TY  - INPR
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
TI  - Metabolic Dysfunction and Alcohol-related Liver Disease (MetALD): Position statement by an expert panel on alcohol-related liver disease
AV  - restricted
Y1  - 2024/11/27/
JF  - Journal of Hepatology
A1  - Arab, Juan Pablo
A1  - Díaz, Luis Antonio
A1  - Rehm, Jürgen
A1  - Im, Gene
A1  - Arrese, Marco
A1  - Kamath, Patrick S
A1  - Lucey, Michael R
A1  - Mellinger, Jessica
A1  - Thiele, Maja
A1  - Thursz, Mark
A1  - Bataller, Ramon
A1  - Burton, Robyn
A1  - Chokshi, Shilpa
A1  - Francque, Sven M
A1  - Krag, Aleksander
A1  - Lackner, Carolin
A1  - Lee, Brian P
A1  - Liangpunsakul, Suthat
A1  - MacClain, Craig
A1  - Mandrekar, Pranoti
A1  - Mitchell, Mack C
A1  - Morgan, Marsha Y
A1  - Morgan, Timothy R
A1  - Pose, Elisa
A1  - Shah, Vijay H
A1  - Shawcross, Debbie
A1  - Sheron, Nick
A1  - Singal, Ashwani K
A1  - Stefanescu, Horia
A1  - Terrault, Norah
A1  - Trépo, Eric
A1  - Moreno, Christophe
A1  - Louvet, Alexandre
A1  - Mathurin, Philippe
KW  - MASLD; MetALD; NASH; MASH; non-alcoholic fatty liver disease; alcohol-related liver disease
KW  - 
alcoholic liver disease
KW  -  alcoholic cirrhosis; public health
N2  - This position statement explores the intricate relationship between alcohol intake and metabolic dysfunction in the context of the 2023 nomenclature for steatotic liver disease (SLD). Recent and lifetime alcohol use should be accurately assessed in all patients with SLD to facilitate classification of alcohol use in grams of alcohol per week. Alcohol biomarkers (i.e., phosphatidylethanol), use of validated questionnaires (i.e. AUDIT-C), and collateral information from friends and relatives could help facilitate differentiation between alcohol-related liver disease (ALD) per se and liver disease with both metabolic and alcohol-related components (MetALD). Heavy alcohol use can contribute to cardiometabolic risk factors such as high blood pressure, hypertriglyceridemia, and hyperglycemia. As a result, caution should be exercised in the application of only one metabolic dysfunction criterion to diagnose MASLD, as suggested in the 2023 nomenclature document, particularly in individuals exceeding weekly alcohol use thresholds of 140 grams for women and 210 grams for men. This is particularly important in those individuals with isolated high blood pressure, hypertriglyceridemia, or hyperglycemia, where the disease process may be driven by alcohol itself. Additionally, metabolic dysfunction and alcohol use should be reassessed over time, especially after periods of changes in risk factor exposure. This approach could ensure a more accurate prognosis and effective management of SLD addressing both metabolic and alcohol-related factors.
ID  - discovery10201497
UR  - https://doi.org/10.1016/j.jhep.2024.11.028
PB  - Elsevier
SN  - 0168-8278
ER  -