NAFLD (non-alcoholic fatty liver disease) is the most common type of liver disease in the developed world, affecting up to one-third of the US population. NAFLD is often associated with obesity and other parameters of the so-called "metabolic syndrome," which is a major risk factor for the development of cardiovascular disease. In a well-done study among subjects with NAFLD, the investigators have demonstrated that modest alcohol consumption (an average of up to 20 grams of alcohol per day and no binge drinking) is associated with less evidence of inflammation of the liver (steatohepatitis), a condition known to markedly increase the risk of progression of liver disease to cirrhosis.
Given that NAFLD and other conditions associated with the metabolic syndrome are so common, and are major risk factors for developing cardiovascular disease, the results of the present study are important. They show that modest drinking is associated with decreased, not increased, inflammation of the liver. Further, even among subjects with NAFLD, cardiovascular disease is a much more common cause of death than liver disease. The authors suggest that intervention studies should be done to support their findings; if confirmed, subjects with NAFLD should not be advised to avoid all alcohol, which is the current advice usually given to such patients.
Reference: Dunn W, Sanyal AJ, Brunt EM, Unalp-Arida A, Donohue M, McCullough AJ, Schwimmer JB. Modest alcohol consumption is associated with decreased prevalence of steatohepatitis in patients with non-alcoholic fatty liver disease (NAFLD). Journal of Hepatology 2012 (pre-publication release)
Comments on this paper were provided by the following members of the International Scientific Forum on Alcohol Research:
Francesco Orlandi, MD, Dept. of Gastroenterology, Università degli Studi di Ancona. Italy.
Erik Skovenborg, MD, Scandinavian Medical Alcohol Board, Practitioner, Aarhus, Denmark.
R. Curtis Ellison, MD, Section of Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, MA, USA.
Arne Svilaas, MD, PhD, general practice and lipidology, Oslo University Hospital, Oslo, Norway.
Tedd Goldfinger, DO, FACC, Desert Cardiology of Tucson Heart Center, Dept. of Cardiology, University of Arizona School of Medicine, Tucson, Arizona, USA
Harvey Finkel, MD, Hematology/Oncology, Boston University Medical Center, Boston, MA, USA.
Gordon Troup, MSc, DSc, School of Physics, Monash University, Victoria, Australia.
David Vauzour, PhD, Senior Research Associate, Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, UK.
David Van Velden, MD, Dept. of Pathology, Stellenbosch University, Stellenbosch, South Africa.
For the detailed critique of this paper by the International Scientific Forum on Alcohol Research and a listing of references, go to www.bu.edu/alcohol-forum, click on Recent Reviews and select Critique 080 – 15 May 2012.
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Read the full critique: http://www.bu.edu/alcohol-forum/critique-080-modest-alcohol-intake-is-associated-with-less-inflammation-among-patients-with-the-most-common-type-of-liver-disease-non-alcoholic-fatty-liver-disease-nafld-15-may-2012/