Risks of Light and Moderate Alcohol Use in Fatty Liver Disease: Follow-Up of Population Cohorts
Risks of Light and Moderate Alcohol Use in Fatty Liver Disease: Follow-Up of Population Cohorts
复制标题
DOI：
10.1002/hep.30864
复制
发表时间：
2020-03-01
期刊：
影响因子：
13.5
通讯作者：
Jula, Antti
中科院分区：
文献类型：
--
作者：
Aberg, Fredrik;Puukka, Pauli;Jula, Antti
背景和目的饮酒对非酒精性脂肪性肝病的影响尚不清楚。我们调查了脂肪肝患者饮酒对肝脏、心血管和恶性疾病以及死亡的影响。方法和结果我们的研究包括8，345名脂肪肝患者（脂肪肝指数>60），他们参加了健康检查调查（FINRISK 1992-2012或Health 2000），并提供了基线酒精摄入量的数据。主要排除的是基线临床肝病、病毒性肝炎、乙醇摄入>50 g/天和当前戒酒者。数据与国家登记的住院、恶性肿瘤和肝脏、心血管和恶性疾病死亡以及全因死亡相关。调整了多个混杂因素。酒精消费显示出剂量依赖性的风险增加事件的晚期肝病和恶性肿瘤。与终身戒酒者相比，一般每天饮酒10-19克或每天饮酒0-9克的非葡萄酒饮料会使晚期肝病的风险增加一倍。相比之下，酒精摄入量高达49克/天与心血管疾病（CVD）事件减少22%-40%相关。我们观察到酒精摄入量与全因死亡之间存在J型关联，与终身戒酒者相比，酒精摄入量为0-9 g/天时，最大风险降低21%（95%置信区间，5%-34%）。然而，这些对CVD和死亡率的益处仅在从不吸烟者中观察到。与终生戒酒者相比，酒精摄入量>30克/天导致死亡风险估计增加。在一个亚群的纵向数据，酒精摄入量保持稳定，随着时间的推移，在>80%的subjects.Conclusions即使是低酒精摄入的脂肪肝疾病与晚期肝病和癌症的风险增加。低至中度饮酒与死亡率和心血管疾病风险降低有关，但仅限于从不吸烟者。
Background and Aims The effects of alcohol use in nonalcoholic fatty liver disease are unclear. We investigated the impact of alcohol use in fatty liver disease on incident liver, cardiovascular, and malignant disease, as well as death.Approach and Results Our study comprised 8,345 persons with hepatic steatosis (fatty liver index >60) who participated in health-examination surveys (FINRISK 1992-2012 or Health 2000), with available data on baseline alcohol intake. Main exclusions were baseline clinical liver disease, viral hepatitis, ethanol intake >50 g/day, and current abstainers. Data were linked with national registers for hospital admissions, malignancies, and death regarding liver, cardiovascular, and malignant disease, as well as all-cause death. Adjustment were for multiple confounders. Alcohol consumption showed a dose-dependent risk increase for incident advanced liver disease and malignancies. Consuming 10-19 g/day of alcohol in general or 0-9 g/day as nonwine beverages doubled the risk for advanced liver disease compared to lifetime abstainers. In contrast, alcohol intake up to 49 g/day was associated with a 22%-40% reduction of incident cardiovascular disease (CVD). We observed a J-shaped association between alcohol intake and all-cause death with a maximal risk reduction of 21% (95% confidence interval, 5%-34%) at alcohol intake of 0-9 g/day compared to lifetime abstainers. However, these benefits on CVD and mortality were only observed in never smokers. Alcohol intake >30 g/day yielded increased risk estimates for mortality compared to lifetime abstainers. In a subpopulation with longitudinal data, alcohol intake remained stable over time in >80% of subjects.Conclusions Even low alcohol intake in fatty liver disease is associated with increased risks for advanced liver disease and cancer. Low to moderate alcohol use is associated with reduced mortality and CVD risk but only among never smokers.