Search resultsNon-heavy alcohol use associates with liver fibrosis and 'nonalcoholic' steatohepatitis in the Framingham Heart Study.
BACKGROUND AND AIMS: While heavy alcohol use consistently associates with liver disease, the effects of non-heavy alcohol consumption are less understood. We aimed to investigate the relationship between non-heavy alcohol use and chronic liver disease.
METHODS: This cross-sectional study included 2629 current drinkers in the Framingham Heart Study who completed alcohol use questionnaires and transient elastography. We defined fibrosis as liver stiffness measurement (LSM) ≥8.2 kPa. We defined at-risk non-alcoholic steatohepatitis (NASH) as Fibroscan-Aspartate Aminotransferase (FAST) score >0.35 (90% sensitivity) or ≥0.67 (90% specificity). We performed logistic regression to investigate associations of alcohol use measures with fibrosis and NASH, adjusting for sociodemographic and metabolic factors. Subgroup analysis excluded heavy drinkers (>14 drinks per week for women or >21 for men).
RESULTS: In this sample (mean age 54.4 ± 8.9 yrs, 53.3% women), mean LSM was 5.6 ± 3.4 kPa, 8.2% had fibrosis, 1.9% had NASH by FAST ≥0.67, and 12.4% had NASH by FAST >0.35. Participants drank 6.2 ± 7.4 drinks/week. Total drinks/week and frequency of drinking associated with increased odds of fibrosis (aOR 1.18, 95% CI 1.04-1.33 and aOR 1.08, 95% CI 1.01-1.16). Risky weekly drinking, present in 17.4%, also associated with fibrosis (aOR 1.49, 95% CI 1.03-2.14). After excluding 158 heavy drinkers, total drinks/week remained associated with fibrosis (aOR 1.16, 95% CI 1.001-1.35). Multiple alcohol use measures positively associated with FAST >0.35.
CONCLUSION: In this community cohort, we demonstrate that non-heavy alcohol use associates with fibrosis and NASH, after adjustment for metabolic factors. Longitudinal studies are needed to determine the benefits of moderating alcohol use to reduce liver-related morbidity and mortality.