ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2025
Association of Alcohol and Incremental Cardiometabolic Risk Factors With Liver Disease: A National Cross-sectional Study.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prevalence of malnutrition and nutritional risk, and associated factors in adults with head and neck cancer: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- The dynamic spectrum of steatotic liver disease: the global perspective.Nature reviews. Gastroenterology & hepatology · 2026Review
- Episodic Heavy Drinking and Implications for Steatotic Liver Disease Nomenclature: A National Cross-Sectional Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Sex-Specific Cardiometabolic Profiles and Severity of Liver Fibrosis.JAMA network open · 2026Article
- Measures of comorbid cardiometabolic burden and cardiovascular disease risk in people with MRI-confirmed steatotic liver disease: a prospective cohort study.Cardiovascular diabetology · 2026Article
- Cytokeratin 18 fragment is associated with steatosis-associated fibrosis estimator score and lipid in patients with steatotic liver disease.World journal of hepatology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
BACKGROUND &
aimsNew nomenclature allows a single cardiometabolic risk factor (CMRF) with alcohol to classify metabolic dysfunction-associated steatotic liver disease (MASLD) and with "increased alcohol intake" (MetALD), which is controversial because alcohol causes CMRFs. Studies regarding incremental CMRFs and liver-related outcomes among alcohol users would be informative.
methodsUsing the National Health and Nutrition Examination Survey (NHANES) (1/2001-3/2020), we included participants aged ≥20 years with complete alcohol and CMRF status. CMRFs were defined by the National Cholesterol Education Program's Adult Treatment Panel III. Increased alcohol use corresponded to ≥140 g/week (women)/≥210 g/week (men). The primary outcome was Fibrosis-4 (FIB-4) >2.67.
resultsAmong 40,898 participants, 2282 had increased vs 38,616 without increased alcohol use. Prevalence of high FIB-4 among increased vs without increased alcohol use was higher at each quantity of CMRFs, and with each incremental CMRF: 0 (2.3%; 95% confidence interval [CI], 1.0%-5.0% vs 0.7%; 95% CI, 0.5%-0.9%), 1 (3.0%; 95% CI, 1.6%-5.6% vs 1.7%; 95% CI, 1.4%-2.1%), 2 (3.3%; 95% CI, 2.1%-5.1% vs 2.1%; 95% CI, 1.8%-2.4%), 3 (5.9%; 95% CI, 3.5%-9.6% vs 2.5%; 95% CI, 2.1%-2.9%), and 4 or 5 (6.1%; 95% CI, 3.3%-9.7% vs 4.0%; 95% CI, 3.5%-4.5%) CMRFs. Among increased alcohol users, in multivariable logistic regression, 3 (adjusted odds ratio [aOR], 2.57; 95% CI, 0.93-7.08), 4 or 5 (aOR, 2.64; 95% CI, 1.05-6.67) CMRFs were associated with 2-fold higher odds of high FIB-4 (vs 0 CMRFs), but not 1 (aOR, 1.24; 95% CI, 0.41-3.69) or 2 (aOR, 1.39; 95% CI, 0.56-3.50) CMRFs. Among individuals with increased alcohol use, sensitivity/specificity-based Euclidean distance suggested an optimal cutoff of ≥3 CMRFs to differentiate higher probability of high FIB-4.
conclusionsStratifying MetALD as ≥3 CMRFs, rather than 1 CMRF, may provide more optimal fibrosis stratification. Diabetes, high waist circumference, and hypertension are associated with significant liver fibrosis among individuals with increased alcohol use, but not dyslipidemia.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.