Modest alcohol consumption is associated with decreased prevalence of steatohepatitis in patients with non-alcoholic fatty liver disease (NAFLD).
Modest alcohol consumption is associated with decreased prevalence of steatohepatitis in patients with non-alcoholic fatty liver disease (NAFLD).
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DOI：
10.1016/j.jhep.2012.03.024
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发表时间：
2012-08
影响因子：
25.7
通讯作者：
Schwimmer, Jeffrey B.
中科院分区：
文献类型：
--
作者：
Dunn, Winston;Sanyal, Arun J.;Brunt, Elizabeth M.;Unalp-Arida, Aynur;Donohue, Michael;McCullough, Arthur J.;Schwimmer, Jeffrey B.
非酒精性脂肪性肝病（NAFLD）是一种心血管危险因素。尽管适度饮酒可能降低心血管死亡风险，但NAFLD患者是否应被允许适度饮酒仍然是一个重要的未解决问题。我们旨在评估NAFLD患者中适度饮酒与非酒精性脂肪性肝炎（NASH）之间的关联。
在对美国国立卫生研究院NASH临床研究网络中成年参与者的一项横断面分析中，仅纳入适度饮酒者或不饮酒者：被确定为1）每日饮酒量>20克、2）酗酒者或3）有既往饮酒史的不饮酒者被排除在外。使用多元有序逻辑回归分析了经组织学诊断为NASH以及NAFLD的其他组织学特征的几率。
该分析包括251名终生不饮酒者和331名适度饮酒者。与不饮酒者相比，适度饮酒者被诊断为NASH的几率较低（汇总优势比为0.56，95%置信区间为0.39 - 0.84，p = 0.002）。在适度饮酒范围内，随着饮酒频率的增加，NASH的几率降低。与终生不饮酒者相比，适度饮酒者患纤维化（优势比为0.56，95%置信区间为0.41 - 0.77）和肝细胞气球样变损伤（优势比为0.66，95%置信区间为0.48 - 0.92）的几率也显著降低。
在一个经活检证实的NAFLD特征明确的大型人群中，适度饮酒与较低的严重程度相关，这是由构成脂肪性肝炎诊断的关键特征以及纤维化的较低几率所确定的。这些发现表明需要进行前瞻性研究，并就NAFLD中的饮酒建议达成协调一致的共识。
Nonalcoholic fatty liver disease (NAFLD) is a cardiovascular risk factor. Although modest alcohol consumption may reduce the risk for cardiovascular mortality, whether patients with NAFLD should be allowed modest alcohol consumption remains an important unaddressed issue. We aimed to evaluate the association between modest alcohol drinking and nonalcoholic steatohepatitis(NASH), among subjects with NAFLD. In a Cross-sectional analysis of adult participants in the NIH NASH Clinical Research Network, only modest or non-drinkers were included: participants identified as 1) drinking > 20gm/day, 2) binge drinkers, or 3) non-drinkers with previous alcohol consumption were excluded. The odds of having a histological diagnosis of NASH and other histological features of NAFLD were analyzed using multiple ordinal logistic regression. The analysis included 251 lifetime non-drinkers and 331 modest drinkers. Modest drinkers compared to nondrinkers had lower odds of having a diagnosis of NASH (Summary odds ratio 0.56, 95%CI 0.39–0.84, p=0.002). The odds of NASH decreased as the frequency of alcohol consumption increased within the range of modest consumption. Modest drinkers also had significantly lower odds for fibrosis (OR 0.56 95%CI 0.41–0.77) and ballooning hepatocellular injury (OR 0.66 95%CI 0.48–0.92) than lifetime non-drinkers. In a large, well-characterized population with biopsy-proven NAFLD, modest alcohol consumption was associated with lesser degree of severity as determined by lower odds of the key features that comprise a diagnosis of steatohepatitis, as well as fibrosis. These findings demonstrate the need for prospective studies and a coordinated consensus on alcohol consumption recommendations in NAFLD.
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DOI：
10.1056/nejmoa0907929
发表时间：
2010-05-06
期刊：
The New England journal of medicine
影响因子：
--
作者：
Sanyal AJ;Chalasani N;Kowdley KV;McCullough A;Diehl AM;Bass NM;Neuschwander-Tetri BA;Lavine JE;Tonascia J;Unalp A;Van Natta M;Clark J;Brunt EM;Kleiner DE;Hoofnagle JH;Robuck PR;NASH CRN
通讯作者：
NASH CRN
影响因子：
13.5
作者：
Browning, JD;Szczepaniak, LS;Hobbs, HH
通讯作者：
Hobbs, HH
影响因子：
158.5
作者：
FUCHS, CS;STAMPFER, MJ;WILLETT, WC
通讯作者：
WILLETT, WC
影响因子：
5.9
作者：
King, Dana E.;Mainous, Arch G., III;Geesey, Mark E.
通讯作者：
Geesey, Mark E.
影响因子：
13.5
作者：
Rotman, Yaron;Koh, Christopher;Zmuda, Joseph M.;Kleiner, David E.;Liang, T. Jake
通讯作者：
Liang, T. Jake