Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis

Abstract

Background Alcohol related liver disease (ARLD) is one of the major chronic liver diseases worldwide. This review aimed to describe the global prevalence, incidence, and outcomes of ARLD. Methods Medline, Embase, The Cochrane Library, and China National Knowledge Infrastructure (CNKI) were searched from inception to May 31, 2022. The language was restricted to English or Chinese. According to the criteria, articles describing the basic characteristics of the population were selected. Two reviewers extracted the data independently. Results A total of 372 studies were identified: 353 were used for prevalence analysis, 7 were used for incidence analysis, and 114 were used to for outcome analysis. The prevalence of ARLD worldwide was 4.8%. The prevalence in males was 2.9%, which was higher than female (0.5%). Among the ethnic groups, the percentage was highest in Caucasians (68.9%). Alcoholic liver cirrhosis comprised the highest proportion in the disease spectrum of ARLD at 32.9%. The prevalence of ascites in ARLD population was highest (25.1%). The ARLD population who drinking for > 20 years accounted for 54.8%, and the average daily alcohol intake was 146.6 g/d. About 59.5% of ARLD patients were current or former smokers, and 18.7% were complicated with hepatitis virus infection. The incidence was 0.208/1000 person-years. The overall mortality was 23.9%, and the liver-related mortality was 21.6%. Conclusion The global prevalence of ARLD was 4.8% and was affected by sex, region, drinking years, and other factors. Therefore, removing the factors causing a high disease prevalence is an urgent requisite. Trial registration PROSPERO Nr: CRD42021286192

Interactions between the metabolic syndrome and alcohol consumption increases the risk of liver disease

“…[4][5][6]15 The prevalence of ALD is estimated at around 5% of the global population, although estimates vary considerably. 16 If an individual who drinks fewer than 14 drinks per week is used as a reference, the hazard ratio (HR) for incident cirrhosis associated with drinking 14-28 drinks per week is about 2.3 for men and 3.5 for women, and the HR associated with drinking 28-42 drinks per week is 7.0 and 16.2 for men and women, respectively. 17 Long-term followup of 3453 patients with biopsy-proven ALD showed that 5-year cumulative mortality was 40.9% in patients with ALD compared with 5.8% in the matched reference population with a near five-fold increase in death.…”

Making the best use of testing for blood phosphatidylethanol

“…Phosphatidylethanol (PEth) is an accurate and specific biomarker that detects recent alcohol use. [1] PEth testing can be performed on whole blood or dried blood spots, has a wide detection window of alcohol use within 2-4 weeks, and can provide an estimate on the level of alcohol consumption. [2] As such, PEth has advantages over other markers of alcohol consumption such as breathalyzer or blood alcohol levels (window of detection is too brief), carboxy-deficient transferrin (inaccurate), or nonspecific markers such as serum gamma-glutamyl transpeptidases (insensitive and inaccurate).…”

A public health perspective on mitigating the global burden of chronic liver disease

“…It also represents a new diagnostic scheme that subclassifies SLD by etiology, 4 with the 2 most common being metabolic dysfunction–associated steatotic liver disease (MASLD, formerly known as NAFLD) and alcohol-associated liver disease (ALD). These affect approximately 30% and 5% of the general population, respectively 5,6 …”