Interaction Between Alcohol Use and Metabolic Risk Factors for Liver Disease : A Critical Review of Epidemiological Studies

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Åberg , F , Färkkilä , M & Männistö , V 2020 , ' Interaction Between Alcohol Use and Metabolic Risk Factors for Liver Disease : A Critical Review of Epidemiological Studies ' , Alcoholism: Clinical and Experimental Research , vol. 44 , no. 2 , pp. 384-403 . https://doi.org/10.1111/acer.14271

Title: Interaction Between Alcohol Use and Metabolic Risk Factors for Liver Disease : A Critical Review of Epidemiological Studies
Author: Åberg, Fredrik; Färkkilä, Martti; Männistö, Ville
Contributor: University of Helsinki, HUS Abdominal Center
University of Helsinki, Centre of Excellence in Complex Disease Genetics
Date: 2020-02
Language: eng
Number of pages: 20
Belongs to series: Alcoholism: Clinical and Experimental Research
ISSN: 0145-6008
URI: http://hdl.handle.net/10138/327110
Abstract: Coexistence of alcohol use and metabolic risk-the 2 commonest population risk factors for nonviral chronic liver disease-is a growing concern. Clinical evidence and mechanistic evidence point to considerable supraadditive interaction effects for the development and progression of chronic liver disease between hazardous alcohol use and metabolic abnormalities including obesity, diabetes, and the metabolic syndrome (MetS). Intermittent binge drinking once monthly or more often seems to be associated with progression of liver disease even when average alcohol intake is within the currently allowed limits for a diagnosis of nonalcoholic fatty liver disease (NAFLD), and supraadditive interaction between binge drinking and the MetS has been reported. There are contradictory findings regarding the association between low alcohol use and liver steatosis, but, clearly, the mechanisms of alcoholic hepatotoxicity extend beyond simple fat accumulation. The presence of liver steatosis seems to amplify alcoholic hepatotoxicity. Recent longitudinal studies of NAFLD subjects report low alcohol use associated with both increased fibrosis progression and an elevated risk for liver cancer and severe liver disease. There is no clear safe limit of alcohol intake in the presence of NAFLD or metabolic risk. The interaction effects between alcohol and metabolic dysfunction merit increased attention in public health policy, individual counseling, and risk stratification. Based on current evidence, a strict dichotomization of liver disease into either pure alcoholic or nonalcoholic may be inappropriate.
Subject: Liver Cirrhosis
Drinking
Metabolic Syndrome
NAFLD
Alcoholic
BODY-MASS INDEX
FATTY LIVER
HEPATOCELLULAR-CARCINOMA
HEPATIC STEATOSIS
BINGE DRINKING
GENERAL-POPULATION
VIRAL-HEPATITIS
CENTRAL OBESITY
CONSUMPTION
PREVALENCE
3121 Internal medicine
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