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. 2024 Jun 3;14(1):12663.
doi: 10.1038/s41598-024-63453-6.

Impact of metabolic phenotype and alcohol consumption on mortality risk in metabolic dysfunction-associated fatty liver disease: a population-based cohort study

Phunchai Charatcharoenwitthaya  1 , Khemajira Karaketklang  2 , Wichai Aekplakorn  3
Affiliations

Impact of metabolic phenotype and alcohol consumption on mortality risk in metabolic dysfunction-associated fatty liver disease: a population-based cohort study

Phunchai Charatcharoenwitthaya et al. Sci Rep. .

Abstract

Patients with metabolic dysfunction-associated fatty liver disease (MAFLD) often present with concomitant metabolic dysregulation and alcohol consumption, potentially leading to distinct clinical outcomes. We analyzed data from 8043 participants with MAFLD in the Thai National Health Examination Survey with linked mortality records. According to the MAFLD criteria, 1432 individuals (17.2%) were categorized as having the diabetes phenotype, 5894 (71.0%) as the overweight/obesity phenotype, and 978 (11.8%) as the lean metabolic phenotype. Over 71,145 person-years, 916 participants died. Using Cox proportional hazard models adjusting for physiological, lifestyle, and comorbid factors, both diabetes (adjusted hazards ratio [aHR] 1.59, 95% CI 1.18-2.13) and lean metabolic phenotypes (aHR 1.28, 95% CI 1.01-1.64) exhibited significantly higher mortality risk compared to the overweight/obesity phenotype. A J-shaped relationship was observed between daily alcohol consumption and the risk of all-cause mortality. Daily alcohol intake exceeding 50 g for women and 60 g for men increased the all-cause mortality risk among MAFLD individuals with the lean metabolic phenotype (aHR 3.39, 95% CI 1.02-11.29). Our study found that metabolic phenotype and alcohol consumption have interactive effects on the risk of all-cause mortality in patients with MAFLD, indicating that evaluating both factors is crucial for determining prognostic outcomes and management strategies.

Keywords: Alcohol consumption; MAFLD; Metabolic phenotype; Mortality; Type 2 diabetes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart of the study population.
Figure 2
Figure 2
Overall survival of participants with MAFLD categorized by metabolic phenotypes.
Figure 3
Figure 3
Spline adjusted hazard ratio graph of daily alcohol consumption on all-cause mortality in MAFLD.
Figure 4
Figure 4
Interaction between metabolic phenotype and alcohol consumption on mortality Risk. Multivariate model was adjusted for age, sex, education, smoking status, leisure time physical activity, Charlson comorbidity index, and handgrip strength.
See this image and copyright information in PMC

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