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 Most people have a little bit of fat in their liver, but fatty liver
disease can be diagnosed when more than 5 percent of the liver by
weight is made up of fat. If the condition isn't linked to liver
damage from heavy drinking, it's known as non-alcoholic fatty liver
disease (NAFLD) and is most often associated with obesity and
certain eating habits.
For the current study, researchers examined data on 58,927 Korean
young and middle aged adults with NAFDL who had low levels of
fibrosis, or scarring on the liver. After following half of these
patients for at least 8.3 years, 5,630 people had progressed from
low to more advanced levels of fibrosis.
Moderate drinkers were 29 percent more likely to have worse fibrosis
by the end of the study than people who didn't drink at all. Men
were considered moderate drinkers when they had up to about two
drinks a day, while women could have up to about 1.5 drinks daily.
But "light drinkers" who averaged less than 10 grams of alcohol
(less than one drink) daily, were also 6 percent more likely to have
their fibrosis become more advanced than people who avoided alcohol
altogether, the study team reports in Hepatology.
"There was no safe limit of alcohol intake in relation to fibrosis
progression," said senior study author Dr. Seungho Ryu of Kangbuk
Samsung Hospital and Sungkyunkwan University School of Medicine in
Seoul, South Korea.
While the study wasn't designed to prove whether or how alcohol
might directly cause advanced fibrosis in people with NAFLD, it's
possible that drinking leads to more extensive scarring because it
contributes to inflammation and kills cells in the liver, Ryu said
by email.
At the start of the study, researchers used ultrasound results to
assess the extent of liver damage during physical exams and relied
on questionnaires to determine participants' drinking habits.
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To determine if people experienced worsening fibrosis, researchers
used non-invasive assessments that focused on things like whether an
individual was obese, or had slightly elevated blood sugar,
full-blown diabetes or low levels of the liver protein albumin that
can indicate worsening liver function.
One limitation of the study is that researchers didn't use a liver
biopsy to diagnose worsening fibrosis, which is invasive but can
provide more accurate results than the methods used in the study.
The study also didn't distinguish between different types of
alcohol.
"The question still remains as to whether wine, particularly red
wine (versus beer or liquor), may have some heart and diabetes
protective effects in small amounts (no more than 1 glass on average
per day) in particular in patients with NAFLD who are at high risk
for complications and death from heart disease and diabetes," said
Dr. Lisa VanWagner of the Northwestern University Feinberg School of
Medicine in Chicago.
Still, people who drink need to keep in mind that the empty calories
in alcohol may contribute to worsening liver disease, VanWagner, who
wasn't involved in the study, said by email.
"The main contributor to NAFLD is obesity, and weight control within
a healthy range is the most important thing that people can do to
lower their risk of liver disease," VanWagner noted. "If abstinence
is not achievable then general health guidelines suggest that no
more than one drink per day for women and no more than two drinks
per day for men is low-risk drinking."
SOURCE: https://bit.ly/2nk4qE6 Hepatology, online July 17, 2018.
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