Published online Sep 27, 2022. doi: 10.4254/wjh.v14.i9.1747
Peer-review started: April 21, 2022
First decision: May 31, 2022
Revised: June 13, 2022
Accepted: August 26, 2022
Article in press: August 26, 2022
Published online: September 27, 2022
Primary biliary cholangitis (PBC) is a chronic progressive liver disease of unknown aetiology characterised by immune-mediated destruction of small and medium-sized intrahepatic bile ducts. There are few well-established risk factors and epidemiological studies are needed to further evaluate the pathogenesis of the disease.
Recurrent urinary tract infections and smoking have been the only risk factors that have been found to be consistently associated with PBC development. However, these environmental factors combined appear insufficient to explain the pathogenesis, and it is likely that other environmental factors play a role in disease onset.
To analyze environmental factors such as smoking, marijuana and alcohol use, and the role they play in PBC development.
A prevalent case control study of 200 cases and 200 age (within a five year age band) and sex-matched controls, identified from the Victorian PBC prevalence study. The associations of alcohol intake with case status were evaluated by conditional logistic regression, estimating an odds ratio.
For PBC development alcohol intake consistently showed a dose-dependent inverse association with case status, and this was most substantial for 21-30 years and 31-40 years. Smoking was associated with PBC, with a stronger association with a longer duration of smoking while there was no association between marijuana use and PBC.
Our study found that alcohol intake may be associated with a reduced risk of PBC, an important finding for a disease with few established risk factors.
The association of alcohol and risk reduction of PBC requires replication in other PBC studies, preferably in cohort studies where the exposure is measured prior to disease onset.