Non-alcoholic fatty liver disease and alcohol-related liver disease: Two intertwined entities

Commentary

In their review, F. Idalsoaga et al. (Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile) aim to summarise current data on the overlapping pathophysiology of NAFLD and alcohol-related fatty liver disease, the available information on alcohol consumption in patients with NAFLD and the effects of MetS and overweight in alcohol-related fatty liver disease.

NAFLD and alcohol-related fatty liver disease share a number of features and often coexist. Alcohol consumption is often a confounding factor in patients with NAFLD. Although initially some studies suggested protective effects in moderate doses, current evidence shows that there is no safe threshold for alcohol consumption in the setting of NAFLD. On the other hand, the presence of MetS and obesity increases the progression of alcohol-related fatty liver disease as well the incidence of HCC and mortality.

For the authors, it is necessary to better define both diseases, acknowledge the presence of a dual aetiology of liver disease in a group of patients, and develop a multidisciplinary approach focused on preventive measures.