Effect of lifetime alcohol consumption on the histological severity of non‐alcoholic fatty liver disease

Abstract

Background & Aims Non‐alcoholic fatty liver disease ( NAFLD ) is defined based on recent alcohol consumption; however, remote or lifetime alcohol consumption is not taken into account. It is not known whether lifetime alcohol consumption contributes to the severity of disease in patients with NAFLD . To determine the effect of lifetime alcohol consumption on the histological severity in patients with NAFLD . Patients & Methods Adults >18 years of age with presumed NAFLD and alcohol consumption <40 g/week were enrolled. Lifetime alcohol consumption was determined using a questionnaire. Patients with a history of long‐term alcohol abuse or dependence were excluded. A liver biopsy was reviewed by a single pathologist in a blinded fashion. Demographic, clinical and histological findings were compared in those who had regular alcohol consumption and those who did not. Results A total of 77 patients had fatty liver on biopsy. Fifty‐two patients had a history of regular alcohol consumption. The median lifetime cumulative alcohol intake was 24 gram‐years. On multivariable analysis, increasing age ( OR 1.07, 95% CI 1.01–1.14) was associated with severe liver disease, whereas alcohol consumption of ≥24 gram‐years was associated with less severe disease ( OR 0.26, 95% CI 0.07–0.97, P = 0.04). Patients who continued to consume alcohol or had been abstinent for ≤1 year had less severe disease. Conclusion Some degree of regular alcohol consumption over the course of a lifetime compared to minimal intake appears to have a protective effect on the histological severity of liver disease among patients with strictly defined NAFLD .