Hepatic steatosis has a pivotal role in the development of chronic liver diseases, even in alcohol-related liver disease. Alcoholic fatty liver disease is an important phenotype among alcohol-related liver diseases. While metabolic syndrome is a dominant risk factor of incident nonalcoholic fatty liver disease, the role of metabolic syndrome in alcoholic fatty liver disease has not been clarified yet. A retrospective cohort study was performed at a health check-up center in Japan. Subjects consisted of male participants without fatty liver who consumed ethanol of 420 g/week or higher. Adjusted hazard ratios and 95% confidence intervals at the baseline examinations for incident alcoholic fatty liver disease were estimated using Cox model. A total of 640 participants were included in this study. During 3.91 years (IQR 1.63–7.09) of follow-up, 168 new cases of alcoholic fatty liver disease developed (49.1 cases per 1000 persons per year). After adjustment for age, smoking status, alcohol consumption, the hazard ratio for a 1 kg/m2 increase in body mass index was 1.2 (1.12–1.28). The hazard ratio of subjects with high triglyceride and low high-density lipoprotein-cholesterol levels were 1.56 (1.12–2.18) and 1.52 (1.03–2.25), respectively. Obesity, high triglyceridemia, and low high-density lipoprotein-cholesterolemia are independent risk factors of alcoholic fatty liver disease in Japanese men who consumed alcohol habitually. In people with these risks, triglyceride lowering and high-density lipoprotein-cholesterol raising by improving insulin resistance and weight maintenance in addition to abstinence from alcohol would be effective in preventing the development of alcoholic fatty liver disease.

中文翻译：

---

肥胖和代谢异常是男性酒精性脂肪肝的风险：NAGALA 研究

肝脂肪变性在慢性肝病的发展中具有关键作用，甚至在与酒精有关的肝病中也是如此。酒精性脂肪肝是酒精相关肝病中的一个重要表型。虽然代谢综合征是非酒精性脂肪肝发病的主要危险因素，但代谢综合征在酒精性脂肪肝中的作用尚未阐明。在日本的健康检查中心进行了一项回顾性队列研究。受试者由没有脂肪肝的男性参与者组成，他们消耗了 420 克/周或更高的乙醇。使用 Cox 模型估计了酒精性脂肪肝事件基线检查的调整后风险比和 95% 置信区间。本研究共包括 640 名参与者。在 3.91 年（IQR 1.63–7.09）的随访期间，新增酒精性脂肪肝病例 168 例（每年每 1000 人 49.1 例）。在调整年龄、吸烟状况、饮酒量后，体重指数增加 1 kg/m2 的风险比为 1.2 (1.12–1.28)。具有高甘油三酯和低高密度脂蛋白胆固醇水平的受试者的风险比分别为 1.56 (1.12–2.18) 和 1.52 (1.03–2.25)。在习惯性饮酒的日本男性中，肥胖、高甘油三酯血症和低高密度脂蛋白胆固醇血症是酒精性脂肪肝的独立危险因素。在有这些风险的人群中，