Nonheavy Drinking and Worsening of Noninvasive Fibrosis Markers in Nonalcoholic Fatty Liver Disease: A Cohort Study
Abstract
The effect of modest alcohol consumption on fibrosis progression in the general population with nonalcoholic fatty liver disease (NAFLD) remains unclear. We examined the association of nonheavy alcohol consumption with worsening of noninvasive fibrosis indices in a large‐scale, low‐risk population with NAFLD. A cohort study was performed in 58,927 Korean adults with NAFLD and low fibrosis scores who were followed for a median of 4.9 years. Non‐, light, and moderate drinkers were defined as 0 g/day, 1‐9.9 g/day, and 10‐29.9 g/day (10‐19.9 g/day for women), respectively. Progression from low to intermediate or high probability of advanced fibrosis was assessed using noninvasive indices including NAFLD fibrosis score (NFS) and Fibrosis‐4 Index (FIB‐4). A parametric proportional hazards model was used to estimate the multivariable‐adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). During 347,925.4 person‐years of follow‐up, 5,630 subjects with low FIB‐4 progressed to intermediate or high FIB‐4. The multivariable‐adjusted HRs (95% CI) for worsening of FIB‐4 comparing light and moderate drinkers with nondrinkers were 1.06 (0.98‐1.16) and 1.29 (1.18‐1.40), respectively. Similarly, using NFS, corresponding HRs (95% CI) comparing light and moderate drinkers with nondrinkers were 1.09 (1.02‐1.16) and 1.31 (1.23‐1.40), respectively. Furthermore, the association of moderate drinkers with worsening of either FIB‐4 or NFS remained significant after introducing alcohol use…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 58,927 participants or records.
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