Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8503, Japan; Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, Shikokuchuo 779-0193, Japan.
Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8503, Japan; Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, Shikokuchuo 779-0193, Japan.
Clin Nutr. 2023 May;42(5):810-816. doi: 10.1016/j.clnu.2023.03.020. Epub 2023 Mar 31.
BACKGROUND & AIMS: The influence of changes in alcohol consumption on newly developed metabolic dysfunction-associated fatty liver disease (MAFLD) is unclear. We investigated the influence of alcohol consumption on newly developed MAFLD in both sexes.
This observational cohort study included 4071 patients who underwent more than two health check-ups between 2015 and 2020 over an interval of more than a year. Generalised estimating equations were used for analyses.
At baseline, the rates of drinking and MAFLD between men and women were 72.5% versus 41.7% and 42.2% versus 22.1%, respectively. At the most recent stage, the rates of an increase in alcohol consumption for men and women were 13.3% and 8.7%, respectively, and 311/1192 (26.1%) men and 155/1566 (9.9%) women had newly developed MAFLD. The odds ratio (OR) for drinking in patients with newly developed MAFLD was 0.863 (men) (95% confidence interval [CI], 0.676-1.102, p = 0.237) and 1.041 (women) (95% CI, 0.753-1.439, p = 0.808); the OR for women who drank 140-279.9 g/week was 2.135 (95% CI, 1.158-3.939, p < 0.05) and that for all drinking categories among women was >1. Several non-invasive fibrosis scores were significantly associated with the quantity of alcohol consumption in patients with newly developed MAFLD (p < 0.005).
Alcohol consumption had no significant protective effect against newly developed MAFLD in both sexes, regardless of quantity. Conversely, alcohol consumption ≥140 g/week was a risk factor for newly developed MAFLD in women. The development of liver fibrosis with increased alcohol intake should be considered in patients with MAFLD.
饮酒量变化对新发生的代谢相关脂肪性肝病（MAFLD）的影响尚不清楚。我们调查了饮酒对男性和女性新发生 MAFLD 的影响。
本观察性队列研究纳入了 4071 例患者，他们在 2015 年至 2020 年期间至少进行了两次健康检查，间隔超过一年。采用广义估计方程进行分析。
在基线时，男性和女性的饮酒率和 MAFLD 发生率分别为 72.5%和 41.7%、42.2%和 22.1%。在最近阶段，男性和女性的饮酒量增加率分别为 13.3%和 8.7%，1192 例男性中有 311 例（26.1%）和 1566 例女性中有 155 例（9.9%）发生了新发生的 MAFLD。新发生 MAFLD 患者饮酒的比值比（OR）为 0.863（男性）（95%置信区间 [CI]：0.676-1.102，p=0.237）和 1.041（女性）（95%CI：0.753-1.439，p=0.808）；女性每周饮酒 140-279.9g 的 OR 为 2.135（95%CI：1.158-3.939，p<0.05），所有女性饮酒类别中的 OR 均>1。几种非侵入性纤维化评分与新发生 MAFLD 患者的饮酒量显著相关（p<0.005）。
无论饮酒量多少，饮酒对男性和女性新发生的 MAFLD 均无显著保护作用。相反，女性每周饮酒≥140g 是新发生 MAFLD 的危险因素。在 MAFLD 患者中，应考虑随着饮酒量增加而发生的肝纤维化发展。
