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Low to moderate lifetime alcohol consumption is associated with less advanced stages of fibrosis in non-alcoholic fatty liver disease

Hagström, Hannes; Nasr, Patrik; Ekstedt, Mattias; Kechagias, Stergios; Önnerhag, Kristina LU ; Nilsson, Emma LU ; Rorsman, Fredrik; Sheikhi, Reza; Marschall, Hanns Ulrich and Hultcrantz, Rolf, et al. (2017) In Scandinavian Journal of Gastroenterology 52(2). p.159-165
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... (More)

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.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
alcohol, fibrosis stage, lifetime alcohol consumption, NAFLD, NASH
in
Scandinavian Journal of Gastroenterology
volume
52
issue
2
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:84990200720
ISSN
0036-5521
DOI
10.1080/00365521.2016.1239759
language
English
LU publication?
no
id
715c16bd-721d-436f-b76c-2830ceceb2ca
date added to LUP
2019-04-01 13:26:17
date last changed
2019-05-14 04:53:02
@article{715c16bd-721d-436f-b76c-2830ceceb2ca,
  abstract     = {<p>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.</p>},
  author       = {Hagström, Hannes and Nasr, Patrik and Ekstedt, Mattias and Kechagias, Stergios and Önnerhag, Kristina and Nilsson, Emma and Rorsman, Fredrik and Sheikhi, Reza and Marschall, Hanns Ulrich and Hultcrantz, Rolf and Stål, Per},
  issn         = {0036-5521},
  keyword      = {alcohol,fibrosis stage,lifetime alcohol consumption,NAFLD,NASH},
  language     = {eng},
  month        = {02},
  number       = {2},
  pages        = {159--165},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {Low to moderate lifetime alcohol consumption is associated with less advanced stages of fibrosis in non-alcoholic fatty liver disease},
  url          = {http://dx.doi.org/10.1080/00365521.2016.1239759},
  volume       = {52},
  year         = {2017},
}