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Modest alcohol consumption may reduce risk for steatohepatitis in patients with NAFLD

Patients with nonalcoholic fatty liver disease who regularly consumed a modest amount of alcohol were less likely to develop nonalcoholic steatohepatitis than nondrinkers, according to study results.

Researchers analyzed data from 251 lifetime nondrinkers and 331 modest drinkers — patients who consume less than 20 g alcohol daily — with nonfatty alcoholic liver disease (NAFLD). The goal of the study was to determine whether the likelihood of patients receiving a nonalcoholic steatohepatitis (NASH) diagnosis was influenced by modest alcohol consumption.

Among the nondrinkers, 69.8% of participants had steatohepatitis, compared with 53.2% among modest drinkers. Modest drinkers were less likely to be diagnosed with NASH than nondrinkers (summary OR=0.56, 95% CI, 0.39-0.84, P=.002), and the odds of NASH diagnosis decreased as alcohol consumption increased, while still within the modest consumption range: Participants who drank once a week or less had a summary OR of 0.54 (95% CI, 0.39-0.79) compared with 0.24 (95% CI, 0.10-0.55) in patients who drank twice weekly or more.

Investigators also found that the drinking group was less likely than nondrinkers to have fibrosis (OR=0.56, 95% CI, 0.41-0.78), ballooning hepatocellular injury (OR=0.62, 95% CI, 0.45-0.87) and Mallory-Denk bodies (OR=0.65, 95% CI, 0.43-0.97). Differences in degree of macrovesicular steatosis (P=.57) and lobular inflammation (P=.63) between the two groups were not considered significant, and slight differences in degree of portal inflammation were observed (P=.052).

“Speculation regarding the role of modest alcohol consumption in prevention or treatment of NASH is tempting but premature,” the researchers wrote. “The provocative nature of these findings juxtaposed against the well-established dangers of excessive alcohol consumption presents a need for future prospective studies and a coordinated consensus on alcohol consumption recommendations in NAFLD.”