Influence of drinking on nonalcoholic fatty liver disease
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摘要:
非酒精性脂肪性肝病(NAFLD)定义为不存在大量饮酒(饮酒量被限定为安全阈值内)的情况下发生的肝脏脂肪变性,与酒精性肝病的区别很大程度上取决于饮酒量。饮酒与NAFLD在一定比例人群中共存,这一比例正在持续增加。关于饮酒"安全阈值"的界定、在"安全阈值内"的适度饮酒对于NAFLD是否具有保护作用,从而改善慢性肝病的不良结局和生存预后,目前尚存争议。针对上述观点进行了分析阐述,并认为在评估饮酒对NAFLD的影响时,重点应当关注个体化风险评估,判断利弊和饮酒建议均应遵循个体化原则。
Abstract:Nonalcoholic fatty liver disease( NAFLD) is defined as hepatic steatosis without heavy drinking( the amount of alcohol intake is limited within the safe threshold),and the difference between NAFLD and alcoholic liver disease is largely dependent on the amount of alcohol intake. Alcohol intake and NAFLD coexist in a considerable proportion of the population,and this proportion is increasing continuously.There are still controversies over the definition of“safe threshold”and whether moderate drinking within the“safe threshold”has a protective effect against NAFLD,so as to improve the adverse outcome and survival prognosis of chronic liver diseases. This article elaborates on the above ideas,and it is believed that we should pay attention to individualized risk assessment when evaluating the influence of drinking on NAFLD and follow the principle of individualization when judging the benefits and harms of drinking and giving suggestions for drinking.
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[1]GOLDBERG D,DITAH IC,SAEIAN K,et al.Changes in the Prevalence of hepatitis c virus infection,nonalcoholic steatohepatitis,and alcoholic liver disease among patients with cirrhosis or liver failure on the waitlist for liver transplantation[J].Gastroenterology,2017,152(5):1090-1099.e1. [2]ROMAN GC,JACKSON RE,GADHIA R,et al.Mediterranean diet:The role of long-chainω-3 fatty acids in fish;polyphenols in fruits,vegetables,cereals,coffee,tea,cacao and wine;probiotics and vitamins in prevention of stroke,age-related cognitive decline,and Alzheimer disease[J].Rev Neurol(Paris),2019,175(10):724-741. [3]GOW P,TESTRO AG,HEY P,et al.Letter to the editor:Moderate alcohol use in fatty liver disease:Don't throw the cabernet out with the bathwater[J].Hepatology,2020,71(5):1887-1888. [4]SODERBERG C,STAL P,ASKLING J,et al.Decreased survival of subjects with elevated liver function tests during a 28-year follow-up[J].Hepatology,2010,51(2):595-602. [5]Bradley KA,Bush KR,McDonellMB,et al.Screening for problem drinking:Comparison of CAGE and AUDIT.Ambulatory Care Quality Improvement Project(ACQUIP).Alcohol use disorders identification test[J].J Gen Intern Med,1998,13(6):379-388. [6]SMITH PC,SCHMIDT SM,ALLENSWORTH-DAVIES D,et al.Primary care validation of a single-question alcohol screening test[J].J Gen Intern Med,2009,24(7):783-788. [7]DI CASTELNUOVO A,COSTANZO S,BAGNARDI V,et al.Alcohol dosingand total mortality in men and women:An updated meta-analysis of 34 prospective studies[J].Arch InternMed,2006,166(22):2437-2445. [8]KERR WC,STOCKWELL T.Understanding standard drinksand drinking guidelines[J].Drug Alcohol Rev,2012,31(2):200-205. [9]PETRONI ML,BRODOSI L,MARCHIGNOLI F,et al.Moderate alcohol intake in non-alcoholic fatty liver disease:To drink or not to drink?[J]Nutrients,2019,11(12):3048. [10]YAMADA K,MIZUKOSHI E,SEIKE T,et al.Light alcohol consumption has the potential to suppress hepatocellular injury and liver fibrosis in non-alcoholic fatty liver disease[J].PLoS One,2018,13(1):e0191026. [11]SUZUKI A,ANGULO P,ST SAUVER J,et al.Light to moderate alcohol consumption is associated with lower frequency of hypertransaminasemia[J].Am J Gastroenterol,2007,102(9):1912-1919. [12]GUNJI T,MATSUHASHI N,SATO H,et al.Light and moderatealcohol consumption significantly reduces the prevalence of fatty liver in the Japanese male population[J].Am J Gastroenterol,2009,104(9):2189-2195. [13]DUNN W,SANYAL AJ,BRUNT EM,et al.Modest alcohol consumption is associated with decreased prevalence of steatohepatitis in patients with non-alcoholic fatty liver disease(NAFLD)[J].J Hepatol,2012,57(2):384-391. [14]HAJIFATHALIAN K,TORABI SAGVAND B,MCCULLOUGH AJ.Effect of alcohol consumption on survival in nonalcoholic fatty liver disease:A national prospective cohort study[J].Hepatology,2019,70(2):511-521. [15]CHALASANI N,YOUNOSSI Z,LAVINE JE,et al.The diagnosis and management of non-alcoholic fatty liver disease:practice guideline by the American Gastroenterological Association,American Association for the Study of Liver Diseases,and American College of Gastroenterology[J].Gastroenterology,2012,142(7):1592-1609. [16]CHALASANI N,YOUNOSSI Z,LAVINE JE,et al.The diagnosis and management of nonalcoholic fatty liver disease:Practice guidance from the American Association for the Study of Liver Diseases[J].Hepatology,2018,67(1):328-357. [17]WHO.Global status report on alcohol and health 2018[R/OL].(2018-09-21)https://www.who.int/substance_abuse/publications/global_alcohol_report/gsr_2018.en/. [18]SUAREZ EC,BECKHAM JC,GREEN KT.The relation of lightto-moderate alcohol consumption to glucose metabolism and insulin resistance in nondiabetic adults:The moderating effects of depressive symptom severity,adiposity,and sex[J].Int J Behav Med,2017,24(6):927-936. [19]KWON HK,GREENSON JK,CONJEEVARAM HS.Effect of lifetime alcohol consumption on the histological severity of non-alcoholic fatty liver disease[J].Liver Int,2014,34(1):129-135. [20]AJMERA V,BELT P,WILSON LA,et al.Among patients with nonalcoholic fatty liver disease,modest alcohol use is associated with less improvement in histologic steatosis and steatohepatitis[J].Clin Gastroenterol Hepatol,2018,16(9):1511-1520.e5. [21]MITCHELL T,JEFFREY GP,de BOER B,et al.Type and pattern of alcohol consumption is associated with liver fibrosis in patients with non-alcoholic fatty liver disease[J].Am J Gastroenterol,2018,113(10):1484-1493. [22] European Association for the Study of the Liver(EASL),European Association for the Study of Diabetes(EASD),European Association for the Study of Obesity(EASO).EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease[J].J Hepatol,2016,64(6):1388-1402. [23]ELEFTHERIOU D,BENETOU V,TRICHOPOULOU A,et al.Mediterranean diet and its components in relation to allcause mortality:Meta-analysis[J].Br J Nutr,2018,120(10):1081-1097. [24]SIERKSMA A,PATEL H,OUCHI N,et al.Effect of moderate alcohol consumption on adiponectin,tumor necrosis factoralpha,and insulin sensitivity[J].Diabetes Care,2004,27(1):184-189. [25]JUNG F,LIPPMANN T,BRANDT A,et al.Moderate consumption of fermented alcoholic beverages diminishes dietinduced non-alcoholic fatty liver disease through mechanisms involving hepatic adiponectin signaling in mice[J].EurJ Nutr,2020,59(2):787-799. [26]SAHA B,BRUNEAU JC,KODYS K,et al.Alcohol-induced miR-27a regulates differentiation and M2 macrophage polarization of normal human monocytes[J].J Immunol,2015,194(7):3079-3087. [27]LU B,SOLOMON DH,COSTENBADER KH,et al.Alcohol consumption and risk of incident rheumatoid arthritis in women:A prospective study[J].Arthritis Rheumatol,2014,66(8):1998-2005. [28]MALEKI SJ,CRESPO JF,CABANILLAS B.Anti-inflammatoryeffects of flavonoids[J].Food Chem,2019,299:125124. [29]BUCHER S,BEGRICHE K,CATHELINE D,et al.Moderate chronic ethanol consumption exerts beneficial effects on nonalcoholic fatty liver in mice fed a high-fat diet:Possible role ofhigher formation of triglyceridesenriched in monounsaturated fatty acids[J].Eur J Nutr,2020,59:1619-1632. [30]ABERG F,PUUKKA P,SALOMAA V,et al.Risks of light and moderate alcohol use in fatty liver disease:follow-up of population cohorts[J].Hepatology,2020,71(3):835-848. [31]EKSTEDT M,FRANZEN LE,HOLMQVIST M,et al.Alcohol consumption is associated with progression of hepatic fibrosis in non-alcoholic fatty liver disease[J].Scand J Gastroenterol,2009,44(3):366-374. [32] CHANG Y,CHO YK,KIM Y,et al.Nonheavy drinking and worsening of noninvasive fibrosis markers in nonalcoholic fatty liver disease:A cohort study[J].Hepatology,2019,69(1):64-75. [33]HAGSTROM H,NASR P,EKSTEDT M,et al.Low to moderate lifetime alcohol consumption is associated with less advanced stages of fibrosis in non-alcoholic fatty liver disease[J].Scand J Gastroenterol,2017,52(2):159-165. [34]CHANG Y,RYU S,KIM Y,et al.Low levels of alcohol consumption,obesity,and development of fatty liver with and without evidence of advanced fibrosis[J].Hepatology,2020,71(3):861-873. [35]ABERG F,FARKKILA M.Drinking and obesity:Alcoholic liver disease/nonalcoholic fatty liver disease interactions[J].Semin Liver Dis,2020,40(2):154-162. [36]KIMURA T,TANAKA N,FUJIMORI N,et al.Mild drinking habit is a risk factor for hepatocarcinogenesis in non-alcoholic fatty liver disease with advanced fibrosis[J].World J Gastroenterol,2018,24(13):1440-1450. [37]BENDINELLI B,PALLI D,ASSEDI M,et al.Alcohol,smoking and rectal cancer risk in a Mediterranean cohort of adults:The European Prospective Investigation into Cancer and Nutrition(EPIC)-Italy cohort[J].Eur J Gastroenterol Hepatol,2020,32(4):475-483. [38]LONG MT,MASSARO JM,HOFFMANN U,et al.Alcohol use is associated with hepatic steatosis among persons with presumed non-alcoholic fatty liver disease[J].Clin Gastroenterol Hepatol,2020,18(8):1831-1841.e5. [39]PHILIPS CA,AUGUSTINE P,YEROL PK,et al.Severe alcoholic hepatitis:Current perspectives[J].Hepat Med,2019,11:97-108. [40]SEITZ HK,BATALLER R,CORTEZ-PINTO H,et al.Alcoholic liver disease[J].Nat Rev Dis Primers,2018,4(1):16. [41] KECHAGIAS S,BLOMDAHL J,EKSTEDT M.Alcohol consumption in non-alcoholic fatty liver disease-harmful or beneficial?[J].Hepatobiliary Surg Nutr,2019,8(3):311-313. [42]ARMSTRONG MJ,MELLINGER JL,TRIVEDI PJ.Alcohol consumption in patients with non-alcoholic fatty liver disease:convenient vs.inconvenient truths[J].Am J Gastroenterol,2018,113(10):1437-1439.
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