Alcohol use and metabolic syndrome are highly prevalent in the population and frequently co-exist. Both are implicated in a large range of health problems, including chronic liver disease, hepatocellular carcinoma, and liver-related outcomes (i.e. decompensation or liver transplantation). Studies have yielded mixed results regarding the effects of mild-moderate alcohol consumption on the risk of metabolic syndrome and fatty liver disease, possibly due to methodological differences. The few available prospective studies have indicated that mild-moderate alcohol use is associated with an increase in liver-related outcomes. This conclusion was substantiated by systems biology analyses suggesting that alcohol and metabolic syndrome may play a similar role in fatty liver disease, potentiating an already existing dysregulation of common vital homeostatic pathways. Alcohol and metabolic factors are independently and jointly associated with liver-related outcomes. Indeed, metabolic syndrome increases the risk of liver-related outcomes, regardless of alcohol intake. Moreover, the components of metabolic syndrome appear to have additive effects when it comes to the risk of liver-related outcomes. A number of population studies have implied that measures of central/abdominal obesity, such as the waist-to-hip ratio, can predict liver-related outcomes more accurately than BMI, including in individuals who consume harmful quantities of alcohol. Many studies even point to synergistic interactions between harmful alcohol use and many metabolic components. This accumulating evidence showing independent, combined, and modifying effects of alcohol and metabolic factors on the onset and progression of chronic liver disease highlights the multifactorial background of liver disease in the population. The available evidence suggests that more holistic approaches could be useful for risk prediction, diagnostics and treatment planning.

饮酒和代谢综合征在人群中非常普遍，并且经常并存。两者都涉及范围广泛的健康问题，包括慢性肝病、肝细胞癌和肝脏相关结果（即. 失代偿或肝移植）。关于轻度至中度饮酒对代谢综合征和脂肪肝疾病风险影响的研究得出了不同的结果，这可能是由于方法学上的差异。少数可用的前瞻性研究表明，轻度至中度饮酒与肝脏相关结局的增加有关。这一结论得到了系统生物学分析的证实，表明酒精和代谢综合征可能在脂肪肝疾病中发挥相似的作用，加剧了常见的重要体内平衡通路已经存在的失调。酒精和代谢因素与肝脏相关结果独立和共同相关。事实上，无论酒精摄入量如何，代谢综合征都会增加肝脏相关结果的风险。而且，当涉及到肝脏相关结果的风险时，代谢综合征的成分似乎具有累加效应。许多人口研究表明，与 BMI 相比，中心性/腹部肥胖的指标（例如腰臀比）可以更准确地预测与肝脏相关的结果，包括饮酒量有害的个体。许多研究甚至指出有害饮酒与许多代谢成分之间存在协同作用。越来越多的证据表明，酒精和代谢因素对慢性肝病的发病和进展具有独立、联合和调节作用，突出了人群中肝病的多因素背景。现有证据表明，更全面的方法可能有助于风险预测，