Alcohol-related liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD, recently renamed metabolic dysfunction-associated steatotic liver disease [MASLD]) share many features, including certain pathophysiological mechanisms, susceptibility genes, and histological lesions. However, the natural history of the two diseases, studied separately, is significantly different, with ALD being associated with a higher risk of cirrhosis and liver-related mortality. Moreover, evidence suggests an interactive effect between ALD and metabolic risk factors that are associated with NAFLD on the risk of progressive fibrosis and development of cirrhosis. Patients with both a high consumption of alcohol and metabolic risk factors, such as obesity or diabetes, should therefore be considered a particularly high-risk group for cirrhosis. Additional studies regarding the efficacy of screening for advanced liver fibrosis or cirrhosis in these risk groups are needed. The most effective and established method for reducing the risk of progression in ALD is alcohol abstinence, whereas weight loss is effective in NAFLD. In this narrative review, we introduce the reader to the literature of the field and present key studies showing this interactive effect.

中文翻译：

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代谢综合征和饮酒之间的相互作用会增加患肝病的风险

酒精相关性肝病（ALD）和非酒精性脂肪性肝病（NAFLD，最近更名为代谢功能障碍相关脂肪肝病[MASLD]）有许多共同特征，包括某些病理生理机制、易感基因和组织学病变。然而，单独研究的这两种疾病的自然史显着不同，ALD 与肝硬化和肝脏相关死亡率较高的风险相关。此外，有证据表明，ALD 和与 NAFLD 相关的代谢危险因素之间存在交互作用，会增加进行性纤维化和肝硬化的风险。因此，同时存在大量饮酒和肥胖或糖尿病等代谢危险因素的患者应被视为肝硬化的高危人群。需要对这些风险人群中晚期肝纤维化或肝硬化筛查的有效性进行更多研究。降低 ALD 进展风险的最有效、最确定的方法是戒酒，而减肥对于 NAFLD 是有效的。在这篇叙述性评论中，我们向读者介绍了该领域的文献，并介绍了显示这种互动效应的关键研究。