The DOI matches its Crossref record; 253 of the 253 references it cites were found in a registry or an index.
The intersection between alcohol-related liver disease and nonalcoholic fatty liver disease
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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“Our findings suggest that factors beyond alcohol consumption contribute to the rising prevalence of ALD and primary liver cancer [25,26].”
From Global epidemiology of alcohol-related liver disease, liver cancer, and alcohol use disorder, 2000–2021 (2025) · cites this paper as [25]
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Cites
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A multisociety Delphi consensus statement on new fatty liver disease nomenclature
Rinella, M. E., Lazarus, J. V., Ratziu, V., Francque, S. M., Sanyal, A. J., Kanwal, F., Romero, D., Abdelmalek, M. F., Anstee, Q. M., Arab, J. P., et al. (2023) · Hepatology · doi:10.1097/hep.0000000000000520 · Cited by 3,476
Self-citationYounossi, Z. M., Golabi, P., Paik, J. M., Henry, A., Van Dongen, C., & Henry, L. (2023) · Hepatology · doi:10.1097/hep.0000000000000004 · Cited by 3,383
MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease
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Self-citationA multisociety Delphi consensus statement on new fatty liver disease nomenclature
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Self-citationMechanisms of hepatic stellate cell activation
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“Alcohol intake can be broadly classified as mild (up to 20 g (women) and 30 g (men) per day), moderate (21–39 g (women) and 31–59 g (men) per day), or heavy (≥40 g (women) and ≥60 g (men) per day) 9 .”
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Mechanisms and disease consequences of nonalcoholic fatty liver disease
Loomba, R., Friedman, S. L., & Shulman, G. I. (2021) · Cell · doi:10.1016/j.cell.2021.04.015 · Cited by 2,002
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Cited by
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Alcohol-associated liver disease
Mackowiak, B., Fu, Y., Maccioni, L., & Gao, B. (2024) · Journal of Clinical Investigation · doi:10.1172/jci176345 · Cited by 359
Hepatocellular carcinoma: updates on epidemiology, surveillance, diagnosis and treatment
Hwang, S. Y., Danpanichkul, P., Agopian, V. G., Mehta, N., Parikh, N. D., Abou‐Alfa, G. K., Singal, A. G., & Yang, J. D. (2024) · Clinical and Molecular Hepatology · doi:10.3350/cmh.2024.0824 · Cited by 359
Metabolic dysfunction-associated steatotic liver disease in adults
Huang, D. Q., Wong, V. W., Rinella, M. E., Boursier, J., Lazarus, J. V., Yki‐Järvinen, H., & Loomba, R. S. (2025) · Nature Reviews Disease Primers · doi:10.1038/s41572-025-00599-1 · Cited by 365
Arab, J. P., Díaz, L. A., Rehm, J. T., Im, G. Y., Arrese, M. A., Kamath, P. S., Lucey, M. R., Mellinger, J. L., Thiele, M. S., Thursz, M. R., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.11.028 · Cited by 193
Self-citationIsraelsen, M., Torp, N., Johansen, S., Hansen, C. D., Hansen, E. D., Thorhauge, K., Hansen, J. K., Villesen, I., Bech, K., Wernberg, C., et al. (2024) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(23)00443-0 · Cited by 174
Metadata
- 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
- Venue
- Nature Reviews Gastroenterology & Hepatology
- Published
- 2023-08-15
- Volume
- 20
- Issue
- 12
- Pages
- 764-783
- ISSN
- 1759-5045 (ISSN-L)
- 1759-5053
- 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
- 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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