935 Light Alcohol Consumption is Associated With Lower Prevalence of NAFLD: the Multi Ethnic Study of Atherosclerosis (MESA)

Abstract

Introduction: Non alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease in the United States. It is commonly associated with metabolic comorbidities such as obesity, diabetes, and metabolic syndrome. Heavy alcohol consumption is unequivocally associated with hepatic steatosis, but recent epidemiological studies suggest that non-heavy alcohol consumption may be associated with lower prevalence of NAFLD. In a recent study of 7000 Japanese individuals by Moriya et al found the prevalence of hepatic steatosis was 50% lower in light to moderate drinkers compared to nondrinkers . Aim: To compare the prevalence of NAFLD in individuals with light alcohol consumption and total abstainers among the MESA participants. Methods: We studied the entire MultiEthnic Study of Atherosclerosis (MESA) cohort; a population-based cohort of 6,814 Caucasian, African American, Hispanic, and Asian adults free from clinical cardiovascular disease. Cardiac CT scans were performed on all the participants, and liver and spleen images were available in > 90% of the CT scans. NAFLD was defined as liver/spleen attenuation 14 drinks on average per week in men and > 7 drinks on average per week in women). Light alcohol consumption was defined as 114 drinks per week in men and 1-7 drinks per week in women. Univariate and multivariate analyses were conducted to examine the relationship between light alcohol consumption and NAFLD. Results: After exclusions, there were a total of 2033 participants; 876 abstainers and 1,157 light drinkers. The total prevalence of NAFLD was 17%. The prevalence of NAFLD among light drinkers was significantly lower than in abstainers (14.8% vs. 18.5% OR:0.77, 95% CI 0.600.97, p=0.026). Age, gender, race, and the prevalence of metabolic syndrome were significantly different between the two groups (Table 1). The relationship between light alcohol consumption and lower prevalence of NAFLD persisted after controlling for age, gender, and race in the multivariate analysis (OR: 0.78, 95% CI: 0.61-0.99, p=0.049). However, the significance of this relationship disappeared once the metabolic syndrome was added to the multivariate analysis (OR: 0.88, 95%CI: 0.68-1.14, p=0.35). Similarly, the significant relationship between light drinking and lower prevalence of NAFLD disappeared by simply controlling for the presence of metabolic syndrome (OR:0.89, 95%CI: 0.69-1.14, p=0.36). Conclusion: Compared to abstainers, light drinkers have a lower prevalence of NAFLD. However, this relationship appears dependent on the metabolic syndrome, suggesting that light alcohol consumption's protective effect against NAFLD is possibly mediated through its effect on the metabolic syndrome. Table 1: Selected clinical characteristics of abstainers and light drinkers