Nonalcoholic fatty liver disease (NAFLD), once considered a benign condition, has been associated with several cardiometabolic complications over the past two decades. The worldwide prevalence of NAFLD is as high as 30%. NAFLD requires the absence of a "significant alcohol intake." Conflicting reports have suggested that moderate alcohol consumption may be protective; therefore, the diagnosis of NAFLD previously relied on negative criteria. However, there has been a significant increase in alcohol consumption globally. Apart from the rise in alcohol-related liver disease (ARLD), alcohol, a major toxin, is associated with an increased risk of several cancers, including hepatocellular carcinoma. Alcohol misuse is a significant contributor to disability-adjusted life years. Recently, the term metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed instead of NAFLD to include the metabolic dysfunction responsible for the major adverse outcomes in patients with fatty liver disease. MAFLD, dependent on the "positive diagnostic criteria" rather than previous exclusion criteria, may identify individuals with poor metabolic health and aid in managing patients at increased risk of all-cause and cardiovascular mortality. Although MAFLD is less stigmatizing than NAFLD, excluding alcohol intake may increase the risk of already existing underreported alcohol consumption in this subgroup of patients. Therefore, alcohol consumption may increase the prevalence of fatty liver disease and its associated complications in patients with MAFLD. This review discusses the effects of alcohol intake and MAFLD on fatty liver disease.

中文翻译：

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饮酒和 MAFLD 对进行性脂肪肝的双向影响。

非酒精性脂肪性肝病 (NAFLD) 曾被认为是一种良性疾病，但在过去二十年中与多种心脏代谢并发症有关。NAFLD 的全球患病率高达 30%。NAFLD 要求没有“大量饮酒”。相互矛盾的报告表明适度饮酒可能具有保护作用；因此，NAFLD 的诊断以前依赖于阴性标准。然而，全球酒精消费量显着增加。除了与酒精相关的肝病 (ARLD) 增加外，酒精是一种主要毒素，与多种癌症（包括肝细胞癌）的风险增加有关。酒精滥用是伤残调整寿命年的一个重要因素。最近，提出了代谢功能障碍相关脂肪肝疾病 (MAFLD) 一词，而不是 NAFLD，以包括导致​​脂肪肝患者主要不良后果的代谢功能障碍。MAFLD 依赖于“阳性诊断标准”而不是以前的排除标准，可以识别代谢健康状况不佳的个体，并有助于管理全因死亡率和心血管死亡风险增加的患者。尽管与 NAFLD 相比，MAFLD 的污名化程度较低，但排除酒精摄入可能会增加该亚组患者中已经存在的酒精摄入量报告不足的风险。因此，饮酒可能会增加 MAFLD 患者脂肪肝及其相关并发症的患病率。