Ethyl glucuronide in hair detects a high rate of harmful alcohol consumption in presumed non-alcoholic fatty liver disease

Staufer, Katharina; Huber-Schönauer, Ursula; Strebinger, Georg; Pimingstorfer, Philipp; Suesse, Silke; Scherzer, Thomas–Matthias; Paulweber, Bernhard; Ferenci, Péter; Stimpfl, Thomas; Yegles, Michel; Datz, Christian; Trauner, Michael

doi:10.1016/j.jhep.2022.04.040

Cited by 111 publications

(83 citation statements)

References 53 publications

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“…This was recently highlighted by a study detecting repeated moderate to excessive alcohol consumption in 29% of patients with presumed NAFLD when assessed by alcohol biomarkers. 35 Despite the relationship between alcohol dose and liver disease risk, only 10 to 20% of individuals with chronic heavy alcohol use develop liver cirrhosis or alcoholic hepatitis. This observation highlights the key role of effect modifiers.…”

Section: Alcohol and Liver Disease: Key Remarksmentioning

confidence: 99%

Alcohol consumption and metabolic syndrome: Clinical and epidemiological impact on liver disease

Åberg¹,

Byrne²,

Pirola³

et al. 2023

Journal of Hepatology

119

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Section: Alcohol and Liver Disease: Key Remarksmentioning

confidence: 99%

Alcohol consumption and metabolic syndrome: Clinical and epidemiological impact on liver disease

Åberg¹,

Byrne²,

Pirola³

et al. 2023

Journal of Hepatology

119

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“…Importantly, a recent study by Trauner’s group demonstrated that at least 25% of NAFLD patients consume substantial alcohol as detected in hair which is assumed to have a major impact on NAFLD/MAFLD phenotype. 29 The authors showed that in 28.6% of NAFLD patients and in 25% of MAFLD patients, alcohol-related liver injury might be relevant. As proposed by Yamamura’s study, the observed ‘mild alcohol’ consumption in Staufer’s study might be clinically highly relevant and in many NAFLD/MAFLD cases associated alcohol consumption might play a major role in disease phenotype and prognosis.…”

Section: Evidence That the New Definition ‘Mafld’ Might Advance The F...mentioning

confidence: 99%

“…This is also supported by the recent study from Vienna as discussed before demonstrating that approximately 25% of also MAFLD patients consume too much alcohol. 29 Another major problem discussed by Younossi et al 50 reflect current and past clinical trials in this field with well-established clinical and histological endpoints which would need to be adapted when using the new definition. How should endpoints of clinical trials be defined when using the new MAFLD definition?…”

Section: Potential Pitfalls Of the New Definition: Consensus Not Yet ...mentioning

confidence: 99%

MAFLD: what 2 years of the redefinition of fatty liver disease has taught us

Grabherr

Grander

Effenberger

et al. 2022

Therapeutic Advances in Endocrinology

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Metabolic dysfunction–associated fatty liver disease (MAFLD) has appeared as the leading liver disease worldwide. Whereas the terminology nonalcoholic fatty liver disease (NAFLD) mainly reflected a negative selection and exclusion of alcohol-related liver disease (ALD), the new definition made its focus on the association of MAFLD with overweight/obesity, type 2 diabetes and metabolic risk factors especially also in normal weight/lean subjects. Several studies from the past 2 years have now used the new definition and have provided substantial information that this new definition might be accurate. Studies from the past 2 years have provided evidence that the new definition might be especially advantageous in the characterization and identification of patients with significant fibrosis. This has also been demonstrated in the well-known Rotterdam study in which the MAFLD-only group showed a higher rate of fibrosis and liver stiffness. MAFLD might also be able to predict all-cause mortality as demonstrated in the Third National Health and Nutrition Examination Survey. Furthermore, MAFLD might improve characterization of the cardiovascular risk of this patient population. As the term MAFLD has not yet been accepted universally, it remains important to coordinate efforts globally to adapt to this new definition and especially involve all specialities dealing with metabolic disorders such as diabetologists to further improve its definition and to prepare the medical community for its future use. The aim of this review is to summarize and critically address evidence emerging over the past 2 years that usage of the term MAFLD could be helpful in daily clinical practice.

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“…We congratulate Staufer et al for examining a controversial topic in the field (1). Alcohol consumption in NAFLD/MAFLD has definitely been "the elephant in the room" for a long time.…”

mentioning

confidence: 95%