LBP-01-In NAFLD, alcohol drinking habits and genetics predict progression to advanced liver disease: follow-up of population surveys

Åberg, Fredrik; Puukka, Pauli; Sahlman, Perttu; Nissinen, Markku; Salomaa, Veikko; Männistö, Satu; Lundqvist, Annamari; Valsta, Liisa; Perola, Markus; Jula, Antti; Färkkilä, Martti

doi:10.1016/s0618-8278(19)30247-6

Cited by 3 publications

(9 citation statements)

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“…46 Another study of 71 patients with biopsy-proven NAFLD (alcohol intake < 140 g/week) found that binge-drinking (60 g ethanol per occasion for men, 48 g for women) as infrequently as once a month was associated with a more rapid progression of liver fibrosis. 90 Furthermore, in recent population studies of NAFLD, binge-drinking emerged as an independent risk factor for progression to advanced clinical liver disease (HR: 1.5-2.7 among monthly to weekly binge drinkers) 91 and all-cause death (HR: 1.5 among monthly binge drinkers). 86 The corollary of these recent studies is that binge-drinking seems to be an important risk factor for advanced liver disease and mortality among persons with the MetS and/or hepatic steatosis.…”

Section: Binge-drinkingmentioning

confidence: 99%

Drinking and Obesity: Alcoholic Liver Disease/Nonalcoholic Fatty Liver Disease Interactions

Åberg

Färkkilä

2020

Semin Liver Dis

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Alcohol and obesity are the main risk factors for alcoholic liver disease and nonalcoholic fatty liver disease (NAFLD), respectively, and they frequently coexist. There are considerable synergistic interaction effects between hazardous alcohol use and obesity-associated metabolic abnormalities in the development and progression of fatty liver disease. Intermittent binge-drinking has been shown to promote steatohepatitis from obesity-related steatosis, and binge-drinking is associated with progression to cirrhosis even when average alcohol intake is within the currently used criteria for a NAFLD diagnosis. Recent longitudinal studies in NAFLD have shown that light-to-moderate alcohol use is associated with fibrosis progression and incident clinical liver disease, suggesting that there is no liver-safe limit of alcohol intake in the presence of NAFLD; a J-shaped association between alcohol and all-cause mortality remains controversial. The interaction effects between alcohol and obesity make the present strict dichotomization of liver disease into alcoholic and NAFLD inappropriate, and require attention in future research, public health policy, individual counseling, and risk stratification.

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Section: Binge-drinkingmentioning

confidence: 99%

Drinking and Obesity: Alcoholic Liver Disease/Nonalcoholic Fatty Liver Disease Interactions

Åberg

Färkkilä

2020

Semin Liver Dis

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“…[48][49][50][51][52][53][54][55] A total of six unique studies representing data from five cohorts were eligible for inclusion in the systematic review, and were assessed for quality (figure 1). [56][57][58][59][60][61] Characteristics of included studies Further details of included studies are shown in table 2.…”

Section: Resultsmentioning

confidence: 99%

“…Two of the studies were rated as having a low risk of bias, 57 61 with one rated as high risk of bias. 56 The general population data presented by Chang et al 59 is supplemented by two recent related studies by Åberg et al, 56 57 using data from the same Finnish National Health Surveys (FINRISK, Health 2000) cohort. The definition of moderate alcohol consumption was increased to include anything up to 50 g/day in these studies.…”

Section: Resultsmentioning

confidence: 99%

“… 48–55 A total of six unique studies representing data from five cohorts were eligible for inclusion in the systematic review, and were assessed for quality ( figure 1 ). 56–61 …”

Section: Resultsmentioning

confidence: 99%

“…This is <20 g/day in women and <30 g/day in men. 26 Three of the studies 56 57 61 looked at low alcohol consumption but also extended moderate consumption up to levels of alcohol consumption which would be considered more consistent with ARLD.…”

Section: Resultsmentioning

confidence: 99%

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Does moderate alcohol consumption accelerate the progression of liver disease in NAFLD? A systematic review and narrative synthesis

et al. 2022

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ObjectivesLiver disease is a leading cause of premature death, partly driven by the increasing incidence of non-alcohol-related fatty liver disease (NAFLD). Many people with a diagnosis of NAFLD drink moderate amounts of alcohol. There is limited guidance for clinicians looking to advise these patients on the effect this will have on their liver disease progression. This review synthesises the evidence on moderate alcohol consumption and its potential to predict liver disease progression in people with diagnosed NAFLD.MethodsA systematic review of longitudinal observational cohort studies was conducted. Databases (Medline, Embase, The Cochrane Library and ClinicalTrials.gov) were searched up to September 2020. Studies were included that reported progression of liver disease in adults with NAFLD, looking at moderate levels of alcohol consumption as the exposure of interest. Risk of bias was assessed using the Quality in Prognostic factor Studies tool.ResultsOf 4578 unique citations, 6 met the inclusion criteria. Pooling of data was not possible due to heterogeneity and studies were analysed using narrative synthesis. Evidence suggested that any level of alcohol consumption is associated with worsening of liver outcomes in NAFLD, even for drinking within recommended limits. Well conducted population based studies estimated up to a doubling of incident liver disease outcomes in patients with NAFLD drinking at moderate levels.ConclusionsThis review found that any level of alcohol intake in NAFLD may be harmful to liver health.Study heterogeneity in definitions of alcohol exposure as well as in outcomes limited quantitative pooling of results. Use of standardised definitions for exposure and outcomes would support future meta-analysis.Based on this synthesis of the most up to date longitudinal evidence, clinicians seeing patients with NAFLD should currently advise abstinence from alcohol.PROSPERO registration numberThe protocol was registered with PROSPERO (#CRD42020168022).

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Synergistic and Detrimental Effects of Alcohol Intake on Progression of Liver Steatosis

Ciaula

Bonfrate

Krawczyk

et al. 2022

IJMS

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Nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) are the most common liver disorders worldwide and the major causes of non-viral liver cirrhosis in the general population. In NAFLD, metabolic abnormalities, obesity, and metabolic syndrome are the driving factors for liver damage with no or minimal alcohol consumption. ALD refers to liver damage caused by excess alcohol intake in individuals drinking more than 5 to 10 daily units for years. Although NAFLD and ALD are nosologically considered two distinct entities, they show a continuum and exert synergistic effects on the progression toward liver cirrhosis. The current view is that low alcohol use might also increase the risk of advanced clinical liver disease in NAFLD, whereas metabolic factors increase the risk of cirrhosis among alcohol risk drinkers. Therefore, special interest is now addressed to individuals with metabolic abnormalities who consume small amounts of alcohol or who binge drink, for the role of light-to-moderate alcohol use in fibrosis progression and clinical severity of the liver disease. Evidence shows that in the presence of NAFLD, there is no liver-safe limit of alcohol intake. We discuss the epidemiological and clinical features of NAFLD/ALD, aspects of alcohol metabolism, and mechanisms of damage concerning steatosis, fibrosis, cumulative effects, and deleterious consequences which include hepatocellular carcinoma.

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LBP-01-In NAFLD, alcohol drinking habits and genetics predict progression to advanced liver disease: follow-up of population surveys

Cited by 3 publications

References 0 publications

Drinking and Obesity: Alcoholic Liver Disease/Nonalcoholic Fatty Liver Disease Interactions

Drinking and Obesity: Alcoholic Liver Disease/Nonalcoholic Fatty Liver Disease Interactions

Does moderate alcohol consumption accelerate the progression of liver disease in NAFLD? A systematic review and narrative synthesis

Synergistic and Detrimental Effects of Alcohol Intake on Progression of Liver Steatosis

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