Arab, Juan Pablo;
Díaz, Luis Antonio;
Rehm, Jürgen;
Im, Gene;
Arrese, Marco;
Kamath, Patrick S;
Lucey, Michael R;
... Mathurin, Philippe; + view all
(2024)
Metabolic Dysfunction and Alcohol-related Liver Disease (MetALD): Position statement by an expert panel on alcohol-related liver disease.
Journal of Hepatology
10.1016/j.jhep.2024.11.028.
(In press).
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Abstract
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.
| Type: | Article |
|---|---|
| Title: | Metabolic Dysfunction and Alcohol-related Liver Disease (MetALD): Position statement by an expert panel on alcohol-related liver disease |
| Location: | Netherlands |
| DOI: | 10.1016/j.jhep.2024.11.028 |
| Publisher version: | https://doi.org/10.1016/j.jhep.2024.11.028 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | MASLD; MetALD; NASH; MASH; non-alcoholic fatty liver disease; alcohol-related liver disease, alcoholic liver disease, alcoholic cirrhosis; public health |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10201497 |
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