This review is to evaluate how much alcohol is safe in the context of alcohol-related liver disease (ALD). In patients without an established diagnosis of ALD consuming alcohol at quantities below 12 to 20 g daily with alcohol-free days is associated with a very low risk of developing disease. This risk is mediated by the presence of cofactors such as sex, medical comorbidity, obesity, and genetic factors. A threshold effect below which liver disease will not occur is not seen, instead a dose–response relationship where risk ranges from low to high. Once ALD is present, natural history studies confirm that continued alcohol consumption is clearly associated with an increased risk of ill health and premature death. In conclusion, low-level alcohol consumption in the absence of liver disease is associated with a very small risk of developing ALD, but once ALD is present patients should be supported to achieve complete abstinence from alcohol.

本综述旨在评估在酒精相关性肝病 (ALD) 的情况下，多少酒精是安全的。对于没有明确诊断为 ALD 的患者，在戒酒日每天饮酒量低于 12 至 20 克，患疾病的风险非常低。这种风险是由性别、合并症、肥胖和遗传因素等辅助因素的存在介导的。没有看到低于不会发生肝病的阈值效应，而是存在风险从低到高的剂量反应关系。一旦出现酒精性肝病，自然史研究证实，持续饮酒显然会增加健康状况不佳和过早死亡的风险。总之，在没有肝病的情况下，少量饮酒与发生酒精性肝病的风险非常小有关，但一旦出现酒精性肝病，应支持患者完全戒酒。