Complete alcohol abstinence increases the risk of NAFLD but not severity. A population analysis with transient elastography

Jieling Xiao, Cheng Han Ng, Kai En Chan, Ansel Shao Pin Tang, Readon Teh, Abel Ho Zhi Ling, Jie Ning Yong, Wen Hui Lim, Darren Jun Hao Tan, Caitlyn Tan, Khin Maung Win, Aung Hlaing Bwa, Nicholas W.S. Chew, Daniel Huang, Yock Young Dan, Mazen Noureddin, Mohammad Shadab Siddiqui, Arun Sanyal, Nobuharu Tamaki, Mark Muthiah

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND & AIMS: As the global prevalence of non-alcoholic fatty liver disease (NAFLD) continues to rise, ubiquity of alcohol use has also prompted discussion regarding the potential interactions between the two. This study aims to examine the effects of modest alcohol consumption on the prevalence and complications of NAFLD in a multi-ethnic population.

METHODS: This study analyses the 2017-2018 cycles of NHANES that examined liver fibrosis and steatosis with vibration controlled transient elastography. A coarsened exact matching was conducted to reduce confounding. Logistic regression was done with a multivariate model to assess the relationship between alcohol consumption (modest drinkers and non-drinkers) and risk of NAFLD and its complications.

RESULTS: 2,067 individuals were found to have NAFLD and 284 NAFLD patients had a total history of alcohol abstinence. After coarsened exact matching, the prevalence of NAFLD was 49% (CI: 0.41 - 0.58) in non-drinkers and 33% (CI: 0.26 - 0.41) in modest drinkers. Non-drinkers had twice the odds of NAFLD compared to modest drinkers (OR: 1.99, CI: 1.22 - 3.22, p<.01) after adjustment for confounders. There were no significant differences in the odds of significant fibrosis, advance fibrosis, cirrhosis, cardiovascular disease and stroke between non-drinkers and modest drinkers. The odds of malignancy in non-drinkers were almost significantly less than modest drinkers (OR: 0.28, CI:0.08 - 1.02, p=.053).

CONCLUSION: Interestingly, modest alcohol consumption is associated with decreased odds of NAFLD. Further investigations are required to examine the relationship between alcohol consumption and NAFLD and subsequently the potential impact on NAFLD management.

Original languageEnglish (US)
Pages (from-to)76-82
Number of pages7
JournalScandinavian Journal of Gastroenterology
Volume58
Issue number1
DOIs
StatePublished - 2023

Keywords

  • alcohol abstinence
  • fibrosis
  • modest alcohol consumption
  • Non-alcoholic fatty liver disease
  • Nutrition Surveys
  • Humans
  • Liver Cirrhosis/epidemiology
  • Fibrosis
  • Alcohol Abstinence
  • Non-alcoholic Fatty Liver Disease/pathology
  • Elasticity Imaging Techniques
  • Alcohol Drinking/adverse effects

ASJC Scopus subject areas

  • Gastroenterology

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