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
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
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
ARTICLE HIGHLIGHTS
Research 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.
Research motivation
Recurrent urinary tract infections and smoking have been the only risk factors that have been found to be consistently associated with PBC development. However, these environmental factors combined appear insufficient to explain the pathogenesis, and it is likely that other environmental factors play a role in disease onset.
Research objectives
To analyze environmental factors such as smoking, marijuana and alcohol use, and the role they play in PBC development.
Research methods
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. The associations of alcohol intake with case status were evaluated by conditional logistic regression, estimating an odds ratio.
Research results
For PBC development 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. Smoking was associated with PBC, with a stronger association with a longer duration of smoking while there was no association between marijuana use and PBC.
Research conclusions
Our study found that alcohol intake may be associated with a reduced risk of PBC, an important finding for a disease with few established risk factors.
Research perspectives
The association of alcohol and risk reduction of PBC requires replication in other PBC studies, preferably in cohort studies where the exposure is measured prior to disease onset.
