The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Interaction between alcohol consumption and metabolic syndrome in predicting severe liver disease in the general population
Abstract
The metabolic syndrome and alcohol risk use are both associated with a high prevalence of hepatic steatosis, but only a minority develop liver failure or liver cancer. Few general population studies have analyzed metabolic predictors of such severe liver complications. We studied which metabolic factors best predict severe liver complications, stratified by alcohol consumption, in 6732 individuals without baseline liver disease who participated in the Finnish population-based Health 2000 Study (2000-2001), a nationally representative cohort. Follow-up data from national registers until 2013 were analyzed for liver-related admissions, mortality, and liver cancer. Baseline alcohol use and metabolic factors were analyzed by backward stepwise Cox regression analysis. Eighty-four subjects experienced a severe liver event during follow-up. In the final multivariate model, factors predictive of liver events were age (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.004-1.04), sex (women: HR, 0.55; 95% CI, 0.34-0.91), alcohol use (HR, 1.002; 95% CI, 1.001-1.002), diabetes (HR, 2.73; 95% CI, 1.55-4.81), low-density lipoprotein (LDL) cholesterol (HR, 0.74; 95% CI, 0.58-0.93), and homeostasis model assessment of insulin resistance (HOMA-IR) (HR, 1.01; 95% CI, 1.004-1.02). Among alcohol risk users (≥210 g/week for men, ≥ 140 g/week for women), diabetes (HR, 6.79; 95% CI, 3.18-14.5) was the only significant predictor. Among nonrisk drinkers, age, alcohol use, smoking, waist circumference, low LDL cholesterol and HOMA-IR were significant independent predictors. The total-to-LDL cholesterol ratio and waist circumference-to-body mass index ratio emerged as additional independent predictors. CONCLUSION: Multiple components of the metabolic syndrome independently affected the risk for severe liver disease. Alcohol was significant even when average alcohol consumption was within the limits currently defining nonalcoholic fatty liver disease. (Hepatology 2018;67:2141-2149).
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“Equally important may be the possible synergy between alcohol consumption and the presence of metabolic risk factors for liver disease progression, 75,83 with the strongest effect for central obesity.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [84]
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Metadata
- Authors
- Åberg, F., Helenius‐Hietala, J., Puukka, P., Färkkilä, M., & Jula, A.
- Affiliations
- University of Helsinki (FI)
- Department of Health,National Institute for Health and Welfare,Turku,Finland
- Corresponding author
- Åberg, Fredrik
- Venue
- Hepatology
- Published
- 2018-04-16
- Volume
- 67
- Issue
- 6
- Pages
- 2141-2149
- ISSN
- 0270-9139 (ISSN-L)
- 1527-3350
- OpenAlex
- W2770566262
- Cited by
- 267
- References
- 32
- Citations by year
- 2026: 20 · 2025: 32 · 2024: 46 · 2023: 28 · 2022: 30 · 2021: 31 · 2020: 34 · 2019: 26 · 2018: 16
- FWCI
- 16.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Finska Läkaresällskapet
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- alcohol consumption, metabolic syndrome, severe liver disease, liver failure, liver cancer, non-alcoholic fatty liver disease, diabetes mellitus, insulin resistance, HOMA-IR, LDL cholesterol, waist circumference, smoking, risk factors, liver-related mortality, general population, Finland, sex differences
- MeSH terms
- Alcohol Drinking, Female, Humans, Liver Diseases, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Severity of Illness Index, Metabolic Syndrome
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