Background

Moderate alcohol consumption is believed to be associated with reduced mortality from cardiovascular disease (CVD) in the general population. This cross-sectional study aimed to comprehensively examine the association between alcohol consumption and subclinical cardiovascular damage or hepatic fibrosis in non-alcoholic fatty liver disease (NAFLD).

Methods

Subjects with NAFLD without a history of heart disease were extracted from 977 consecutive examinees who completed health checkups and optional cardiovascular examinations. Subclinical cardiovascular damage was assessed by coronary artery calcification (CAC), carotid artery ultrasound, and brachial-ankle pulse wave velocity (ba-PWV). CAC scores were classified into three grades (0, ≤100, and >100) by Agatston's method. Alcohol consumption was divided into three groups [Non-drinking (G0); Light (G1), 0.1–6.9 drinks/week; Moderate (G2), 7–20.9 drinks/week for men and 7–13.9 drinks/week for women]. Noninvasive markers (FIB-4, Fibrosis-4; NFS, NAFLD fibrosis score) were calculated for assessment of hepatic fibrosis and classified into low and intermediate-high grade.

Results

The overall mean age was 60.2 years and males were 200 (74.6%) among 268 subjects with NAFLD. Number (%) of G0, G1, and G2 were 102 (38.1%), 103 (38.4%), and 63 (23.5%). Binary logistic regression analysis showed no significant difference between G0 and G1, or G0 and G2 in any of the above subclinical cardiovascular damages (CAC score >0, or CAC score >100, carotid plaque +, intima-media thickness ≥1.1 mm, and ba-PWV >1400 cm/s). However, only G2 had a significant association with intermediate-high grade of FIB-4 or NFS [odds ratio (95% confidence intervals), p value: 1.871 (1.209–2.893), p = 0.005; 2.910 (1.715–4.939), p = 0.000], compared to G0.

Conclusions

Non-heavy drinking might not reduce the risk of CVD in NAFLD subjects. On the contrary, even moderate drinking could promote hepatic fibrosis. Thus, NAFLD drinkers should not be recommended for even a moderate amount of alcohol.

中文翻译：

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适度饮酒与亚临床心血管损伤无关，但与非酒精性脂肪肝中的肝纤维化有关。

背景

适度饮酒被认为与降低普通人群心血管疾病 (CVD) 死亡率有关。这项横断面研究旨在全面检查饮酒与非酒精性脂肪性肝病 (NAFLD) 中亚临床心血管损伤或肝纤维化之间的关联。

方法

从 977 名完成健康检查和可选心血管检查的连续受试者中提取无心脏病史的 NAFLD 受试者。通过冠状动脉钙化 (CAC)、颈动脉超声和臂踝脉搏波速度 (ba-PWV) 评估亚临床心血管损伤。通过 Agatston 方法将 CAC 评分分为三个等级（0、≤100 和 >100）。饮酒分为三组 [非饮酒 (G0); 清淡 (G1)，每周 0.1–6.9 杯；中等 (G2)，男性每周 7-20.9 杯，女性每周 7-13.9 杯]。计算无创标志物（FIB-4、Fibrosis-4；NFS、NAFLD 纤维化评分）用于评估肝纤维化并分为低级和中高级。

结果

在 268 名 NAFLD 受试者中，总体平均年龄为 60.2 岁，男性为 200 (74.6%)。G0、G1、G2的数量（%）分别为102（38.1%）、103（38.4%）、63（23.5%）。二元逻辑回归分析显示，上述任何亚临床心血管损害（CAC 评分>0，或CAC 评分>100，颈动脉斑块+，内中膜厚度≥1.1 mm，和ba-PWV >1400 厘米/秒）。然而，只有 G2 与中高级别 FIB-4 或 NFS [优势比（95% 置信区间），p值：1.871 (1.209–2.893)，p  = 0.005；2.910 (1.715–4.939), p  = 0.000]，与 G0 相比。

结论

非大量饮酒可能不会降低 NAFLD 受试者的 CVD 风险。相反，即使适度饮酒也会促进肝纤维化。因此，即使是适量的酒精，也不应推荐 NAFLD 饮酒者。