Table 1. Studies exploring the epidemiologic link between alcohol consumption and NAFLD.
| Study | Country | Definition of NAFLD/NASH | Number of subjects | Amount of alcohol (g/day) | Odds ratio (CI) males* | Odds ratio (CI) females* |
|---|---|---|---|---|---|---|
| Bellentani et al, 2000 (128) | Italy | Ultrasound | 3,299 | >60 | 2.8 (1.4–7.1) | |
| Moriya et al, 2010 (129) | Japan | Ultrasound | 7,112 | Any alcohol consumption: 0–10, 10–20, 20–40, >40 | 0.54 (0.46–0.63) | 0.80 (0.57–1.12) |
| 0.75 (0.60–0.94) | 0.68 (0.44–1.05) | |||||
| 0.62 (0.49–0.77) | 0.85 (0.48–1.51) | |||||
| 0.50 (0.41–0.61) | 1.26 (0.60–2.65) | |||||
| 0.40 (0.32–0.49) | 1.13 (0.25–5.19) | |||||
| Hamaguchi et al, 2012 (131) | Japan | Ultrasound | 18,571 | −0 to 20; −20 to 40; >40 | 0.69 (0.60–0.79) | 0.54 (0.34–0.88) |
| 0.72 (0.63–0.83) | 0.43 (0.21–0.88) | |||||
| 0.74 (0.64–0.85) | 1.02 (0.44–2.35) | |||||
| Takahashi et al, 2015 (132) | Japan | Ultrasound | 8,029 | Moderate (20 to 50); heavy (>50) | 0.90 (0.78–1.04) | 0.68 (0.395–1.15) |
| 0.95 (0.79–1.15) | 3.35 (1.56–7.13) | |||||
| Hiramine et al, 2010 (133) | Japan | Ultrasound | 9,886 males | <20; 20–59; >60 | 0.71 (0.59–0.86) | – |
| 0.55 (0.45–0.67) | – | |||||
| 0.44 (0.32–0.62) | – | |||||
| Gunji et al, 2009 (134) | Japan | Ultrasound | 5,599 males | 0–20; 20–40; >40 | 0.82 (0.68–0.99) | – |
| 0.75 (0.61–0.93) | – | |||||
| 0.85 (0.67–1.09) | – | |||||
| Sogabe et al, 2014 (135) | Japan | Ultrasound and ALT ≥31 | 1,055 males with MS | <20 | 0.65 (0.47–0.91) | – |
| Dunn et al, 2008 (136) | US | ALT >43 | 11,745 | Wine <20 | 0.51 (0.33–0.80) | |
| Dunn et al, 2012 (137) | US | Liver biopsy | 582 | <20 | Less NASH: 0.56 (0.39–0.84) | |
| Less fibrosis: 0.56 (0.41–0.78) | ||||||
| Ekstedt et al, 2009 (138) | Sweden | Liver biopsy | 71 | Men >60 g; women >48 g | More fibrosis: 42.15 (5.390–329.57) | |
| Sookoian et al, 2016 (139) | Argentina | Ultrasound and liver biopsy | 414 | Wine ≤20 | 0.49 (0.29–0.79) | |
| Ajmera et al, 2018 (140) | US | Liver biopsy | 285 | <20 | NASH resolution on follow–up: 0.32 (0.11–0.92) | |
| Chang et al, 2019 (141) | Korea | NFS and FIB-4 scores | 58,927 adults with NAFLD | Light: 1–10; modest: 10–29.9 (10–19.9 for women) | Worsening of FIB–4 on follow up: | |
| • Light drinkers: 1.06 (0.98–1.16); | ||||||
| • Moderate drinkers: 1.29 (1.18–1.40) | ||||||
| Worsening of NFS on follow up | ||||||
| • Light drinkers: 1.09 (1.02–1.16); | ||||||
| • Moderate drinkers: 1.31 (1.23–1.40) | ||||||
*, outcomes with statistically significant p values are in bold. NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis; NFS, NAFLD fibrosis score; FIB-4, fibrosis-4 index.