How Would You Manage This Patient With Nonalcoholic Fatty Liver Disease?
Authors: Brian L. Pearlman
Journal: Annals of Internal Medicine (2019)

Letters3 December 2019How Would You Manage This Patient With Nonalcoholic Fatty Liver Disease?Brian L. Pearlman, MDBrian L. Pearlman, MDWellStar Atlanta Medical Center, Medical College of Georgia, and Emory School of Medicine, Atlanta, Georgia (B.L.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0667 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Libman and colleagues' (1) discussion on the management of patients with nonalcoholic fatty liver disease (NAFLD) briefly addresses alcohol use in this population. Tapper notes that there is no evidence that abstaining from alcohol improves outcomes and refers to an analysis of 83 prospective studies in which moderate drinking (≤7 drinks per week) was not associated with harm (2).Regarding the J-shaped relationship between alcohol and mortality in both men and women, a prospective study of a large U.S. population followed for 9 years showed that the overall mortality rate was lowest in men and women who ...References1. Libman H, Jiang ZG, Tapper EB, et al. How would you manage this patient with nonalcoholic fatty liver disease? Grand rounds discussion from Beth Israel Deaconess Medical Center. Ann Intern Med. 2019;171:199-207. [PMID: 31382287]. doi:10.7326/M19-1125 LinkGoogle Scholar2. Wood AM, Kaptoge S, Butterworth AS, et al; Emerging Risk Factors Collaboration/EPIC-CVD/UK Biobank Alcohol Study Group. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet. 2018;391:1513-23. [PMID: 29676281] doi:10.1016/S0140-6736(18)30134-X CrossrefMedlineGoogle Scholar3. Thun MJ, Peto R, Lopez AD, et al. Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engl J Med. 1997;337:1705-14. [PMID: 9392695] CrossrefMedlineGoogle Scholar4. Hajifathalian K, Torabi Sagvand B, McCullough AJ. Effect of alcohol consumption on survival in nonalcoholic fatty liver disease: a national prospective cohort study. Hepatology. 2019;70:511-21. [PMID: 30125379] doi:10.1002/hep.30226 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: WellStar Atlanta Medical Center, Medical College of Georgia, and Emory School of Medicine, Atlanta, Georgia (B.L.P.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0667. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHow Would You Manage This Patient With Nonalcoholic Fatty Liver Disease? Howard Libman , Z. Gordon Jiang , Elliot B. Tapper , and Eileen E. Reynolds How Would You Manage This Patient With Nonalcoholic Fatty Liver Disease? Howard Libman , Z. Gordon Jiang , Elliot B. Tapper , and Eileen E. Reynolds Metrics Cited byBlueberry-derived exosomes-like nanoparticles ameliorate nonalcoholic fatty liver disease by attenuating mitochondrial oxidative stress 3 December 2019Volume 171, Issue 11Page: 861-862KeywordsAlcohol consumptionAlcoholicsAlcoholsDeath ratesDisclosureHazard ratioLiver fibrosisMortalityNon-alcoholic fatty liver diseaseProspective studies ePublished: 3 December 2019 Issue Published: 3 December 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...