Abstract：
BACKGROUND: The effects of excessive alcohol consumption on the prognosis of metabolic dysfunction-associated fatty liver disease (MAFLD) remain unclear. We investigated all-cause and cause-specific mortality according to the amount of alcohol consumed by Asian individuals with MAFLD.
METHODS: This nationwide retrospective study included 996,508 adults aged 40-79 years who underwent health check-ups between 2009 and 2012. Participants were categorized by the alcohol consumption-non-alcohol, moderate alcohol, and heavy alcohol group (≥ 30 g/day for men, ≥ 20 g/day for women) and by the combination of the presence or absence of MAFLD. Hepatic steatosis was defined as the fatty liver index ≥ 30. Cox analyses were used to analyze the association between alcohol consumption and MAFLD and all-cause and cause-specific mortality.
RESULTS: MAFLD significantly increased all-cause, liver-, and cancer-related mortality. Individuals with both MAFLD and heavy alcohol consumption expressed the highest mortality risk in liver-related mortality compared to non-MAFLD and non-alcohol group (adjusted hazard ratio (HR), 9.8; 95% confidence interval (CI), 8.20-12.29). Regardless of MAFLD, heavy alcohol consumption increased the risk of liver- and cancer-related mortality.
CONCLUSIONS: MAFLD and heavy alcohol consumption increased all-cause, liver-, and cancer-related mortality. Heavy alcohol consumption and MAFLD synergistically increase liver-related mortality.
METHODS: This nationwide retrospective study included 996,508 adults aged 40-79 years who underwent health check-ups between 2009 and 2012. Participants were categorized by the alcohol consumption-non-alcohol, moderate alcohol, and heavy alcohol group (≥ 30 g/day for men, ≥ 20 g/day for women) and by the combination of the presence or absence of MAFLD. Hepatic steatosis was defined as the fatty liver index ≥ 30. Cox analyses were used to analyze the association between alcohol consumption and MAFLD and all-cause and cause-specific mortality.
RESULTS: MAFLD significantly increased all-cause, liver-, and cancer-related mortality. Individuals with both MAFLD and heavy alcohol consumption expressed the highest mortality risk in liver-related mortality compared to non-MAFLD and non-alcohol group (adjusted hazard ratio (HR), 9.8; 95% confidence interval (CI), 8.20-12.29). Regardless of MAFLD, heavy alcohol consumption increased the risk of liver- and cancer-related mortality.
CONCLUSIONS: MAFLD and heavy alcohol consumption increased all-cause, liver-, and cancer-related mortality. Heavy alcohol consumption and MAFLD synergistically increase liver-related mortality.
摘要：
背景：过量饮酒对代谢功能障碍相关性脂肪肝（MAFLD）预后的影响尚不清楚。我们根据亚洲MAFLD患者的饮酒量调查了全因死亡率和特定原因死亡率。
方法：这项全国性的回顾性研究包括996,508名40-79岁的成年人，他们在2009年至2012年间接受了健康检查。参与者按酒精消费分类-非酒精，适度酒精,和重度酒精组(男性≥30克/天，女性≥20g/天）以及是否存在MAFLD的组合。肝脏脂肪变性定义为脂肪肝指数≥30。Cox分析用于分析饮酒和MAFLD与全因死亡率和特定原因死亡率之间的关系。
结果：MAFLD显著增加了所有原因，肝脏-,和癌症相关的死亡率。与非MAFLD和非酒精组相比，MAFLD和重度饮酒的个体在肝脏相关死亡率中表现出最高的死亡风险（调整后的风险比（HR），9.8；95%置信区间(CI)，8.20-12.29）。不管MAFLD,大量饮酒会增加肝脏和癌症相关死亡的风险.
结论：MAFLD和大量饮酒增加了所有原因，肝脏-,和癌症相关的死亡率。大量饮酒和MAFLD协同增加肝脏相关死亡率。
方法：这项全国性的回顾性研究包括996,508名40-79岁的成年人，他们在2009年至2012年间接受了健康检查。参与者按酒精消费分类-非酒精，适度酒精,和重度酒精组(男性≥30克/天，女性≥20g/天）以及是否存在MAFLD的组合。肝脏脂肪变性定义为脂肪肝指数≥30。Cox分析用于分析饮酒和MAFLD与全因死亡率和特定原因死亡率之间的关系。
结果：MAFLD显著增加了所有原因，肝脏-,和癌症相关的死亡率。与非MAFLD和非酒精组相比，MAFLD和重度饮酒的个体在肝脏相关死亡率中表现出最高的死亡风险（调整后的风险比（HR），9.8；95%置信区间(CI)，8.20-12.29）。不管MAFLD,大量饮酒会增加肝脏和癌症相关死亡的风险.
结论：MAFLD和大量饮酒增加了所有原因，肝脏-,和癌症相关的死亡率。大量饮酒和MAFLD协同增加肝脏相关死亡率。
