Cited by 207Liver Disease Diagnosis and TreatmentAlcohol Consumption and Health EffectsLiver Diseases and Immunity

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The intersection between alcohol-related liver disease and nonalcoholic fatty liver disease

Díaz, Luis Antonio, Arab, Juan Pablo, Louvet, Alexandre, Bataller, Ramón, Arrese, Marco·2023·Nature Reviews Gastroenterology & Hepatology

DOI 10.1038/s41575-023-00822-y

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Abstract

Nonalcoholic fatty liver disease (NAFLD) and alcohol-related liver disease (ALD) are the leading causes of chronic liver disease worldwide. NAFLD and ALD share pathophysiological, histological and genetic features and both alcohol and metabolic dysfunction coexist as aetiological factors in many patients with hepatic steatosis. A diagnosis of NAFLD requires the exclusion of significant alcohol consumption and other causes of liver disease. However, data suggest that significant alcohol consumption is often under-reported in patients classified as having NAFLD and that alcohol and metabolic factors interact to exacerbate the progression of liver disease. In this Review, we analyse existing data on the interaction between alcohol consumption and metabolic syndrome as well as the overlapping features and differences in the pathogenesis of ALD and NAFLD. We also discuss the clinical implications of the coexistence of alcohol consumption, of any degree, in patients with evidence of metabolic derangement as well as the use of alcohol biomarkers to detect alcohol intake. Finally, we summarize the evolving nomenclature of fatty liver disease and describe a recent proposal to classify patients at the intersection of NAFLD and ALD. We propose that, regardless of the presumed aetiology, patients with fatty liver disease should be evaluated for both metabolic syndrome and alcohol consumption to enable better prognostication and a personalized medicine approach.

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Authors: Díaz, L. A., Arab, J. P., Louvet, A., Bataller, R., & Arrese, M.
Affiliations: Pontificia Universidad Católica de Chile (CL)
Western University (CA)
Inserm (FR)
Corresponding author: Arrese, Marco
ORCID: Díaz, Luis Antonio
Arab, Juan Pablo
Louvet, Alexandre
Arrese, Marco
Venue: Nature Reviews Gastroenterology & Hepatology
Publisher: Springer Science and Business Media LLC
Published: 2023-08-15
Volume: 20
Issue: 12
Pages: 764-783
ISSN: 1759-5045 (ISSN-L)
1759-5053
DOI: 10.1038/s41575-023-00822-y
OpenAlex: W4385851156
Semantic Scholar: f457122280dbd0b72d6e068cbffa2b2fe281bb04
Cited by: 207
References: 252
Citations by year: 2026: 58 · 2025: 75 · 2024: 63 · 2023: 11
FWCI: 8.06
Type: journal article
Language: en
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Nature Reviews Gastroenterology & Hepatology (publishedVersion)
PubMed (publishedVersion)
HAL (submittedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (U01AA021908, U01AA020821)
Topics: Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
Keywords: non-alcoholic fatty liver disease, alcoholic liver disease, metabolic syndrome, hepatic steatosis, alcohol consumption, alcohol biomarkers, disease classification, pathogenesis, chronic liver disease
MeSH terms: Alcohol Drinking, Ethanol, Humans, Biomarkers, Metabolic Syndrome, Non-alcoholic Fatty Liver Disease

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The intersection between alcohol-related liver disease and nonalcoholic fatty liver disease

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