well as patients who consume large amounts of alcohol. In addition, principles for developing personalized tobacco-cessation programs, using both traditional and newer motivational and pharmacological approaches, are presented.
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Affiliation(s)
- Mark I Ryder
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, CA, USA
| | - Elizabeth T Couch
- Department or Preventive and Restorative Sciences, School of Dentistry, University of California, San Francisco, CA, USA
| | - Benjamin W Chaffee
- Department or Preventive and Restorative Sciences, School of Dentistry, University of California, San Francisco, CA, USA
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Pinto-Filho JM, Ribeiro LSF, Sartori L, Dos Santos JN, Ramalho LMP, Cury PR. Association between alcohol dependence and both periodontal disease and tooth loss: a cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:29089-29095. [PMID: 30112640 DOI: 10.1007/s11356-018-2807-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
The impact of alcohol consumption on periodontal disease and tooth loss is still under debate. The aim of this cross-sectional study was to evaluate the association between alcohol dependence and both periodontal diseases and tooth loss in Brazilian native Indians. Full mouth periodontal examination was performed and tooth loss was clinically evaluated in a representative sample of 225 Indians (≥ 19 years). Sociodemographic, oral health-related data, and alcohol dependence were evaluated using structured questionnaires. The subjects were categorized as either alcohol-dependent or non-dependent according to the Alcohol Use Disorders Identification Test results. Severe periodontal disease was defined in individuals with ≥ 2 proximal sites with a clinical attachment level ≥ 6 mm, not on the same tooth, and ≥ 1 proximal site with a probing depth ≥ 5 mm. Tooth loss was categorized as one or more missing teeth, or no missing teeth. Bivariate models followed by logistic regression were used to assess the association between alcohol dependence and both periodontal disease and tooth loss. Prevalence ratio (PR) was calculated using Mantel-Haenszel analysis. Alcohol dependence increased 2.5 times the risk for tooth loss (prevalence ratio [PR] =2.49, 95% confidence interval [CI] = 1.01-9.04, p = 0.05). Severe periodontal disease was not associated with alcohol dependence (OR = 0.54, 95% CI = 0.22-1.31, p = 0.23). In conclusion, alcohol dependence was associated with tooth loss in the present population, but severe periodontal disease was not. Questions on alcohol dependence should be included in dental anamnesis questionnaires, and patients diagnosed with alcohol dependence should be referred for dental evaluation.
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Affiliation(s)
- Jorge M Pinto-Filho
- Postgraduate Program in Health and Dentistry, School of Dentistry, Av. Araújo Pinho, 62. Canela, Salvador, Bahia, 40110-150, Brazil
| | - Lívia S F Ribeiro
- Postgraduate Program in Health and Dentistry, School of Dentistry, Av. Araújo Pinho, 62. Canela, Salvador, Bahia, 40110-150, Brazil
| | - Luiza Sartori
- Postgraduate Program in Health and Dentistry, School of Dentistry, Av. Araújo Pinho, 62. Canela, Salvador, Bahia, 40110-150, Brazil
| | - Jean N Dos Santos
- Postgraduate Program in Health and Dentistry, School of Dentistry, Av. Araújo Pinho, 62. Canela, Salvador, Bahia, 40110-150, Brazil
| | - Luciana M P Ramalho
- Postgraduate Program in Health and Dentistry, School of Dentistry, Av. Araújo Pinho, 62. Canela, Salvador, Bahia, 40110-150, Brazil
| | - Patricia R Cury
- Postgraduate Program in Health and Dentistry, School of Dentistry, Av. Araújo Pinho, 62. Canela, Salvador, Bahia, 40110-150, Brazil.
- Faculdade de Odontologia, Federal University of Bahia, Av. Araújo Pinho, 62. Canela, Salvador, Bahia, 40110-150, Brazil.
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Stress, salivary cortisol and periodontitis: A systematic review and meta-analysis of observational studies. Arch Oral Biol 2018; 96:58-65. [PMID: 30189327 DOI: 10.1016/j.archoralbio.2018.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/21/2018] [Accepted: 08/27/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This meta-analysis aims to systematically assess whether periodontitis has a meaningful effect on salivary cortisol, reflecting changes on free blood cortisol levels. DESIGN The Cochrane Handbook and the PRISMA statement were used as reporting guidelines. The MEDLINE-PubMed, Google Scholar, EMBASE, and CENTRAL databases were searched until September 2017 to identify eligible studies, screened by seven independent authors and verified by an eighth. Studies comparing salivary cortisol level of periodontitis cases to controls were included. Data were extracted using a predefined table and since all papers were non-randomized clinical trials they were appraised using Downs and Black tool. DerSimonian random effects meta-analysis was performed using OpenMetaAnalyst. RESULTS Six cross-sectional studies were included, with 258 participants with chronic periodontitis and 72 with aggressive periodontitis, in a total of 573 participants. Overall results showed that aggressive periodontitis patients have, on average, 53% higher salivary cortisol levels than healthy controls 1.53 (1.11-2.12). Meta-regression exploring the relationship among salivary cortisol levels and periodontal measures, i.e., periodontitis severity, showed a global neutral effect, although this result requires future confirmation due to the low power of the model. CONCLUSION Observational studies results suggest that subjects with aggressive periodontitis have higher salivary cortisol levels than healthy ones or patients with chronic periodontitis. Such salivary cortisol response difference may have a negative impact on the periodontium, contributing to worse the burden of aggressive periodontitis disease. In the future, wide and well-designed longitudinal studies should be carried out in order to extensively confirm this possible effect, considering the complex nature of periodontitis and its many confounders factors that may contribute to this outcome.
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Machado V, Botelho J, Amaral A, Proença L, Alves R, Rua J, Cavacas MA, Delgado AS, Mendes JJ. Prevalence and extent of chronic periodontitis and its risk factors in a Portuguese subpopulation: a retrospective cross-sectional study and analysis of Clinical Attachment Loss. PeerJ 2018; 6:e5258. [PMID: 30065871 PMCID: PMC6063205 DOI: 10.7717/peerj.5258] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 06/28/2018] [Indexed: 12/30/2022] Open
Abstract
Objectives To assess the prevalence and extent of chronic periodontitis, and its risk factors in a Portuguese subpopulation referred to periodontal examination. Methods This retrospective cross-sectional study used a subset of data from patients who sought dental treatment in a university dental clinic in the Lisbon metropolitan area. The sample consisted of 405 individuals (225 females/180 males), aged 20–90 years. All patients underwent a full-mouth periodontal examination and chronic periodontitis was defined as Clinical Attachment Loss (CAL) ≥ 3 mm affecting two or more teeth. Aggressive periodontitis cases were excluded from the analysis. Results Prevalence of chronic periodontitis was 83.5% (95% CI [80.4–86.6%]). For these subjects, CAL ≥ 3 mm affected 86.0% (95% CI [84.7–87.2]) of sites and 83.7% (95% CI [81.7–85.6]) of teeth, respectively. Mean CAL ranged from 3.6 to 4.3 mm, according to age. In the multivariate logistic regression model, smoking (OR = 3.55, 95% CI [1.80–7.02]) and older age (OR = 8.70, 95% CI [3.66–20.69] and OR = 4.85, 95% CI [2.57–9.16]), for 65+ and 45–64 years old, respectively, were identified as risk indicators for CAL ≥ 3 mm. Conclusions This particular Portuguese adult subpopulation had a high prevalence of chronic periodontitis, with severe and generalized clinical attachment loss, and its presence was significantly associated with age and smoking. This data should serve to prepare future detailed epidemiological studies and appropriate public health programs.
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Affiliation(s)
- Vanessa Machado
- Department of Periodontology, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal.,Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
| | - João Botelho
- Department of Periodontology, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal.,Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
| | - António Amaral
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
| | - Luís Proença
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
| | - Ricardo Alves
- Department of Periodontology, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal.,Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
| | - João Rua
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
| | - Maria Alzira Cavacas
- Environmental Health, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
| | - Ana Sintra Delgado
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
| | - José João Mendes
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
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Wagner MC, Haas AN, Oppermann RV, Rosing CK, Albandar JM, Susin C. Effect of Alcohol Consumption on Clinical Attachment Loss Progression in an Urban Population From South Brazil: A 5-Year Longitudinal Study. J Periodontol 2017; 88:1271-1280. [DOI: 10.1902/jop.2017.170231] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Marcius C. Wagner
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alex N. Haas
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rui V. Oppermann
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cassiano K. Rosing
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jasim M. Albandar
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA
| | - Cristiano Susin
- Department of Periodontology, Dental College of Georgia, Augusta University, Augusta, GA
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Nascimento GG, Leite FRM, Scheutz F, López R. Periodontitis: from Infection to Inflammation. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s40496-017-0158-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Wellapuli N, Ekanayake L. Risk factors for chronic periodontitis in Sri Lankan adults: a population based case-control study. BMC Res Notes 2017; 10:460. [PMID: 28882173 PMCID: PMC5590132 DOI: 10.1186/s13104-017-2778-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 08/31/2017] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To determine risk factors for chronic periodontitis in 30-60 year olds in Sri Lanka. Cases and controls for this population based unmatched case-control study were identified from a broader cross-sectional study which was conducted to determine the prevalence of chronic periodontitis in 30-60 year old adults in Colombo district Sri Lanka. The study included 694 cases and 706 controls. Data were collected by means of a pre-tested interviewer administered questionnaire to obtain information about socio-demographic and behavioural factors, a physical examination to record anthropometric measurements and an oral examination. RESULTS Being a male, a Muslim, belonging to the 45-60 year old age group, having less than 12 years of education, using the finger to clean teeth, current smoking, current betel quid chewing, self-reported diabetes and hypertension emerged as risk factors for chronic periodontitis. CONCLUSIONS Several socio-demographic and behavioural factors as well as co-morbid conditions emerged as independent risk factors for chronic periodontits in this population. The findings could be used for planning programmes to reduce the burden of chronic periodontits in Colombo district Sri Lanka.
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Affiliation(s)
- Nimali Wellapuli
- Ministry of Health, Nutrition and Indigenous Medicine, Colombo, Sri Lanka
| | - Lilani Ekanayake
- Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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Abstract
Epidemiology studies have been carried out to investigate the association between alcohol consumption and the risk of gallstone disease, but the results remain controversial. We carried out a meta-analysis to quantitatively summarize the evidences from observational studies on alcohol consumption and the risk of gallstone disease. Eligible studies published in English were identified by searching PubMed, Web of Science, and Embase databases. The random-effect model was used to calculate the pooled relative risks (RRs) with 95% confidence intervals (CIs). Restricted cubic splines were used to assess the dose-response relationship. Eight cohort studies and 10 case-control studies were included in our meta-analysis. The pooled RR of gallstone disease for the highest versus the lowest alcohol consumption was 0.62 (95% CI: 0.49-0.78). Statistically significant associations were also found in stratified analysis by study design (cohort studies: RR=0.66, 95% CI: 0.48-0.91 and case-control studies: RR=0.58, 95% CI: 0.45-0.73). With respect to sex, both men (RR=0.57, 95% CI: 0.4-0.8) and women (RR=0.64, 95% CI: 0.53-0.77) showed statistically significant associations between alcohol consumption and the risk of gallstone disease. A linear dose-response relationship was found between alcohol consumption and gallstone disease risk and the risk of gallstone disease decreased by 12% (RR=0.88, 95% CI: 0.84-0.92; Pnonlinearity=0.079) for each 10 g/day increment in alcohol consumption. This meta-analysis suggests that alcohol consumption is associated with significantly decreased risk of gallstone disease.
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