SNFGE SNFGE
 
Thématique :
- Foie
Originalité :
Réexamen
Solidité :
Très solide
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Professeur Christine SILVAIN
Coup de coeur :
 
 
Hepatology
  2019/01  
 
  2019 Jan;69(1):64-75.  
  doi: 10.1002/hep.30170.  
 
  Nonheavy Drinking and Worsening of Noninvasive Fibrosis Markers in Nonalcoholic Fatty Liver Disease: A Cohort Study.  
 
  Chang Y, Cho YK, Kim Y, Sung E, Ahn J, Jung HS, Yun KE, Shin H, Ryu S  
  https://www.ncbi.nlm.nih.gov/pubmed/30019340  
 
 

Abstract

The effect of modest alcohol consumption on fibrosis progression in the general population with nonalcoholic fatty liver disease (NAFLD) remains unclear. We examined the association of nonheavy alcohol consumption with worsening of noninvasive fibrosis indices in a large-scale, low-risk population with NAFLD. A cohort study was performed in 58,927 Korean adults with NAFLD and low fibrosis scores who were followed for a median of 4.9 years. Non-, light, and moderate drinkers were defined as 0 g/day, 1-9.9 g/day, and 10-29.9 g/day (10-19.9 g/day for women), respectively. Progression from low to intermediate or high probability of advanced fibrosis was assessed using noninvasive indices including NAFLD fibrosis score (NFS) and Fibrosis-4 Index (FIB-4). A parametric proportional hazards model was used to estimate the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). During 347,925.4 person-years of follow-up, 5,630 subjects with low FIB-4 progressed to intermediate or high FIB-4. The multivariable-adjusted HRs (95% CI) for worsening of FIB-4 comparing light and moderate drinkers with nondrinkers were 1.06 (0.98-1.16) and 1.29 (1.18-1.40), respectively. Similarly, using NFS, corresponding HRs (95% CI) comparing light and moderate drinkers with nondrinkers were 1.09 (1.02-1.16) and 1.31 (1.23-1.40), respectively. Furthermore, the association of moderate drinkers with worsening of either FIB-4 or NFS remained significant after introducing alcohol use and confounders treated as time-varying covariates.

Conclusion: In this large-scale cohort of young and middle-aged individuals with NAFLD, nonheavy alcohol consumption, especially moderate alcohol consumption, was significantly and independently associated with worsening of noninvasive markers of fibrosis, indicating that even moderate alcohol consumption might be harmful.

 
Question posée
 
Effet de la “faible” prise de boissons alcoolisées (0 g/j : non buveur; 1 à 9,9 g/j: faible buveur; 10 à 29,9 g/j(10 à 19,9 g/j chez les femmes): buveur modéré),sur l’aggravation des marqueurs non invasifs de la fibrose hépatique (NFS, FIB-4) à partir de l’étude d’une grande population à faible risque (score de fibrose faible) avec NAFLD et suivi pendant 5 ans/
 
Question posée
 
Les buveurs modérés ont une aggravation de la fibrose hépatique évalués par NFS et FIB-4.
 
Commentaires

En cas de NAFLD, pas d’alcool…pour conserver un foie sans fibrose, cela se confirme.

 
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