Even low alcohol intake detrimental to East Asian men with MASLD

Intake of even small amounts of alcohol appears to pose a significant health risk for East Asian men with metabolic dysfunction-associated steatotic liver disease (MASLD), according to a South Korean nationwide cohort study.

The study included 1,087,803 men (age ≥40 years) with MASLD identified during national health examinations. Alcohol intake was categorized as follows: none, <70 g, 70–140 g, 140–210 g, and ≥210 g/week.

Liver-related events (LREs), the primary study outcome, were defined as newly diagnosed hepatocellular carcinoma, liver cirrhosis (with or without decompensation), or liver-related mortality. Cox-proportional hazards models were used in the analyses.

Over a median follow-up of 11 years, LREs occurred in 26,742 participants (2.5 percent). LRE risk was elevated at an alcohol intake level of 140–210 g/week vs no intake (adjusted hazard ratio [aHR], 1.10, 95 percent confidence interval [CI], 1.05–1.14). The risk further increased at intake levels of ≥210 g/week (aHR, 1.30, 95 percent CI, 1.25–1.34).

Notably, vulnerable subgroups (diabetes, BMI <25 kg/m², abnormal alanine aminotransferase levels) showed a significantly increased LRE risk at an even lower alcohol intake threshold, at 70–140 g/week.

Spline analysis indicated the presence of a nonlinear, generally J-shaped, dose–response association between alcohol consumption and LRE risk.