Search resultsNon-heavy drinking and worsening of non-invasive fibrosis markers in nonalcoholic fatty liver disease: A cohort study.
The effect of modest alcohol consumption on fibrosis progression in the general population with NAFLD remains unclear. We examined the association of non-heavy alcohol consumption with worsening of non-invasive fibrosis indices in a large-scale, low-risk population with non-alcoholic fatty liver disease (NAFLD). A cohort study was performed in 58,927 Korean adults with NAFLD and low fibrosis scores who were followed for a median of 8.3 years. Non-, light, and moderate drinkers were defined as 0 g/day, 1-9.9 g/day, and 10-29.9 g/day (10-19.9 g/day for women), respectively. Progression from low to intermediate or high probability of advanced fibrosis was assessed using non-invasive indices including NAFLD fibrosis score (NFS) and FIB-4. Parametric proportional hazards model was used to estimate the multivariate-adjusted hazard ratios and 95% confidence intervals. During 347,925.4 person-years of follow-up, 5,630 subjects with low FIB-4 progressed to intermediate or high FIB-4. The multivariable-adjusted HRs (95% CI) for worsening of FIB-4 comparing light-drinkers and moderate-drinkers with non-drinkers were 1.06 (0.98-1.16) and 1.29 (1.18-1.40), respectively. Similarly, using NFS, corresponding HRs (95% CI) comparing light-drinkers and moderate-drinkers with non-drinkers were 1.09 (1.02-1.16) and 1.31 (1.23-1.40), respectively. Furthermore, the association of moderate drinkers with worsening of either FIB-4 or NFS remained significant after introducing alcohol use and confounders treated as time-varying covariates.
CONCLUSION: In this large-scale cohort of young and middle aged individuals with NAFLD, non-heavy alcohol consumption, especially moderate alcohol consumption, was significantly and independently associated with worsening of noninvasive markers of fibrosis, indicating that even moderate alcohol consumption might be harmful. This article is protected by copyright. All rights reserved.