关键词: 脑卒中, 酒精, Meta分析；前瞻性研究；剂量反应

Abstract: Background Alcohol consumption is widespread in China, and excessive intake can induce the development of many diseases. Several studies at home and abroad have reported the relationship between alcohol intake and the risk of stroke, but there is still controversy about the specific dose of intake and the risk of stroke. Objective To explore the dose-response relationship between alcohol intake and the risk of stroke. Methods A computerized search was performed for prospective cohort studies on the relationship between alcohol and the risk of stroke incidence in the China Knowledge Network (CNKI), Wipu Database (VIP), China Biomedical Literature Database (CBM), Wanfang Data Knowledge Service Platform, PubMed, Embase, Cochrane Library, and Web of Science databases, with a timeframe of was from database construction to December 2023, and the literature was extracted independently by 2 researchers. Literature data were extracted independently by 2 researchers and evaluated for literature quality. Dose-response Meta-analysis was performed by applying Stata/MP17.0 software. Results A total of 16 studies were included, with 548 595 study subjects and 13 831 exposures.The results of Meta-analysis showed that alcohol intake was associated with the risk of stroke onset (RR=1.20, 95% CI=1.04 - 1.39, P<0.05). Subgroup analyses showed that alcohol intake <20 g per day was associated with an 8% reduction in the risk of stroke (RR=0.92, 95% CI=0.82 - 1.03, P<0.05 ), and alcohol intake >40 g per day was associated with a significant 46% increase in the risk of stroke (RR=1.46, 95% CI=1.15 - 1.85, P<0.05). Dose-response Meta-analysis showed a J-shaped nonlinear relationship between alcohol intake and the risk of stroke onset (nonlinear P value of 0.000 2), with drinkers with an average alcohol intake of <20 g per day demonstrating a reduced risk of stroke onset compared with never drinkers. Conclusions Alcohol intake has a J-shaped nonlinear dose-response relationship with stroke risk, and moderate alcohol intake is negatively associated with stroke risk, which is lowest when the average daily alcohol intake is 7-11 g.

Key words: Stroke, Alcohol, Meta-analysis；Prospective study；Dose-response