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Alcohol intake and the risk of osteonecrosis of the femoral head in Japanese populations: a dose-response meta-analysis of case-control studies

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Abstract

Studies examining the association between alcohol intake and the risk of osteonecrosis of the femoral head (ONFH) have inconsistent results. The purpose of this study was to examine and summarize the evidence regarding the association between alcohol intake and ONFH based on results from case-control studies. This analysis included five case-control studies reporting data from 1251 individuals. Alcohol intake habits (never, former, or current), average drinking consumption (g/week), and cumulative drinking consumption (drink-years) were extracted. The risk of ONFH was evaluated, and a two-stage dose-response meta-analysis was performed using restricted cubic splines with four knots at fixed percentiles of 5, 35, 65, and 95% of the distribution. Former alcohol intake increased the risk of ONFH with a marginal significance (odds ratio [OR], 2.62; p = 0.055). Current alcohol intake was associated with an increased risk of ONFH (OR, 3.63; p < 0.001 in occasional drinkers, OR, 5.90; p < 0.001 in daily drinkers). The dose-response meta-analysis revealed that the risk of ONFH increased by 35.3% for every 100 g/week (95% confidence interval [CI], 1.24–1.47; p < 0.001) and by 44.1% for every 500 g drink-years (95% CI, 1.295–1.601; p < 0.001). Current intake and the dose of alcohol were positively associated with an increased risk of ONFH in a non-linear pattern.

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Author notes

  1. Byung-Ho Yoon and Tae-young Kim equally contributed to this work and are co-first authors.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, South Korea

    Byung-Ho Yoon

  2. Department of Orthopaedic Surgery, School of Medicine, Hallym University, Anyang, South Korea

    Tae-young Kim

  3. Department of Education, Jeonju University, Jeonju, South Korea

    In-Soo Shin

  4. Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam, South Korea

    Hee young Lee

  5. Department of Internal Medicine, Seoul National University Bundang Hospital and Medical College of Seoul National University, Seongnam, South Korea

    Yun Jong Lee

  6. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu KS009, Seongnam, 463707, South Korea

    Kyung-Hoi Koo

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Correspondence to Kyung-Hoi Koo.

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Electronic supplementary material

Online Resource 1

MOOSE checklist for meta-analyses of observational studies. (DOCX 22 kb)

Online Resource 2

The search strategy that details the searching process of relevant clinical study selection. (DOCX 207 kb)

Online Resource 3

Methodological quality assessment of included studies measured by Newcastle-Ottawa Scale (DOCX 16 kb)

Online Resource 4

Overall statistics for publication bias analysis among included studies. (DOCX 18 kb)

Online Resource 5

Funnel plot of the association between alcohol intake and the risk of osteonecrosis of the femoral head. (A) Alcohol intake and drinking habit (former and occasional drinking). (B) Alcohol intake and drinking habit (former and regular drinking). (C) Alcohol intake and average alcohol intake. (D) Alcohol intake and cumulative alcohol intake. (JPEG 73 kb)

Online Resource 6

Sensitivity analysis by excluding one study at the time for overall odds ratio. (DOCX 18 kb)

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Yoon, BH., Kim, Ty., Shin, IS. et al. Alcohol intake and the risk of osteonecrosis of the femoral head in Japanese populations: a dose-response meta-analysis of case-control studies. Clin Rheumatol 36, 2517–2524 (2017). https://doi.org/10.1007/s10067-017-3740-4

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  • DOI: https://doi.org/10.1007/s10067-017-3740-4

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