Résumé :
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[BDSP. Notice produite par INIST-CNRS UY7XeR0x. Diffusion soumise à autorisation]. Objective : To determine the influence of six determining variables on the shape of the risk curve between alcohol and all-cause mortality. Methods : Data : Based on a systematic search with clear inclusion criteria, all articles on alcohol and all-cause mortality until 2000 were included. Statistical methods : Precision-weighted pooling of relative risks (RRs) ; precision-weighted hierarchical analysis. Variables : For pooling : RRs for different categories of average volume of drinking, lifetime abstainers and ex-drinkers. For hierarchical analysis : on first level : consumption in grams of pure alcohol per day ; on second level : length of follow-up time in months ; per capita consumption ; average age, proportion of abstainers, average volume of drinking, and variability of average volume of drinking at baseline. Outcomes measures : RR of former and current drinkers for all-cause mortality compared to abstainers. Results : The main hypotheses could be confirmed for males : Ex-drinkers had a higher mortality risk than lifetime abstainers ; the higher and the more diverse the average volume of alcohol consumption, the wider the dip of the curve ; the older the persons at baseline, the more pronounced the protective effect ; and the longer the follow-up time, the less pronounced the protective effect. Except for average volume of drinking effects for females went in the same direction but with one exception did not reach significance. Conclusions : There are systematic influences on the shape of the risk curve between alcohol and all-cause mortality. The overall beneficial effect of light to moderate drinking remained under all scenarios, indicating a high validity of the overall shape despite the heterogeneity between studies.
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