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Modest alcohol consumption linked to lower fibrosis in NAFLD

Modest alcohol consumption correlated with lower fibrosis among patients with nonalcoholic fatty liver disease, according to a recently published study.

“Notably, this protective association was seen in exclusive wine drinkers but not beer drinkers and was lost among subjects who consumed alcohol in a binge-type pattern,” Tim Mitchell, MBBS, from the Sir Charles Gairdner Hospital in Australia, and colleagues wrote.

However, Mitchell and colleagues noted that the threshold for harm remains uncertain and confounding factors such as diet are unknown.

“Given the demonstrated relationship between heavy alcohol consumption and risk of cirrhosis in chronic liver diseases including chronic hepatitis C infection, there has been a reluctance to recommend any level of alcohol consumption among patients with NAFLD,” the researchers wrote.

The study comprised 187 patients with biopsy-proven NAFLD. Seventy-four patients had never consumed alcohol, 91 were current drinkers and 22 were past drinkers. The researchers excluded patients who had been abstinent over the past 12 months but had a history of previous alcohol consumption.

Multivariate analysis showed a significant correlation between modest alcohol consumption (1 gram to 70 grams per week) and a decreased risk for advanced fibrosis (OR = 0.33; 95% CI, 0.14-0.78) compared with lifetime abstinence. The association did not change after adjustment for homeostasis model assessment, sex and total lifetime alcohol consumption.

Among the 91 current drinkers, 32 exclusively drank wine and 22 exclusively drank beer. Exclusive wine drinkers consumed less alcohol than exclusive beer drinkers (15 vs. 25.4 grams per week).

Additionally, exclusive wine consumption correlated with lower mean fibrosis stage (0.8 vs. 1.6; P = .02) and a lower proportion of advanced fibrosis cases (12.5% vs. 35.1%; P = .02) compared with lifetime abstinence. The researchers observed no such correlations among exclusive beer drinkers.

Neither male nor female sex had any significant interaction with the type of alcohol consumed or level of current alcohol consumption, “indicating the association between alcohol and advanced fibrosis was similar in males and females.”

“Alcohol consumption should be avoided in patients with NAFLD-related cirrhosis due to the association with hepatocellular carcinoma and further research is needed to establish whether low-level alcohol consumption represents a ‘healthier’ lifestyle effect in NAFLD, as well to determine the impact on cardiovascular end points and mortality in these patients,” Mitchell and colleagues concluded. – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.