TY - JOUR
T1 - Smoking & risk of advanced liver fibrosis among patients with primary biliary cholangitis
T2 - A systematic review & meta-analysis
AU - Wijarnpreecha, Karn
AU - Werlang, Monia
AU - Panjawatanan, Panadeekarn
AU - Pungpapong, Surakit
AU - Lukens, Frank
AU - Harnois, Denise
AU - Ungprasert, Patompong
N1 - Publisher Copyright:
© 2022 Indian Journal of Medical Research, published by Wolters Kluwer-Medknow for Director-General, Indian Council of Medical Research.
PY - 2021/12
Y1 - 2021/12
N2 - Background & objectives: Studies have suggested that smoking may accelerate the progression of fibrosis among patients with primary biliary cholangitis (PBC), although the data are limited. The current review was undertaken with the aim to comprehensively analyze this possible association by identifying all relevant studies and summarizing their results. Methods: A comprehensive literature review on MEDLINE and EMBASE databases was performed from inception through February 2019 to identify all relevant studies. Eligible studies included cross-sectional studies that recruited patients with PBC and collected data on the smoking status and presence or absence of advanced liver fibrosis for each participant. Odds ratios (OR) with 95 per cent confidence intervals (CI) was desirable for inclusion or sufficient raw data to calculate the same for this association. Adjusted point estimates from each study were extracted and combined together using the generic inverse variance method of DerSimonian and Laird. I 2 statistic, which quantifies the proportion of total variation across studies was used to determine the between-study heterogeneity. Results: Three cross-sectional studies with 544 participants were included. The pooled analysis found a significantly increased risk of advanced liver fibrosis among patients with PBC who were ever-smokers compared to those who were nonsmokers with the pooled OR of 3.00 (95% CI, 1.18-7.65). Statistical heterogeneity was high with I 2 of 89 per cent. Interpretation & conclusions: This meta-analysis found that smoking is associated with a significantly higher risk of advanced liver fibrosis among patients with PBC. Further prospective studies are still required to determine whether this association is causal.
AB - Background & objectives: Studies have suggested that smoking may accelerate the progression of fibrosis among patients with primary biliary cholangitis (PBC), although the data are limited. The current review was undertaken with the aim to comprehensively analyze this possible association by identifying all relevant studies and summarizing their results. Methods: A comprehensive literature review on MEDLINE and EMBASE databases was performed from inception through February 2019 to identify all relevant studies. Eligible studies included cross-sectional studies that recruited patients with PBC and collected data on the smoking status and presence or absence of advanced liver fibrosis for each participant. Odds ratios (OR) with 95 per cent confidence intervals (CI) was desirable for inclusion or sufficient raw data to calculate the same for this association. Adjusted point estimates from each study were extracted and combined together using the generic inverse variance method of DerSimonian and Laird. I 2 statistic, which quantifies the proportion of total variation across studies was used to determine the between-study heterogeneity. Results: Three cross-sectional studies with 544 participants were included. The pooled analysis found a significantly increased risk of advanced liver fibrosis among patients with PBC who were ever-smokers compared to those who were nonsmokers with the pooled OR of 3.00 (95% CI, 1.18-7.65). Statistical heterogeneity was high with I 2 of 89 per cent. Interpretation & conclusions: This meta-analysis found that smoking is associated with a significantly higher risk of advanced liver fibrosis among patients with PBC. Further prospective studies are still required to determine whether this association is causal.
KW - Analysis
KW - Cigarettes
KW - Liver fbrosis
KW - Meta
KW - Primary biliary cholangitis
KW - Smoking
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U2 - 10.4103/ijmr.IJMR_639_19
DO - 10.4103/ijmr.IJMR_639_19
M3 - Review article
C2 - 35662085
AN - SCOPUS:85131701051
SN - 0971-5916
VL - 154
SP - 806
EP - 812
JO - Indian Journal of Medical Research
JF - Indian Journal of Medical Research
IS - 6
ER -