Moderate alcohol consumption is associated with advanced fibrosis in non-alcoholic fatty liver disease and shows a synergistic effect with type 2 diabetes mellitus

Blomdahl, Julia; Nasr, Patrik; Ekstedt, Mattias; Kechagias, Stergios

doi:10.1016/j.metabol.2020.154439

Cited by 55 publications

(55 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Further research is needed to explore this finding. Lastly, liver damage slows alcohol elimination (Cederbaum, 2012), and we found that higher fibrosis scores were associated with increased odds of PEth sensitivity, consistent with a recent study (Blomdahl et al, 2020). However, fibrosis is frequently the result of high levels of alcohol consumption, so this finding may instead or in part reflect residual confounding by underreported alcohol use.…”

Section: Discussionsupporting

confidence: 91%

Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta‐analysis

Hahn

Murnane

Vittinghoff

et al. 2021

Alcoholism Clin & Exp Res

View full text Add to dashboard Cite

Background Objective measurement of alcohol consumption is important for clinical care and research. Adjusting for self‐reported alcohol use, we conducted an individual participant data (IPD) meta‐analysis to examine factors associated with the sensitivity of phosphatidylethanol (PEth), an alcohol metabolite, among persons self‐reporting unhealthy alcohol consumption. Methods We identified 21 eligible studies and obtained 4073 observations from 3085 participants with Alcohol Use Disorders Identification Test—Consumption (AUDIT‐C) positive scores (≥3 for women and ≥4 for men) and PEth measurements. We conducted 1‐step IPD meta‐analysis using mixed effects models with random intercepts for study site. We examined the associations between demographic (sex, race/ethnicity, and age) and biologic (body mass index—BMI, hemoglobin, HIV status, liver fibrosis, and venous versus finger‐prick blood collection) variables with PEth sensitivity (PEth≥8 ng/ml), adjusting for the level of self‐reported alcohol use using the AUDIT‐C score. Results One third (31%) of participants were women, 32% were African, 28% African American, 28% White, and 12% other race/ethnicity. PEth sensitivity (i.e., ≥8 ng/ml) was 81.8%. After adjusting for AUDIT‐C, we found no associations of sex, age, race/ethnicity, or method of blood collection with PEth sensitivity. In models that additionally included biologic variables, those with higher hemoglobin and indeterminate and advanced liver fibrosis had significantly higher odds of PEth sensitivity; those with higher BMI and those living with HIV had significantly lower odds of PEth sensitivity. African Americans and Africans had higher odds of PEth sensitivity than whites in models that included biologic variables. Conclusions Among people reporting unhealthy alcohol use, several biological factors (hemoglobin, BMI, liver fibrosis, and HIV status) were associated with PEth sensitivity. Race/ethnicity was associated with PEth sensitivity in some models but age, sex, and method of blood collection were not. Clinicians should be aware of these factors, and researchers should consider adjusting analyses for these characteristics where possible.

show abstract

Section: Discussionsupporting

confidence: 91%

Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta‐analysis

Hahn

Murnane

Vittinghoff

et al. 2021

Alcoholism Clin & Exp Res

View full text Add to dashboard Cite

show abstract

“…Interestingly, in this research, none or minimal alcohol consumption was linked with a reduced risk of incident T2DM in subjects without FLD, but not in those with FLD [70]. On the other hand, moderate alcohol consumption correlates with extensive fibrosis in non-alcoholic FLD, exhibiting a synergistic effect with T2DM [71].…”

Section: Linkage Of Alcohol Consumption With Type 2 Diabetes Mellitusmentioning

confidence: 45%

Consensus and Controversy in the Debate over the Biphasic Impact of Alcohol Consumption on the Cardiovascular System

et al. 2021

View full text Add to dashboard Cite

In the past few decades, research has focused on the importance of addressing modifiable risk factors as a means of lowering the risk of cardiovascular disease (CVD), which represents the worldwide leading cause of death. For quite a long time, it has been considered that ethanol intake has a biphasic impact on the cardiovascular system, mainly depending on the drinking pattern, amount of consumption, and type of alcoholic beverage. Multiple case-control studies and meta-analyses reported the existence of a “U-type” or “J-shaped” relationship between alcohol and CVD, as well as mortality, indicating that low to moderate alcohol consumption decreases the number of adverse cardiovascular events and deaths compared to abstinence, while excessive alcohol use has unquestionably deleterious effects on the circulatory system. However, beginning in the early 2000s, the cardioprotective effects of low doses of alcohol were abnegated by the results of large epidemiological studies. Therefore, this narrative review aims to reiterate the association of alcohol use with cardiac arrhythmias, dilated cardiomyopathy, arterial hypertension, atherosclerotic vascular disease, and type 2 diabetes mellitus, highlighting literature disagreements over the risk and benefits of low to moderate drinking on the cardiovascular system.

show abstract

“…It has also been demonstrated that both these causes together can intensify disease progression to more severe liver disease and liver cancer. [33][34][35][36] In such mixed cases, it can be difficult to identify the leading cause, and it seems fair to indicate both NAFLD and ALD. This helps avoid focusing on and treating only one of the causes.…”

Section: Nafld Nafl Nash Cirrhosismentioning

confidence: 99%

“…At the population level, the combination of alcohol and obesity increases the probability of developing NAFLD and increases the severity of liver disease, reflecting a synergistic effect. 33,36,[228][229][230][231] A large cohort study from the U.S. reported that patients with NAFLD who drank more alcohol than the threshold of > − 3 drinks/day for men and > − 2 for women, were 3x more likely to have advanced fibrosis than those with NAFLD alone. 34,228 In addition, overall mortality was higher in adults with NAFLD who consumed excess alcohol.…”

Section: Tips On Managing Fatiguementioning

confidence: 99%

Non-alcoholic fatty liver disease: A patient guideline

et al. 2021

View full text Add to dashboard Cite

This patient guideline is intended for all patients at risk of or living with non-alcoholic fatty liver disease (NAFLD). NAFLD is the most frequent chronic liver disease worldwide and comes with a high disease burden. Yet, there is a lot of unawareness. Furthermore, many aspects of the disease are still to be unravelled, which has an important impact on the information that is given (or not) to patients. Its management requires a close interaction between patients and their many healthcare providers. It is important for patients to develop a full understanding of NAFLD in order to enable them to take an active role in their disease management. This guide summarises the current knowledge relevant to NAFLD and its management. It has been developed by patients, patient representatives, clinicians and scientists and is based on current scientific recommendations, intended to support patients in making informed decisions.

show abstract

Moderate alcohol consumption is associated with advanced fibrosis in non-alcoholic fatty liver disease and shows a synergistic effect with type 2 diabetes mellitus

Cited by 55 publications

References 21 publications

Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta‐analysis

Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta‐analysis

Consensus and Controversy in the Debate over the Biphasic Impact of Alcohol Consumption on the Cardiovascular System

Non-alcoholic fatty liver disease: A patient guideline

Contact Info

Product

Resources

About