Hannes Hagström1,2, Patrik Nasr3,4, Mattias Ekstedt3,4, Stergios Kechagias3,4, Kristina Önnerhag5, Emma Nilsson5, Fredrik Rorsman6, Reza Sheikhi6, Hanns-Ulrich Marschall7, Rolf Hultcrantz1,2, Per Stål1,2. 1. a Centre for Digestive Diseases, Division of Hepatology , Karolinska University Hospital , Stockholm , Sweden. 2. b Department of Medicine , Karolinska Institutet , Stockholm , Sweden. 3. c Department of Gastroenterology and Hepatology , Linköping University , Linköping , Sweden. 4. d Department of Medical and Health Sciences , Linköping University , Linköping , Sweden. 5. e Department of Gastroenterology and Hepatology , Skåne University Hospital, Malmö/Lund , Sweden. 6. f Department of Gastroenterology and Hepatology , Uppsala University Hospital , Uppsala , Sweden. 7. g Department of Molecular and Clinical Medicine, Sahlgrenska Academy , Institute of Medicine, University of Gothenburg , Gothenburg , Sweden.
Abstract
BACKGROUND AND AIM: Moderate alcohol consumption has been associated with a lower risk of disease severity in non-alcoholic fatty liver disease (NAFLD). It is unclear if this reflects current or lifetime drinking, or can be attributed to confounders such as diet and exercise. We evaluated the impact of lifetime alcohol consumption on fibrosis severity in NAFLD. METHODS: We prospectively enrolled 120 subjects with biopsy-proven NAFLD and through detailed questionnaires examined lifetime alcohol consumption, diet and physical activity. Main outcome measures were odds ratios (OR) for fibrosis stage, calculated through ordinal regression after adjustment for body mass index, diabetes mellitus type 2, smoking and age at biopsy. A biomarker for recent alcohol consumption, phosphatidyl ethanol (PEth) was sampled. RESULTS: An increase in median weekly alcohol consumption to a maximum of 13 drinks per week was associated with lower fibrosis stage (adjusted OR for each incremental unit, 0.86; 95% CI, 0.76-0.97; p = .017). The lowest risk for fibrosis was found with the lowes`t odds seen in the top quartile of alcohol consumption (aOR 0.23; 95% CI 0.08-0.66; p = .006). Adding soft drink and coffee consumptions, and physical activity to the model did not change the estimates. Subjects with PEth ≥0.3 μmol/L had higher ORs for a higher fibrosis stage (aOR 2.77; 95% CI 1.01-7.59; p = .047). CONCLUSION: Lifetime alcohol consumption with up to 13 units per week is associated with lower fibrosis stage in NAFLD. Elevated PEth is associated with higher stages of fibrosis.
BACKGROUND AND AIM: Moderate alcohol consumption has been associated with a lower risk of disease severity in non-alcoholic fatty liver disease (NAFLD). It is unclear if this reflects current or lifetime drinking, or can be attributed to confounders such as diet and exercise. We evaluated the impact of lifetime alcohol consumption on fibrosis severity in NAFLD. METHODS: We prospectively enrolled 120 subjects with biopsy-proven NAFLD and through detailed questionnaires examined lifetime alcohol consumption, diet and physical activity. Main outcome measures were odds ratios (OR) for fibrosis stage, calculated through ordinal regression after adjustment for body mass index, diabetes mellitus type 2, smoking and age at biopsy. A biomarker for recent alcohol consumption, phosphatidyl ethanol (PEth) was sampled. RESULTS: An increase in median weekly alcohol consumption to a maximum of 13 drinks per week was associated with lower fibrosis stage (adjusted OR for each incremental unit, 0.86; 95% CI, 0.76-0.97; p = .017). The lowest risk for fibrosis was found with the lowes`t odds seen in the top quartile of alcohol consumption (aOR 0.23; 95% CI 0.08-0.66; p = .006). Adding soft drink and coffee consumptions, and physical activity to the model did not change the estimates. Subjects with PEth ≥0.3 μmol/L had higher ORs for a higher fibrosis stage (aOR 2.77; 95% CI 1.01-7.59; p = .047). CONCLUSION: Lifetime alcohol consumption with up to 13 units per week is associated with lower fibrosis stage in NAFLD. Elevated PEth is associated with higher stages of fibrosis.
Authors: Paul M Trembling; Sophia Apostolidou; Aleksandra Gentry-Maharaj; Julie Parkes; Andy Ryan; Sudeep Tanwar; Matthew Burnell; Ian Jacobs; Usha Menon; William M Rosenberg Journal: BMC Public Health Date: 2017-06-28 Impact factor: 3.295
Authors: Preya J Patel; David Smith; Jason P Connor; Leigh U Horsfall; Kelly L Hayward; Fabrina Hossain; Suzanne Williams; Tracey Johnson; Katherine A Stuart; Nigel N Brown; Nivene Saad; Andrew D Clouston; Katharine M Irvine; Anthony W Russell; Patricia C Valery; Elizabeth E Powell Journal: Can J Gastroenterol Hepatol Date: 2017-11-01