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Meta-Analysis
. 2023 Nov 1;46(11):2076-2083.
doi: 10.2337/dc23-1015.

The Relationship Between Alcohol Consumption, BMI, and Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis

Laura Llamosas-Falcón  1 , Jürgen Rehm  1   2   3   4   5   6   7 , Sophie Bright  8 , Charlotte Buckley  9 , Tessa Carr  1 , Carolin Kilian  1 , Aurélie M Lasserre  10 , Julia M Lemp  11 , Yachen Zhu  12 , Charlotte Probst  1   2   3   11
Affiliations
Meta-Analysis

The Relationship Between Alcohol Consumption, BMI, and Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis

Laura Llamosas-Falcón et al. Diabetes Care. .

Abstract

Background: Moderate alcohol use may be associated with lower risk of type 2 diabetes mellitus (T2DM). Previous reviews have reached mixed conclusions.

Purpose: To quantify the dose-response relationship between alcohol consumption and T2DM, accounting for differential effects by sex and BMI.

Data sources: Medline, Embase, Web of Science, and one secondary data source.

Study selection: Cohort studies on the relationship between alcohol use and T2DM.

Data extraction: Fifty-five studies, and one secondary data source, were included with a combined sample size of 1,363,355 men and 1,290,628 women, with 89,983 and 57,974 individuals, respectively, diagnosed with T2DM.

Data synthesis: Multivariate dose-response meta-analytic random-effect models were used. For women, a J-shaped relationship was found with a maximum risk reduction of 31% (relative risk [RR] 0.69, 95% CI 0.64-0.74) at an intake of 16 g of pure alcohol per day compared with lifetime abstainers. The protective association ceased above 49 g per day (RR 0.82, 95% CI 0.68-0.99). For men, no statistically significant relationship was identified. When results were stratified by BMI, the protective association was only found in overweight and obese women.

Limitations: Our analysis relied on aggregate data. We included some articles that determined exposure and cases via self-report, and the studies did not account for temporal variations in alcohol use.

Conclusions: The observed reduced risk seems to be specific to women in general and women with a BMI ≥25 kg/m2. Our findings allow for a more precise prediction of the sex-specific relationship between T2DM and alcohol use, as our results differ from those of previous studies.

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Conflict of interest statement

Duality of Interest. No potential conflicts of interest relevant to this article were reported.

Figures

None
Graphical abstract
Figure 1
Figure 1
Flowchart for study selection.
Figure 2
Figure 2
Dose-response meta-analysis between alcohol intake in average grams per day and risk of type 2 diabetes for men (A) and women (B).
Figure 3
Figure 3
Dose-response meta-analysis between alcohol intake in average grams per day and risk of type 2 diabetes by sex and BMI.
See this image and copyright information in PMC

References

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    1. Institute for Health Metrics and Evaluation (IHME) . GBD Results, 2022. Accessed 29 July 2022. Available from https://vizhub.healthdata.org/gbd-results/
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