Farzaneh Asoudeh - Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Asma Salari-Moghaddam - Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Bagher Larijani - Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Ahmad Esmaillzadeh - Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IranObesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran Unive

Background and Objective: Background: Previous studies on the association between alcohol intake and risk of fracture have reached conflicting findings. The aim of this systematic review and meta-analysis of prospective cohort studies was to summarize earlier studies on the association of alcohol intake with risk of fracture.Materials and Methods: A systemic search of PubMed, Scopus and ISI Web of Science was conducted up to Nov ۲۰۲۰. Prospective cohort studies that had considered alcohol consumption as the exposure variable and fracture as the main outcome or as one of the outcome variables were included in this systematic review. Publications in which risk ratios (RRs) or hazard ratios (HRs) and ۹۵% confidence intervals (CIs) were reported, were included in the meta-analysis.Results: In total, ۴۰ prospective cohort studies including ۵,۰۸۴,۳۰۳ participants and ۱۷۰,۹۱۶ subjects with fracture were included in this systematic review; of them ۳۸ studies with a total sample size of ۵,۰۵۳,۱۱۷ participants and ۱۶۹,۵۶۰ cases of fracture were included in the metaanalysis. Using random-effects meta-analysis, we found a significant positive association between alcohol consumption and risk of total fractures (RR: ۱.۳۵; ۹۵% CI: ۱.۰۱, ۱.۸۱) and any fractures (RR: ۱.۲۴; ۹۵% CI: ۱.۱۱, ۱.۳۸). However, no significant association was observed between alcohol intake and risk of hip fractures (RR: ۱.۱۹; ۹۵% CI: ۰.۹۶, ۱.۴۸), osteoporotic fractures (RR: ۲.۰۱; ۹۵% CI: ۰.۷۶, ۵.۳۴), vertebral fractures (RR: ۰.۹۸; ۹۵% CI: ۰.۶۸, ۱.۴۰), and wrist fractures (RR: ۰.۹۹; ۹۵% CI: ۰.۸۵, ۱.۱۶).Conclusion: We found that alcohol consumption was positively associated with risk of total fractures and any fractures. However, we did not observe any significant association between alcohol consumption and risk of hip, osteoporotic, vertebral, and wrist fractures.

alcohol, fracture, systematic review, meta-analysis