Liver Unit, CEMAD Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia, Catholic University, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Department of Abdominal, Endocrine and Metabolic Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Nutrients. 2024 Feb 23;16(5):613. doi: 10.3390/nu16050613.
Although alcohol is one of the most important etiologic agents in the development of chronic liver disease worldwide, also recognized as a promoter of carcinogenesis, several studies have shown a beneficial effect of moderate consumption in terms of reduced cardiovascular morbidity and mortality. Whether this benefit is also present in patients with liver disease due to other causes (viral, metabolic, and others) is still debated. Although there is no clear evidence emerging from guidelines and scientific literature, total abstention from drinking is usually prescribed in clinical practice. In this review, we highlight the results of the most recent evidence on this controversial topic, in order to understand the effect of mild alcohol use in this category of individuals. The quantification of alcohol intake, the composition of the tested populations, and the discrepancy between different works in relation to the outcomes represent important limitations emerging from the scientific literature. In patients with NAFLD, a beneficial effect is demonstrated only in a few works. Even if there is limited evidence in patients affected by chronic viral hepatitis, a clear deleterious effect of drinking in determining disease progression in a dose-dependent manner emerges. Poor data are available about more uncommon pathologies such as hemochromatosis. Overall, based on available data, it is not possible to establish a safe threshold for alcohol intake in patients with liver disease.
尽管酒精是全球范围内导致慢性肝病的最重要病因之一，也被认为是致癌的促进因素，但多项研究表明，适量饮酒可降低心血管疾病的发病率和死亡率。这种益处是否也存在于因其他原因（病毒、代谢等）导致肝病的患者中，仍存在争议。尽管指南和科学文献中没有明确的证据，但在临床实践中通常会建议患者完全戒酒。在这篇综述中，我们重点介绍了这一争议性话题的最新证据结果，以了解轻度饮酒对这一类人群的影响。酒精摄入量的量化、测试人群的构成以及不同研究在结果方面的差异是从科学文献中得出的重要局限性。在非酒精性脂肪性肝病（NAFLD）患者中，仅有少数研究证实了饮酒的有益作用。即使在慢性病毒性肝炎患者中，证据有限，但饮酒会以剂量依赖的方式对疾病进展产生明显的有害影响。关于血色病等罕见疾病的数据很少。总体而言，根据现有数据，无法确定肝病患者饮酒的安全阈值。
