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Impact of Longitudinal Alcohol Use Patterns on Long-Term Risk of Cirrhosis Among US Veterans With Steatotic Liver Disease.
- Source :
-
Gastroenterology [Gastroenterology] 2024 Jun; Vol. 166 (6), pp. 1156-1165.e4. Date of Electronic Publication: 2024 Feb 29. - Publication Year :
- 2024
-
Abstract
- Background & Aims: Conflicting data exist on the impact of alcohol use on risk of liver disease progression in patients with steatotic liver disease. We aimed to evaluate the effect of longitudinal alcohol use on risk of cirrhosis among veterans with steatotic liver disease.<br />Methods: US veterans with steatotic liver disease were identified from January 2010 through December 2022. Alcohol use was assessed using documented Alcohol Use Disorders Identification Test-Concise (AUDIT-C) scores and categorized as no alcohol (AUDIT-C = 0), low-risk alcohol use (AUDIT-C 1-2 for women and 1-3 for men), and high-risk alcohol (AUDIT-C ≥ 3 for women and ≥ 4 for men). Incidence of cirrhosis was evaluated with competing risks Nelson-Aalen methods. Adjusted multivariable regression models evaluated risks of cirrhosis associated with baseline alcohol use and changes in alcohol use during follow-up.<br />Results: There were 1,156,189 veterans with steatotic liver disease identified (54.2% no alcohol, 34.6% low-risk alcohol, and 11.2% high-risk alcohol). Veterans with steatotic liver disease and high-risk alcohol have a 43% higher incidence of cirrhosis compared with patients reporting no alcohol use. Compared with patients with baseline high-risk alcohol who reported no change in alcohol use, those who decreased their alcohol use during follow-up experienced a 39% reduction in long-term risk of cirrhosis (hazard ratio, 0.61; 95% CI, 0.45-0.83; P < .01).<br />Conclusions: One in 9 veterans with steatotic liver disease report concurrent high-risk alcohol use, which is associated with 43% greater risk of cirrhosis compared with no alcohol use. However, reducing alcohol use lowers risk of cirrhosis, emphasizing the importance of timely alcohol use assessment and early interventions to address high-risk alcohol use in steatotic liver disease.<br /> (Published by Elsevier Inc.)
- Subjects :
- Humans
Female
Male
Middle Aged
United States epidemiology
Incidence
Risk Factors
Aged
Disease Progression
Veterans statistics & numerical data
Risk Assessment
Fatty Liver epidemiology
Fatty Liver diagnosis
Longitudinal Studies
Time Factors
Adult
Retrospective Studies
Alcohol Drinking adverse effects
Alcohol Drinking epidemiology
Liver Cirrhosis epidemiology
Liver Cirrhosis diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0012
- Volume :
- 166
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 38428619
- Full Text :
- https://doi.org/10.1053/j.gastro.2024.02.032