Ye Rui-Qi, Chen Yi-Fan, Ma Chang, Cheng Xi, Guo Wei, Li Sha
Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province 430022, China; Xinhua Clinical Medical College, Shanghai Jiao Tong University, Shanghai 200135, China.
College of Basic Medical Sciences, Shanghai Jiao Tong University, Shanghai 200025, China.
Biomed Pharmacother. 2025 Jul;188:118191. doi: 10.1016/j.biopha.2025.118191. Epub 2025 May 22.
Metabolic dysfunction-associated alcohol-related liver disease (MetALD) is an emerging clinical entity that reflects the coexistence of metabolic dysfunction and alcohol-related liver injury. Unlike classical alcoholic liver disease (ALD), MetALD patients often present with lower to moderate alcohol consumption alongside metabolic risk factors such as obesity, insulin resistance, and dyslipidemia. These factors can synergistically worsen liver injury even at lower alcohol intake levels. Alcohol abuse remains a major global health concern, with the liver being the primary target of alcohol's toxic effects. Long-term alcohol exposure, especially when compounded by metabolic dysfunction, can accelerate the progression from steatosis to inflammation, fibrosis, cirrhosis, and hepatocellular carcinoma. Besides alcohol itself, various factors, including genetic predispositions, gender, type of alcoholic beverage, drinking patterns, and co-morbidities such as viral infections (HBV, HCV) modulate disease susceptibility and severity. This review summarizes current knowledge of risk factors contributing to MetALD, highlights the synergistic interactions between metabolic dysfunction and alcohol consumption, and discusses potential strategies for disease prevention and management.
代谢功能障碍相关酒精性肝病（MetALD）是一种新出现的临床病症，反映了代谢功能障碍与酒精性肝损伤的并存。与经典酒精性肝病（ALD）不同，MetALD患者通常饮酒量较低至中等，同时伴有肥胖、胰岛素抵抗和血脂异常等代谢风险因素。即使在较低的酒精摄入量水平下，这些因素也可协同加重肝损伤。酒精滥用仍然是全球主要的健康问题，肝脏是酒精毒性作用的主要靶器官。长期接触酒精，尤其是在合并代谢功能障碍时，可加速从脂肪变性进展为炎症、纤维化、肝硬化和肝细胞癌。除酒精本身外，包括遗传易感性、性别、酒精饮料类型、饮酒模式以及病毒感染（HBV、HCV）等合并症在内的各种因素，均可调节疾病易感性和严重程度。本综述总结了目前对导致MetALD的危险因素的认识，强调了代谢功能障碍与酒精消费之间的协同相互作用，并讨论了疾病预防和管理的潜在策略。
