French JA, Gow P, Simpson-Yap S, Collins K, Ng J, Angus PW, van der Mei IAF. Alcohol intake is associated with a decreased risk of developing primary biliary cholangitis. World J Hepatol 2022; 14(9): 1747-1756 [PMID: 36185715 DOI: 10.4254/wjh.v14.i9.1747]
Corresponding Author of This Article
Janine Adele French, MBBS, Doctor, Department of Gastroenterology, Austin Hospital, 145 Studley Road, PO Box 5555, Heidelberg 3084, VIC, Australia. janine.french@austin.org.au
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Control Study
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French JA, Gow P, Simpson-Yap S, Collins K, Ng J, Angus PW, van der Mei IAF. Alcohol intake is associated with a decreased risk of developing primary biliary cholangitis. World J Hepatol 2022; 14(9): 1747-1756 [PMID: 36185715 DOI: 10.4254/wjh.v14.i9.1747]
World J Hepatol. Sep 27, 2022; 14(9): 1747-1756 Published online Sep 27, 2022. doi: 10.4254/wjh.v14.i9.1747
Alcohol intake is associated with a decreased risk of developing primary biliary cholangitis
Janine Adele French, Paul Gow, Steven Simpson-Yap, Kate Collins, Justin Ng, Peter W Angus, Ingrid A F van der Mei
Janine Adele French, Paul Gow, Kate Collins, Justin Ng, Peter W Angus, Department of Gastroenterology, Austin Hospital, Heidelberg 3084, Australia
Steven Simpson-Yap, Melbourne School of Population and Global Health, University of Melbourne, Carlton 3053, Australia
Steven Simpson-Yap, Ingrid A F van der Mei, Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia
Author contributions: French JA, Gow P, Angus PW and van der Mei IAF conducted the research design; French JA conducted the data acquisition; French JA, Simpson-Yap S and van der Mei IAF conducted the data interpretation and all authors were involved with the manuscript preparation; French JA, Simpson-Yap S, Ng J, van der Mei IAF, Angus PW and Gow P approved the final submitted draft; Collins K assisted with submission; Nil other authors/institutions other than those listed were involved with this study; all authors have approved the final version of this manuscript, including the authorship list.
Institutional review board statement: Ethical clearance was obtained from the Austin Hospital’s Health Research and Ethics Committee (HREC 2013/04859) and it complies with acceptable international standards.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Dr. French reports grants from Orphan Australia, grants from Austin Medical Research Foundation, during the conduct of the study.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Corresponding author: Janine Adele French, MBBS, Doctor, Department of Gastroenterology, Austin Hospital, 145 Studley Road, PO Box 5555, Heidelberg 3084, VIC, Australia. janine.french@austin.org.au
Received: April 21, 2022 Peer-review started: April 21, 2022 First decision: May 31, 2022 Revised: June 13, 2022 Accepted: August 26, 2022 Article in press: August 26, 2022 Published online: September 27, 2022 Processing time: 154 Days and 13.6 Hours
Abstract
BACKGROUND
Primary biliary cholangitis (PBC) is a chronic progressive liver disease of unknown aetiology characterised by immune-mediated destruction of small and medium-sized intrahepatic bile ducts. There are few well-established risk factors and epidemiological studies are needed to further evaluate the pathogenesis of the disease.
AIM
To evaluate the relationship between alcohol intake, smoking and marijuana use with PBC development.
METHODS
We conducted a prevalent case control study of 200 cases and 200 age (within a five year age band) and sex-matched controls, identified from the Victorian PBC prevalence study. We assessed lifetime alcohol intake and smoking behaviour (both tobacco and marijuana) prior to PBC onset and used conditional logistic regression for analyses.
RESULTS
Alcohol intake consistently showed a dose-dependent inverse association with case status, and this was most substantial for 21-30 years and 31-40 years (Ptrend < 0.001). Smoking was associated with PBC, with a stronger association with a longer duration of smoking [e.g., adjusted OR 2.27 (95%CI: 1.12- 4.62) for those who had smoked for 20-35 years]. There was no association between marijuana use and PBC.
CONCLUSION
Alcohol appears to have an inverse relationship with PBC. Smoking has been confirmed as an environmental risk factor for PBC. There was no association between marijuana use and PBC.
Core Tip: Given the paucity of knowledge regarding the aetiology of this disease and that there are likely to be other environmental and lifestyle factors yet to be identified that are related to disease development, we designed this study to address the association of primary biliary cholangitis and lifestyle factors. We have identified, from a case control study, that alcohol intake is associated with a decreased risk of developing primary biliary cholangitis. This is a significant finding in a disease for which very little is known regarding its aetiology.
