MGH Alcohol Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States.
Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States.
Alcohol Alcohol. 2023 Sep 9;58(5):472-477. doi: 10.1093/alcalc/agad052.
Therapies to prevent alcohol-associated liver disease (ALD) in high-risk patients are needed.
In this retrospective association study, we examined whether patients with alcohol use disorder (AUD) who reported greater exercise were less likely to develop liver disease.
In this retrospective cohort study, we used the Mass General Brigham Biobank to investigate the impact of both moderate-high and light-intensity exercise on the development of ALD in patients with AUD, using clinician-provided diagnostic International Classification of Diseases 10 codes. Exercise was evaluated using a questionnaire completed after an AUD diagnosis, and before evidence of liver disease. Cox regressions were used to generate hazard ratios (HRs) for the development of ALD.
1987 patients met inclusion criteria. These patients were followed for an average of 10.7 years. In multivariable analyses, we found that patients that reported at least 2.5 h of moderate-high intensity exercise/week (confidence interval recommendation for exercise) were less likely to develop ALD compared to patients that did not exercise (HR: 0.26, 95%CI: 0.085-0.64, P = 0.007). Indeed, each hour of moderate-high intensity exercise was associated with progressively decreasing odds of developing ALD (HR: 0.76, 95%CI: 0.58-0.91, P = 0.02). Conversely, patients who did not engage in any moderate-high intensity exercise were more likely to develop ALD (HR: 2.76, 95%CI: 1.44-5.40, P = 0.003).
In our cohort, patients with AUD who reported moderate-high intensity exercise showed a lower association with incidence of ALD development than patients who did not exercise.
需要针对高危患者的预防酒精相关肝病 (ALD) 的治疗方法。
在这项回顾性关联研究中,我们研究了报告运动量较大的酒精使用障碍 (AUD) 患者是否不太可能发展为肝病。
在这项回顾性队列研究中,我们使用麻省总医院布列根生物库,通过临床医生提供的国际疾病分类第 10 版诊断代码,调查 AUD 患者的中高强度和低强度运动对 ALD 发展的影响。运动使用 AUD 诊断后且在出现肝病证据之前完成的问卷进行评估。使用 Cox 回归生成 ALD 发展的风险比 (HR)。
1987 名患者符合纳入标准。这些患者的平均随访时间为 10.7 年。在多变量分析中,我们发现与不运动的患者相比,报告每周至少 2.5 小时中高强度运动(运动推荐的置信区间)的患者发生 ALD 的可能性较小 (HR:0.26,95%CI:0.085-0.64,P=0.007)。实际上,每小时的中高强度运动与逐渐降低发生 ALD 的几率相关 (HR:0.76,95%CI:0.58-0.91,P=0.02)。相反,不进行任何中高强度运动的患者更有可能发生 ALD (HR:2.76,95%CI:1.44-5.40,P=0.003)。
在我们的队列中,报告中高强度运动的 AUD 患者与 ALD 发展的发生率相关性较低,而不运动的患者则相关性较高。