Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jun 5:14:20420188231178370.
doi: 10.1177/20420188231178370. eCollection 2023.

The bidirectional impacts of alcohol consumption and MAFLD for progressive fatty liver disease

Anand V Kulkarni  1 , Shiv Kumar Sarin  2
Affiliations
Review

The bidirectional impacts of alcohol consumption and MAFLD for progressive fatty liver disease

Anand V Kulkarni et al. Ther Adv Endocrinol Metab. .

Abstract

Nonalcoholic fatty liver disease (NAFLD), once considered a benign condition, has been associated with several cardiometabolic complications over the past two decades. The worldwide prevalence of NAFLD is as high as 30%. NAFLD requires the absence of a "significant alcohol intake." Conflicting reports have suggested that moderate alcohol consumption may be protective; therefore, the diagnosis of NAFLD previously relied on negative criteria. However, there has been a significant increase in alcohol consumption globally. Apart from the rise in alcohol-related liver disease (ARLD), alcohol, a major toxin, is associated with an increased risk of several cancers, including hepatocellular carcinoma. Alcohol misuse is a significant contributor to disability-adjusted life years. Recently, the term metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed instead of NAFLD to include the metabolic dysfunction responsible for the major adverse outcomes in patients with fatty liver disease. MAFLD, dependent on the "positive diagnostic criteria" rather than previous exclusion criteria, may identify individuals with poor metabolic health and aid in managing patients at increased risk of all-cause and cardiovascular mortality. Although MAFLD is less stigmatizing than NAFLD, excluding alcohol intake may increase the risk of already existing underreported alcohol consumption in this subgroup of patients. Therefore, alcohol consumption may increase the prevalence of fatty liver disease and its associated complications in patients with MAFLD. This review discusses the effects of alcohol intake and MAFLD on fatty liver disease.

Keywords: insulin resistance; lean NASH; metabolic dysfunction; obesity; terminology.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
The bidirectional impacts of alcohol and metabolic dysfunction-associated fatty liver disease on fatty liver disease. MAFLD, metabolic dysfunction-associated fatty liver disease.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Younossi Z, Henry L. Contribution of alcoholic and nonalcoholic fatty liver disease to the burden of liver-related morbidity and mortality. Gastroenterology 2016; 150: 1778–1785. - PubMed
    1. World Health Organization. World health statistics 2022: monitoring health for the SDGs, sustainable development goals. Geneva, Switzerland: World Health Organization, 2022.
    1. Grossman ER, Benjamin-Neelon SE, Sonnenschein S. Alcohol consumption during the COVID-19 pandemic: A cross-sectional survey of US adults. Int J Environ Res Public Health 2020; 17: 9189. - PMC - PubMed
    1. Sarin SK, Kumar M, Eslam M, et al.. Liver diseases in the Asia-Pacific region: a lancet gastroenterology & hepatology commission. Lancet Gastroenterol Hepatol 2020; 5: 167–228. - PMC - PubMed
    1. Fuster D, Samet JH. Alcohol use in patients with chronic liver disease. New Engl J Med 2018; 379: 1251–1261. - PubMed

LinkOut - more resources