Presence of Fatty Liver and the Relationship between Alcohol Consumption and Markers of Inflammation

Abstract

Background and Aims. Local and systemic inflammation represent a major feature of atherosclerotic cardiovascular disease (CVD) and are also linked to nonalcoholic fatty liver disease (NAFLD). Studies indicate that NAFLD might be a risk factor for CVD whereas low-to-moderate alcohol consumption is associated with lower cardiovascular morbidity and mortality compared to abstainers and heavy drinkers. We hypothesize that FLD interacts with the effect of alcohol intake on markers of inflammation, and thus potentially on cardiovascular risk. Methods and Results. We evaluated alcohol consumption, markers of inflammation and sonographic criteria of FLD in 515 subjects, representing a subsample of a cross-sectional population based study (Echinococcus multilocularis and Internal Diseases in Leutkirch (EMIL) Study). Presence of FLD was markedly reduced in subjects drinking 0–20 g alcohol/d (19%), compared to nondrinkers (35%) and heavy drinkers (34–44.9%). Serum concentrations of inflammatory markers were substantially higher in subjects with FLD. However, presence of FLD showed no effect on the association between alcohol consumption and inflammatory biomarkers. Conclusions. Based on data from a population-based sample, there is no evidence for a link between FLD, alcohol consumption, and inflammatory cardiovascular risk markers. However, larger prospective studies are needed to confirm this.

Alcohol consumption and risk of fatty liver disease: a meta-analysis

“…Then, 19 English and four Chinese studies remained for complete evaluation, four Chinese studies were excluded due to design weakness or low quality data, two English studies were excluded due to a lack of data for calculation, and one English study was discarded due to duplication. In the end, 16 observational articles with a total of 76,608 participants including 39,198 nondrinkers, 31,942 light to moderate drinkers (LM drinkers), and 5,468 heavy drinkers met our inclusion criteria (Dunn, Xu & Schwimmer, 2008; Cotrim et al, 2009; Gunji et al, 2009; Yamada et al, 2010; Hiramine et al, 2011; Dunn et al, 2012; Hamaguchi et al, 2012; Wong et al, 2012; Moriya et al, 2013; Sookoian, Castaño & Pirola, 2014; Hashimoto et al, 2015; Kächele et al, 2015; Lau et al, 2015; Moriya et al, 2015; Nishioji et al, 2015; Sogabe et al, 2015). There were 13 cross-sectional studies (Dunn, Xu & Schwimmer, 2008; Cotrim et al, 2009; Gunji et al, 2009; Hiramine et al, 2011; Dunn et al, 2012; Hamaguchi et al, 2012; Wong et al, 2012; Moriya et al, 2013; Sookoian, Castaño & Pirola, 2014; Kächele et al, 2015; Lau et al, 2015; Nishioji et al, 2015; Sogabe et al, 2015), two cross-sectional following longitudinal studies (Yamada et al, 2010; Moriya et al, 2015) and one cohort study (Hashimoto et al, 2015).…”

“…In the end, 16 observational articles with a total of 76,608 participants including 39,198 nondrinkers, 31,942 light to moderate drinkers (LM drinkers), and 5,468 heavy drinkers met our inclusion criteria (Dunn, Xu & Schwimmer, 2008; Cotrim et al, 2009; Gunji et al, 2009; Yamada et al, 2010; Hiramine et al, 2011; Dunn et al, 2012; Hamaguchi et al, 2012; Wong et al, 2012; Moriya et al, 2013; Sookoian, Castaño & Pirola, 2014; Hashimoto et al, 2015; Kächele et al, 2015; Lau et al, 2015; Moriya et al, 2015; Nishioji et al, 2015; Sogabe et al, 2015). There were 13 cross-sectional studies (Dunn, Xu & Schwimmer, 2008; Cotrim et al, 2009; Gunji et al, 2009; Hiramine et al, 2011; Dunn et al, 2012; Hamaguchi et al, 2012; Wong et al, 2012; Moriya et al, 2013; Sookoian, Castaño & Pirola, 2014; Kächele et al, 2015; Lau et al, 2015; Nishioji et al, 2015; Sogabe et al, 2015), two cross-sectional following longitudinal studies (Yamada et al, 2010; Moriya et al, 2015) and one cohort study (Hashimoto et al, 2015). Of the studies, 10 were conducted in Asia (nine in Japan (Gunji et al, 2009; Yamada et al, 2010; Hiramine et al, 2011; Hamaguchi et al, 2012; Moriya et al, 2013; Hashimoto et al, 2015; Moriya et al, 2015; Nishioji et al, 2015; Sogabe et al, 2015) and one in Hong Kong (Wong et al, 2012)) and six in other countries (two in the US (Dunn, Xu & Schwimmer, 2008; Dunn et al, 2012), 1 in Brazil (Cotrim et al, 2009), 1 in Argentina (Sookoian, Castaño & Pirola, 2014) and 2 in Germany (Kächele et al, 2015; Lau et al, 2015)).…”

“…There were 13 cross-sectional studies (Dunn, Xu & Schwimmer, 2008; Cotrim et al, 2009; Gunji et al, 2009; Hiramine et al, 2011; Dunn et al, 2012; Hamaguchi et al, 2012; Wong et al, 2012; Moriya et al, 2013; Sookoian, Castaño & Pirola, 2014; Kächele et al, 2015; Lau et al, 2015; Nishioji et al, 2015; Sogabe et al, 2015), two cross-sectional following longitudinal studies (Yamada et al, 2010; Moriya et al, 2015) and one cohort study (Hashimoto et al, 2015). Of the studies, 10 were conducted in Asia (nine in Japan (Gunji et al, 2009; Yamada et al, 2010; Hiramine et al, 2011; Hamaguchi et al, 2012; Moriya et al, 2013; Hashimoto et al, 2015; Moriya et al, 2015; Nishioji et al, 2015; Sogabe et al, 2015) and one in Hong Kong (Wong et al, 2012)) and six in other countries (two in the US (Dunn, Xu & Schwimmer, 2008; Dunn et al, 2012), 1 in Brazil (Cotrim et al, 2009), 1 in Argentina (Sookoian, Castaño & Pirola, 2014) and 2 in Germany (Kächele et al, 2015; Lau et al, 2015)). A total of 12 studies provided adjusted risk estimate, and four studies reported only crude data.…”

“…But only a few studies obtained a follow-up (Yamada et al, 2010; Moriya et al, 2015) and explained how missing data were handled (Dunn, Xu & Schwimmer, 2008; Moriya et al, 2013; Kächele et al, 2015; Lau et al, 2015; Moriya et al, 2015; Nishioji et al, 2015; Sogabe et al, 2015). Most of the studies (Dunn, Xu & Schwimmer, 2008; Gunji et al, 2009; Hiramine et al, 2011; Hamaguchi et al, 2012; Wong et al, 2012; Moriya et al, 2013; Kächele et al, 2015; Lau et al, 2015; Nishioji et al, 2015; Sogabe et al, 2015; Yamada et al, 2010; Moriya et al, 2015) were evaluated as low risk of bias, 2 studies (Cotrim et al, 2009; Dunn et al, 2012) had moderate risk of bias, and 1 study (Sookoian, Castaño & Pirola, 2014) had high risk of bias (Table 3). The quality of cohort study (Hashimoto et al, 2015) was full score of 9, and a score ≥6 stars is considered to be high quality.…”

“…Then, when a stratified analysis was conducted according to different amounts of alcohol consumption, a total of 15 heterogeneous studies (Dunn, Xu & Schwimmer, 2008; Cotrim et al, 2009; Gunji et al, 2009; Yamada et al, 2010; Hiramine et al, 2011; Dunn et al, 2012; Hamaguchi et al, 2012; Wong et al, 2012; Moriya et al, 2013; Hashimoto et al, 2015; Kächele et al, 2015; Lau et al, 2015; Moriya et al, 2015; Nishioji et al, 2015; Sogabe et al, 2015) were included in light alcohol consumption group ( I 2  = 66%; P  < 0.001), and eight heterogeneous studies (Cotrim et al, 2009; Gunji et al, 2009; Yamada et al, 2010; Hamaguchi et al, 2012; Hashimoto et al, 2015; Kächele et al, 2015; Lau et al, 2015; Moriya et al, 2015) in moderate alcohol consumption group ( I 2  = 82.7%; P  < 0.001). The combined analysis showed a greater reduction (25.3%) in risk of FLD in light alcohol consumption group (OR = 0.747; 95% CI [0.673–0.830]; P  < 0.001) compared with moderate alcohol consumption group (19.6%) (OR = 0.804; 95% CI [0.661–0.979]; P  = 0.03) in random effect model (Fig.…”