Effects of Alcohol Consumption and BMI on Hepatic Steatosis
Effects of Alcohol Consumption and BMI on Hepatic Steatosis
Background Research on the association between alcohol consumption and hepatic steatosis revealed conflictive results.
Aim To investigate the associations between average daily alcohol consumption and binge drinking with hepatic steatosis, and to analyse combined effects of average daily alcohol consumption and binge drinking with body mass index (BMI) on hepatic steatosis.
Methods Data from the population-based Study of Health in Pomerania (SHIP) conducted in north-east Germany comprising 4009 adults were used. Alcohol consumption was assessed by self-report. Serum carbohydrate-deficient transferrin (CDT) was analysed as biomarker for alcohol consumption. Hepatic steatosis was diagnosed by ultrasonography.
Results Analyses revealed a dose–response relationship between average daily alcohol consumption and hepatic steatosis in men starting with a consumption of 20 g of alcohol per day [adjusted odds ratio (OR) compared to abstainers 1.53; 95% confidence interval (CI) 1.15–2.05]. Using CDT as alternative exposure variable confirmed these results. Binge drinking was associated with hepatic steatosis in men (adjusted OR of binge drinkers compared to nonbinge drinkers 1.36, 95% CI 1.06–1.74). The likelihood of having hepatic steatosis increased in men and women with increasing levels of average daily alcohol consumption in combination with overweight or obesity. Similarly, binge drinking in combination with overweight or obesity enhanced the likelihood of having hepatic steatosis.
Conclusions Overweight or obesity substantially enhanced the effect of high levels of average daily alcohol consumption and binge drinking on hepatic steatosis in the present study population. This finding underlines the necessity to screen for multiple risk factors in the prevention of hepatic steatosis.
Hepatic steatosis is a major cause of liver morbidity in western countries, and its clinical importance has grown in recent years. In addition to obesity, alcohol consumption has been demonstrated to be a major risk factor of hepatic steatosis. However, the effect of alcohol consumption on hepatic steatosis is controversial and findings from recent studies suggest that small amounts of alcohol consumption may be protective against hepatic steatosis. These studies, however, used mainly cross-sectional data from samples of Asian populations undergoing medical check-ups. To our knowledge, the association between alcohol consumption and hepatic steatosis in healthy individuals of Caucasian origin from the general population has not yet been well investigated.
Previous studies analysing effects of alcohol consumption on hepatic steatosis have focused on average daily alcohol consumption and have not considered binge drinking. Binge drinking, the excessive consumption of large amounts of alcohol in a short-time period, is increasing in popularity in western Europe. Although the consequences of binge drinking have been intensively studied in the past, data on the influence of binge drinking on hepatic steatosis are scarce.
Results from several studies imply that the association between alcohol consumption and hepatic disorders may be modified by obesity. For example, data from a cross-sectional survey conducted in northern Europe demonstrated that the effect of alcohol consumption on hepatic steatosis, as measured by the examination of serum liver enzymes, increased with increasing body mass index (BMI). Similar results were reported by another cross-sectional study from the United States. This study used survey sample data to investigate the effects of alcohol consumption and BMI on elevated liver enzymes. In that study, the co-occurrence of high levels of alcohol consumption and obesity increased the risk of abnormal liver enzyme activity more than the two single risk factors alone. Recently, these results were confirmed by data from a prospective population-based cohort demonstrating that an average daily alcohol intake of at least 40 g, together with obesity, was associated with liver enzyme abnormalities after 7 years. To date, there is no study investigating the combined effect of binge drinking and being overweight or obese on hepatic steatosis.
The present study has two major aims. First, to investigate the separate associations between average daily alcohol consumption and binge drinking and hepatic steatosis in a general population sample. Second, to analyse both the combined effect of average daily alcohol consumption and BMI on hepatic steatosis, and the combined effect of binge drinking and BMI on hepatic steatosis.
Abstract and Introduction
Abstract
Background Research on the association between alcohol consumption and hepatic steatosis revealed conflictive results.
Aim To investigate the associations between average daily alcohol consumption and binge drinking with hepatic steatosis, and to analyse combined effects of average daily alcohol consumption and binge drinking with body mass index (BMI) on hepatic steatosis.
Methods Data from the population-based Study of Health in Pomerania (SHIP) conducted in north-east Germany comprising 4009 adults were used. Alcohol consumption was assessed by self-report. Serum carbohydrate-deficient transferrin (CDT) was analysed as biomarker for alcohol consumption. Hepatic steatosis was diagnosed by ultrasonography.
Results Analyses revealed a dose–response relationship between average daily alcohol consumption and hepatic steatosis in men starting with a consumption of 20 g of alcohol per day [adjusted odds ratio (OR) compared to abstainers 1.53; 95% confidence interval (CI) 1.15–2.05]. Using CDT as alternative exposure variable confirmed these results. Binge drinking was associated with hepatic steatosis in men (adjusted OR of binge drinkers compared to nonbinge drinkers 1.36, 95% CI 1.06–1.74). The likelihood of having hepatic steatosis increased in men and women with increasing levels of average daily alcohol consumption in combination with overweight or obesity. Similarly, binge drinking in combination with overweight or obesity enhanced the likelihood of having hepatic steatosis.
Conclusions Overweight or obesity substantially enhanced the effect of high levels of average daily alcohol consumption and binge drinking on hepatic steatosis in the present study population. This finding underlines the necessity to screen for multiple risk factors in the prevention of hepatic steatosis.
Introduction
Hepatic steatosis is a major cause of liver morbidity in western countries, and its clinical importance has grown in recent years. In addition to obesity, alcohol consumption has been demonstrated to be a major risk factor of hepatic steatosis. However, the effect of alcohol consumption on hepatic steatosis is controversial and findings from recent studies suggest that small amounts of alcohol consumption may be protective against hepatic steatosis. These studies, however, used mainly cross-sectional data from samples of Asian populations undergoing medical check-ups. To our knowledge, the association between alcohol consumption and hepatic steatosis in healthy individuals of Caucasian origin from the general population has not yet been well investigated.
Previous studies analysing effects of alcohol consumption on hepatic steatosis have focused on average daily alcohol consumption and have not considered binge drinking. Binge drinking, the excessive consumption of large amounts of alcohol in a short-time period, is increasing in popularity in western Europe. Although the consequences of binge drinking have been intensively studied in the past, data on the influence of binge drinking on hepatic steatosis are scarce.
Results from several studies imply that the association between alcohol consumption and hepatic disorders may be modified by obesity. For example, data from a cross-sectional survey conducted in northern Europe demonstrated that the effect of alcohol consumption on hepatic steatosis, as measured by the examination of serum liver enzymes, increased with increasing body mass index (BMI). Similar results were reported by another cross-sectional study from the United States. This study used survey sample data to investigate the effects of alcohol consumption and BMI on elevated liver enzymes. In that study, the co-occurrence of high levels of alcohol consumption and obesity increased the risk of abnormal liver enzyme activity more than the two single risk factors alone. Recently, these results were confirmed by data from a prospective population-based cohort demonstrating that an average daily alcohol intake of at least 40 g, together with obesity, was associated with liver enzyme abnormalities after 7 years. To date, there is no study investigating the combined effect of binge drinking and being overweight or obese on hepatic steatosis.
The present study has two major aims. First, to investigate the separate associations between average daily alcohol consumption and binge drinking and hepatic steatosis in a general population sample. Second, to analyse both the combined effect of average daily alcohol consumption and BMI on hepatic steatosis, and the combined effect of binge drinking and BMI on hepatic steatosis.
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