Body mass index of 23 or greater is relevant to hepatic steatosis and fibrosis in patients with harmful alcohol use.
MetALD
SLD
alcohol use disorder
Journal
Hepatology research : the official journal of the Japan Society of Hepatology
ISSN: 1386-6346
Titre abrégé: Hepatol Res
Pays: Netherlands
ID NLM: 9711801
Informations de publication
Date de publication:
22 Oct 2024
22 Oct 2024
Historique:
revised:
01
10
2024
received:
09
07
2024
accepted:
06
10
2024
medline:
23
10
2024
pubmed:
23
10
2024
entrez:
23
10
2024
Statut:
aheadofprint
Résumé
Steatotic liver disease, characterized by a combination of metabolic dysfunction, alcohol use, or specific etiologies, is a leading cause of chronic liver disease. However, the role of metabolic dysfunction in chronic liver disease with harmful alcohol use remains unclear. This study aimed to investigate factors associated with hepatic steatosis and fibrosis in patients with harmful alcohol use. Over a 2-year period, we registered patients with harmful alcohol use, defined by an Alcohol Use Disorders Identification Test score of 8 or higher. We retrospectively analyzed background information, blood test results, ultrasound-guided attenuation parameter (attenuation coefficient), and liver stiffness measurement. Hepatic steatosis was defined as attenuation coefficient ≥0.65 dB/cm/MHz, and fibrosis as liver stiffness measurement ≥7.5 kPa. The study included 131 patients (82% men, median age 59 years). Linear regression analysis revealed significant associations with attenuation coefficient for body mass index ≥23 (0.08, p < 0.0001) and age (-0.002, p = 0.002). Liver stiffness measurement was associated with body mass index ≥23 (2.52, p = 0.001), aspartate aminotransferase (0.02, p = 0.0189), gamma-glutamyl transpeptidase (0.008, p < 0.0001), platelet count (-0.02, p = 0.001), and prothrombin international normalized ratio (26.40, p < 0.0001). Among the four groups classified by the presence or absence of steatosis and fibrosis, patients with fibrosis, but without steatosis, demonstrated the lowest liver reserve. In contrast, patients with both steatosis and fibrosis showed higher aspartate aminotransferase and gamma-glutamyl transpeptidase levels. Body mass index is associated with both hepatic steatosis and fibrosis in patients with harmful alcohol use.
Sections du résumé
BACKGROUND
BACKGROUND
Steatotic liver disease, characterized by a combination of metabolic dysfunction, alcohol use, or specific etiologies, is a leading cause of chronic liver disease. However, the role of metabolic dysfunction in chronic liver disease with harmful alcohol use remains unclear. This study aimed to investigate factors associated with hepatic steatosis and fibrosis in patients with harmful alcohol use.
METHODS
METHODS
Over a 2-year period, we registered patients with harmful alcohol use, defined by an Alcohol Use Disorders Identification Test score of 8 or higher. We retrospectively analyzed background information, blood test results, ultrasound-guided attenuation parameter (attenuation coefficient), and liver stiffness measurement. Hepatic steatosis was defined as attenuation coefficient ≥0.65 dB/cm/MHz, and fibrosis as liver stiffness measurement ≥7.5 kPa.
RESULTS
RESULTS
The study included 131 patients (82% men, median age 59 years). Linear regression analysis revealed significant associations with attenuation coefficient for body mass index ≥23 (0.08, p < 0.0001) and age (-0.002, p = 0.002). Liver stiffness measurement was associated with body mass index ≥23 (2.52, p = 0.001), aspartate aminotransferase (0.02, p = 0.0189), gamma-glutamyl transpeptidase (0.008, p < 0.0001), platelet count (-0.02, p = 0.001), and prothrombin international normalized ratio (26.40, p < 0.0001). Among the four groups classified by the presence or absence of steatosis and fibrosis, patients with fibrosis, but without steatosis, demonstrated the lowest liver reserve. In contrast, patients with both steatosis and fibrosis showed higher aspartate aminotransferase and gamma-glutamyl transpeptidase levels.
CONCLUSIONS
CONCLUSIONS
Body mass index is associated with both hepatic steatosis and fibrosis in patients with harmful alcohol use.
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Taiju Life Social Welfare Foundation
Informations de copyright
© 2024 Japan Society of Hepatology.
Références
Rinella ME, Lazarus JV, Ratziu V, Francque SM, Sanyal AJ, Kanwal F, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Hepatology. 2023;78:1966–1986. https://doi.org/10.1097/hep.0000000000000520
Heeren J, Scheja L. Metabolic‐associated fatty liver disease and lipoprotein metabolism. Mol Metabol. 2021;50:101238. https://doi.org/10.1016/j.molmet.2021.101238
Rada P, Gonzalez‐Rodriguez A, Garcia‐Monzon C, Valverde AM. Understanding lipotoxicity in NAFLD pathogenesis: is CD36 a key driver? Cell Death Dis. 2020;11(9):802. https://doi.org/10.1038/s41419‐020‐03003‐w
Parthasarathy G, Revelo X, Malhi H. Pathogenesis of nonalcoholic steatohepatitis: an overview. Hepatol Commun. 2020;4:478–492. https://doi.org/10.1002/hep4.1479
Liangpunsakul S, Chalasani N. Lipid mediators of liver injury in nonalcoholic fatty liver disease. Am J Physiol Gastrointest Liver Physiol. 2019;316:G75–G81. https://doi.org/10.1152/ajpgi.00170.2018
Sozio MS, Liangpunsakul S, Crabb D. The role of lipid metabolism in the pathogenesis of alcoholic and nonalcoholic hepatic steatosis. Semin Liver Dis. 2010;30(04):378–390. https://doi.org/10.1055/s‐0030‐1267538
Purohit V, Gao B, Song BJ. Molecular mechanisms of alcoholic fatty liver. Alcohol Clin Exp Res. 2009;33(2):191–205. https://doi.org/10.1111/j.1530‐0277.2008.00827.x
Subramaniyan V, Chakravarthi S, Jegasothy R, Seng WY, Fuloria NK, Fuloria S, et al. Alcohol‐associated liver disease: a review on its pathophysiology, diagnosis and drug therapy. Toxicol Rep. 2021;8:376–385. https://doi.org/10.1016/j.toxrep.2021.02.010
Zeng T, Zhang CL, Xiao M, Yang R, Xie KQ. Critical roles of kupffer cells in the pathogenesis of alcoholic liver disease: from basic science to clinical trials. Front Immunol. 2016;7:538. https://doi.org/10.3389/fimmu.2016.00538
Osna NA, Donohue TM, Jr., Kharbanda KK. Alcoholic liver disease: pathogenesis and current management. Alcohol Res. 2017;38:147–161.
Minea H, Singeap AM, Sfarti CV, et al. The impact of alcohol consumption pattern on liver fibrosis in asymptomatic patients. J Clin Med. 2023:12.
Bohn MJ, Babor TF, Kranzler HR. The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings. J Stud Alcohol. 1995;56(4):423–432. https://doi.org/10.15288/jsa.1995.56.423
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption‐‐II. Addiction. 1993;88(6):791–804. https://doi.org/10.1111/j.1360‐0443.1993.tb02093.x
Zheng Q, Zou B, Wu Y, Yeo Y, Wu H, Stave CD, et al. Systematic review with meta‐analysis: prevalence of hepatic steatosis, fibrosis and associated factors in chronic hepatitis B. Aliment Pharmacol Ther. 2021;54:1100–1109. https://doi.org/10.1111/apt.16595
van Kleef LA, Choi HSJ, Brouwer WP, Hansen BE, Patel K, de Man RA, et al. Metabolic dysfunction‐associated fatty liver disease increases risk of adverse outcomes in patients with chronic hepatitis B. JHEP Rep. 2021;3(5):100350. https://doi.org/10.1016/j.jhepr.2021.100350
Kawada T, Inagaki H, Kuratomi Y. The alcohol use disorders identification test: reliability study of the Japanese version. Alcohol. 2011;45(3):205–207. https://doi.org/10.1016/j.alcohol.2010.08.012
Reid MC, Fiellin DA, O'Connor PG. Hazardous and harmful alcohol consumption in primary care. Arch Intern Med. 1999;159(15):1681–1689. https://doi.org/10.1001/archinte.159.15.1681
Hiraoka A, Nakai M, Hara N, Hanai T, Namisaki T, Miyaaki H, et al. Clinical features of patients with chronic liver disease in Japan related to alcohol use: nationwide examination using alcohol use disorders identification test. Hepatol Res. 2023;53(1):43–50. https://doi.org/10.1111/hepr.13835
Imajo K, Toyoda H, Yasuda S, Suzuki Y, Sugimoto K, Kuroda H, et al. Utility of ultrasound‐guided attenuation parameter for grading steatosis with reference to MRI‐PDFF in a large cohort. Clin Gastroenterol Hepatol. 2022;20(11):2533. https://doi.org/10.1016/j.cgh.2021.11.003
Zheng J, Guo H, Zeng J, Huang Z, Zheng B, Ren J, et al. Two‐dimensional shear‐wave elastography and conventional US: the optimal evaluation of liver fibrosis and cirrhosis. Radiology. 2015;275(1):290–300. https://doi.org/10.1148/radiol.14140828
Abe T, Kuroda H, Fujiwara Y, Yoshida Y, Miyasaka A, Kamiyama N, et al. Accuracy of 2D shear wave elastography in the diagnosis of liver fibrosis in patients with chronic hepatitis C. J Clin Ultrasound. 2018;46(5):319–327. https://doi.org/10.1002/jcu.22592
Zhang Z. Missing data imputation: focusing on single imputation. Ann Transl Med. 2016;4:9.
Shearer JE, Jones R, Parker R, Ferguson J, Rowe IA. The natural history of advanced chronic liver disease defined by transient elastography. Clin Gastroenterol Hepatol. 2023;21(3):694–703e8. https://doi.org/10.1016/j.cgh.2022.03.015
Kezer CA, Simonetto DA, Shah VH. Sex differences in alcohol consumption and alcohol‐associated liver disease. Mayo Clin Proc. 2021;96(4):1006–1016. https://doi.org/10.1016/j.mayocp.2020.08.020
Simonetto DA, Shah VH, Kamath PS. Outpatient management of alcohol‐related liver disease. Lancet Gastroenterol Hepatol. 2020;5:485–493. https://doi.org/10.1016/s2468‐1253(19)30415‐7
Peterson K. Biomarkers for alcohol use and abuse‐‐a summary. Alcohol Res Health. 2004;28:30–37.
Hart CL, Morrison DS, Batty GD, Mitchell RJ, Davey Smith G. Effect of body mass index and alcohol consumption on liver disease: analysis of data from two prospective cohort studies. BMJ. 2010;340(mar11 1):c1240. https://doi.org/10.1136/bmj.c1240
Traversy G, Chaput JP. Alcohol consumption and obesity: an update. Curr Obes Rep. 2015;4(1):122–130. https://doi.org/10.1007/s13679‐014‐0129‐4
Naveau S, Giraud V, Borotto E, Aubert A, Capron F, Chaput JC. Excess weight risk factor for alcoholic liver disease. Hepatology. 1997;25(1):108–111. https://doi.org/10.1002/hep.510250120
Raynard B, Balian A, Fallik D, Capron F, Bedossa P, Chaput JC, et al. Risk factors of fibrosis in alcohol‐induced liver disease. Hepatology. 2002;35(3):635–638. https://doi.org/10.1053/jhep.2002.31782
Abdul‐Rahman AK, Card TR, Grainge MJ, Fleming KM. All‐cause and cause‐specific mortality rates of patients treated for alcohol use disorders: a meta‐analysis. Subst Abuse. 2018;39(4):509–517. https://doi.org/10.1080/08897077.2018.1475318
Kim SJ, Kim DJ. Alcoholism and diabetes mellitus. Diabetes Metab J. 2012;36(2):108–115. https://doi.org/10.4093/dmj.2012.36.2.108
Kuroda H, Fujiwara Y, Abe T, Nagasawa T, Oguri T, Noguchi S, et al. Two‐dimensional shear wave elastography and ultrasound‐guided attenuation parameter for progressive non‐alcoholic steatohepatitis. PLoS One. 2021;16(4):e0249493. https://doi.org/10.1371/journal.pone.0249493
Hanai T, Nishimura K, Unome S, Miwa T, Nakahata Y, Imai K, et al. Nutritional counseling improves mortality and prevents hepatic encephalopathy in patients with alcohol‐associated liver disease. Hepatol Res. 2024. https://doi.org/10.1111/hepr.14053
Crabb DW, Im GY, Szabo G, Mellinger JL, Lucey MR. Diagnosis and treatment of alcohol‐associated liver diseases: 2019 practice guidance from the American association for the study of liver diseases. Hepatology. 2020;71(1):306–333. https://doi.org/10.1002/hep.30866
Hara N, Hiraoka A, Nakai M, Shiraki M, Namisaki T, Miyaaki H, et al. Brief intervention for chronic liver disease patients with alcohol use disorder in a hepatology outpatient unit: effects and limitations. Hepatol Res. 2024. https://doi.org/10.1111/hepr.14060
Brennan PN, Dillon JF, Tapper EB. Gamma‐Glutamyl Transferase (gamma‐GT) ‐ an old dog with new tricks? Liver Int. 2022;42(1):9–15. https://doi.org/10.1111/liv.15099
Cunningham JA, Godinho A, Kushnir V, Bertholet N. What does it mean when people say that they have received expressions of concern about their drinking or advice to cut down on the AUDIT scale? BMC Med Res Methodol. 2017;17(1):158. https://doi.org/10.1186/s12874‐017‐0435‐0
Kakisaka K, Kuroda H, Abe T, Nakaya I, Watanabe T, Yusa K, et al. Coincidental items in the definition of metabolic dysfunction‐associated fatty liver are useful in identifying patients having significant fibrosis with fatty liver. Hepatol Res. 2023;53(9):857–865. https://doi.org/10.1111/hepr.13928