Modest alcohol consumption is associated with decreased prevalence of steatohepa

StephenW

http://www.journal-of-hepatology.eu/article/S0168-8278%2812%2900279-6/abstract
Article in Press
Modest alcohol consumption is associated with decreased prevalence of steatohepatitis in patients with nonalcoholic fatty liver disease (NAFLD)

• Winston Dunn
  ,
• Arun J. Sanyal
  ,
• Elizabeth M. Brunt
  ,
• Aynur Unalp-Arida
  ,
• Michael Donohue
  ,
• Arthur J. McCullough
  ,
• Jeffrey B. Schwimmer
  ,
• for the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN)
  

Received 26 January 2012; received in revised form 8 March 2012; accepted 12 March 2012.  published online 18 April 2012.
Accepted Manuscript

• 
  

Abstract Background & aimsNonalcoholic fatty liver disease (NAFLD) is a cardiovascular risk factor. Although modest alcohol consumption may reduce the risk for cardiovascular mortality, whether patients with NAFLD should be allowed modest alcohol consumption remains an important unaddressed issue. We aimed to evaluate the association between modest alcohol drinking and nonalcoholic steatohepatitis(NASH), among subjects with NAFLD.
MethodsIn a Cross-sectional analysis of adult participants in the NIH NASH Clinical Research Network, only modest or non-drinkers were included: participants identified as 1) drinking > 20gm/day, 2) binge drinkers, or 3) non-drinkers with previous alcohol consumption were excluded. The odds of having a histological diagnosis of NASH and other histological features of NAFLD were analyzed using multiple ordinal logistic regression.
ResultsThe analysis included 251 lifetime non-drinkers and 331 modest drinkers. Modest drinkers compared to nondrinkers had lower odds of having a diagnosis of NASH (Summary odds ratio 0.56, 95%CI 0.39-0.84, p=0.002). The odds of NASH decreased as the frequency of alcohol consumption increased within the range of modest consumption. Modest drinkers also had significantly lower odds for fibrosis (OR 0.56 95%CI 0.41–0.77) and ballooning hepatocellular injury (OR 0.66 95%CI 0.48–0.92) than lifetime non-drinkers.
ConclusionsIn a large, well-characterized population with biopsy-proven NAFLD, modest alcohol consumption was associated with lesser degree of severity as determined by lower odds of the key features that comprise a diagnosis of steatohepatitis, as well as fibrosis. These findings demonstrate the need for prospective studies and a coordinated consensus on alcohol consumption recommendations in NAFLD.

StephenW

在非酒精性脂肪性肝病（NAFLD）患者中，适度饮酒与肝炎的患病率下降

    温斯顿·邓恩
    ，
    阿伦研究桑亚尔
    ，
    伊丽莎白研究布伦特
    ，
    aynur Unalp-Arida
    ，
    迈克尔·多诺霍
    ，
    亚瑟研究麦卡洛
    ，
    杰弗里乙Schwimmeremail地址
    ，
    非酒精性脂肪性肝炎的临床研究网络（CRN的纳什）

收到2012年1月26日收到2012年3月在修订后的形式8，接受2012年3月12日。 2012年4月18日网上公布。
接受手稿

   
背景及目的

非酒精性脂肪性肝病（NAFLD）是心血管疾病的危险因素。虽然适度饮酒可降低心血管疾病死亡率的风险，NAFLD患者是否应该被允许适度饮酒，仍然是一个重要的未解决的问题。我们的目的是评估适度饮酒和非酒精性脂肪性肝炎（NASH）与NAFLD科目之间，之间的关联。
方法

在成人学员在美国国立卫生研究院NASH的临床研究网络，只有少量或不饮酒的横断面分析包括：参与者确定为1）生活饮用水> 20gm/day，2）饮酒狂欢，或3）与以往不饮酒饮酒被排除在外。有纳什和其他NAFLD的病理特征病理诊断的可能性进行了分析使用多个有序logistic回归。
结果

分析包括251终身不饮酒和适度饮酒者331。适度饮酒者比不饮酒者的胜算较低的NASH的诊断（摘要胜算比0.56，95％CI 0.39-0.84，P = 0.002）。纳什的几率降低饮酒的频率范围内适度消费的增加。适度饮酒也有显着降低肝纤维化（或0.56 95％CI 0.41-0.77）和气球比终身不饮酒者的肝细胞损伤（或0.66 95％CI 0.48-0.92）赔率。
结论

在一个大型的，具有脂肪肝活检证实的人口，适度饮酒与更低的严重程度确定的关键功能，包括对肝炎的诊断，以及纤维化的胜算较低。这些结果表明，前瞻性研究的需要和对NAFLD的饮酒建议在协调共识。