HUBUNGAN KONSUMSI ALKOHOL BERLEBIH DENGAN PERUBAHAN HISTOPATOLOGI HEPAR: TINJAUAN SISTEMATIS DAN META-ANALISIS

Abstrak

Konsumsi alkohol berlebih merupakan salah satu penyebab utama penyakit hati di dunia karena dapat menginduksi stres oksidatif, peroksidasi lipid, serta kerusakan struktural hepatosit. Penelitian ini bertujuan untuk melakukan systematic review dan meta-analysis guna mensintesis bukti ilmiah mengenai hubungan konsumsi alkohol berlebih dengan perubahan histopatologi hepar pada hewan uji rodensia. Penelusuran literatur dilakukan secara sistematis berdasarkan pedoman PRISMA melalui database Google Scholar dan Garuda terhadap artikel yang diterbitkan pada tahun 2021–2026 dengan menggunakan kriteria kelayakan PICOS. Sebanyak 10 artikel penelitian primer in vivo yang membandingkan kelompok paparan alkohol dengan kelompok kontrol sehat dianalisis secara kualitatif dan kuantitatif menggunakan perangkat lunak JASP. Hasil analisis kualitatif menunjukkan bahwa konsumsi alkohol berlebih secara konsisten menyebabkan pembengkakan sel berupa degenerasi parenkimatosa dan hidropik, penumpukan lemak (steatosis), infiltrasi sel peradangan (inflamasi), gangguan vaskular seperti dilatasi sinusoid, kongesti, dan hemoragi, hingga kematian sel hati (nekrosis) serta progresivitas fibrosis. Sementara itu, hasil meta-analysis menunjukkan bahwa efek gabungan (pooled effect size) paparan alkohol sebesar 3,701 belum signifikan secara statistik (t(9) = 2,08; p = 0,067; IK 95% = −0,3231 hingga 7,725). Hasil tersebut dipengaruhi oleh tingginya heterogenitas antarstudi (Qe(9) = 87,08; p < 0,001; τ² = 25,75), adanya potensi bias publikasi akibat dominasi penelitian dengan ukuran sampel kecil, serta ditemukannya studi pencilan (outlier) yang ekstrem. Dengan demikian, meskipun dampak destruktif alkohol terhadap jaringan hepar terbukti secara nyata melalui analisis histopatologi kualitatif, tingginya variabilitas metodologis antarpenelitian menyebabkan besaran efek gabungan secara kuantitatif belum dapat disimpulkan secara seragam.

Excessive alcohol consumption is one of the leading causes of liver disease worldwide, as it induces oxidative stress, lipid peroxidation, and structural damage to hepatocytes. This study aimed to conduct a systematic review and meta-analysis to synthesize scientific evidence regarding the association between excessive alcohol consumption and histopathological changes in the liver of rodent models. A systematic literature search was performed following the PRISMA guidelines using the Google Scholar and Garuda databases to identify studies published between 2021 and 2026 based on the PICOS eligibility criteria. A total of 10 primary in vivo studies comparing alcohol-exposed groups with healthy control groups were included and analyzed qualitatively and quantitatively using JASP software. Qualitative analysis consistently demonstrated that excessive alcohol consumption induced cellular swelling, including parenchymatous and hydropic degeneration, lipid accumulation (steatosis), inflammatory cell infiltration, vascular alterations such as sinusoidal dilatation, congestion, and hemorrhage, hepatocyte death (necrosis), and progression to fibrosis. However, the quantitative meta-analysis revealed that the pooled effect size of alcohol exposure was 3.701, which did not reach statistical significance (t(9) = 2.08; p = 0.067; 95% CI = −0.3231 to 7.725). This finding was influenced by substantial inter-study heterogeneity (Qe(9) = 87.08; p < 0.001; τ² = 25.75), potential publication bias resulting from the predominance of small-sample studies, and the presence of extreme outlier studies. Therefore, although the destructive effects of alcohol on liver tissue were consistently demonstrated through qualitative histopathological analysis, the high methodological variability across studies prevented a uniform quantitative conclusion regarding the overall pooled effect size.