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Moderate alcohol intake effects differ based on steatosis status, obesity

Light to moderate alcohol intake correlated with a decreased risk for simple hepatic steatosis in patients without nonalcoholic fatty liver disease, whereas the same consumption in those with nonalcoholic fatty liver disease and those with obesity had an increased risk, according to recently published data.

Yoosoo Chang, MD, PhD, from the Sungkyunkwan University in South Korea, and colleagues wrote that while studies have suggested that modest alcohol intake correlated with a lower risk for NAFLD compared with no alcohol consumption, those studies did not consider fibrosis and other studies have shown a correlation between modest alcohol intake and hepatic steatosis (HS) in patients with established fatty liver disease.

“Importantly, since HS with fibrosis rather than simple HS alone is associated with adverse hepatic outcomes, inclusion of simple HS as an endpoint (without considering liver fibrosis) may provide misleading evidence for the effect of low levels of alcohol consumption on liver health,” they wrote.

The study comprised 190,048 participants who drank up to 30 grams of alcohol per day if they were men or up to 20 grams per day if they were women. During a median follow-up period of 4.1 years, 43,466 participants developed HS and 2,983 developed HS with an increase in Fibrosis-4 score.

The multivariable-adjusted hazard ratios for new-onset HS was 0.94 (95% CI, 0.92-0.96) in light to moderate drinkers compared with 1.02 (95% CI, 0.99-1.05) in nondrinkers, while the ratios for HS plus an increase in FIB-4 were 1.16 (95% CI, 1.05-1.28) in light to moderate drinkers and 1.65 (95% CI, 1.48-1.84) in nondrinkers.

Chang and colleagues noted further that the correlation between alcohol intake and the risk for HS or HS with an increase in FIB-4 differed significantly by the presence of obesity, where moderate consumption in those without obesity correlated positively with simple HS and HS with FIB-4 increase while those with obesity had a positive correlation with incident HS and FIB-4 increase.

“These data also show the effects of low levels of alcohol consumption on the liver are modified by the presence of co-existing obesity,” they wrote. “We suggest that in both obese and non-obese subjects, the thresholds for safe drinking need to be reassessed.” – by Talitha Bennett

Disclosures: The authors report no relevant financial disclosures.