Abstract
Background
Fatty liver is an important clinical feature not only in alcoholic and non-alcoholic fatty liver diseases, but in other chronic liver diseases as well. Our aim was to elucidate the effect and relationship between habitual alcohol intake and obesity in the development of fatty liver disease.
Methods
We enrolled 8,029 subjects undergoing abdominal ultrasonography with general medical examinations, and analyzed the factors associated with fatty liver based on daily alcohol intake, body mass index (BMI), and waist circumference.
Results
For fatty liver, BMI, waist circumference, total cholesterol, triglycerides, and fasting plasma glucose were significant and independent risk factors. Heavy alcohol intake (50 g/day) was a significant risk factor for fatty liver in women (odds ratio [OR], 3.35). Analysis based on the presence or absence of obesity revealed that moderate alcohol intake was a significant negative risk factor for fatty liver in both male and female obese (BMI ≥25 kg/m2) subjects (OR, 0.74 for non-obese and 0.39 for obese patients, respectively). Heavy alcohol intake was also a significant negative risk factor in obese males (0.62). In contrast, heavy alcohol intake was a risk factor in non-obese males (OR, 1.29) and in all females (OR, 2.22 for non-obese and 6.6 for obese patients, respectively).
Conclusions
The influence of alcohol intake on fatty liver differed depending on the level of alcohol consumption, gender, and the presence of obesity, and showed biphasic effects.
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Abbreviations
- ALD:
-
Alcoholic liver disease
- ALT:
-
Alanine aminotransferase
- NAFLD:
-
Non-alcoholic fatty liver disease
- BMI:
-
Body mass index
- WC:
-
Waist circumference
- AST:
-
Aspartate aminotransferase
- GGT:
-
Gamma-glutamyl transferase
- TC:
-
Total cholesterol
- HDL:
-
High-density lipoprotein
- TG:
-
Triglycerides
- FPG:
-
Fasting plasma glucose
- LDL:
-
Low-density lipoprotein
- NASH:
-
Nonalcoholic steatohepatitis
- OR:
-
Odds ratio
- CI:
-
Confidence interval
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Acknowledgments
The authors thank Professor Kyuichi Tanikawa (International Institute for Liver Research) for his excellent advice; the entire medical staff at Eguchi Hospital, Kochi Medical School, and Kawamura Clinic for assistance; and members of the Japan Study Group of Nonalcoholic Fatty Liver Disease (JSG-NAFLD) for their excellent advice. The authors have no conflicts of interest to declare. This work was supported in part by a Grant-in-Aid from the Ministry of Health, Labour and Welfare of Japan (2014 non-numbered). All authors approved the final version of the article and the guarantor of the article is Hideyuki Hyogo. Author contributions are described as follows: (a) substantial contributions to the conception and design; or the acquisition, analysis, or interpretation of the data: MO, HT, TE, CT, YK, and NO; (b) drafting of the article or critical revision for important intellectual content: HT, HH, MO, YE. and KF; (c) final approval of the version to be published: all authors; (d) agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the article are appropriately investigated and resolved: HT, HH, MO, and YE.
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The authors declare that they have no conflict of interest.
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Takahashi, H., Ono, M., Hyogo, H. et al. Biphasic effect of alcohol intake on the development of fatty liver disease. J Gastroenterol 50, 1114–1123 (2015). https://doi.org/10.1007/s00535-015-1058-z
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DOI: https://doi.org/10.1007/s00535-015-1058-z