《代谢功能障碍和酒精相关性肝病(MetALD)：酒精相关性肝病专家小组立场声明》摘译
| 作 者：European Association for the Study of the Liver, 蒋晓玲 |
| 单 位：上海交通大学医学院附属仁济医院 上海市消化疾病研究所 |
| 基金项目： |
| 摘 要： |
| 本立场声明探讨了2023年脂肪性肝病（SLD）命名下酒精使用与代谢功能障碍之间的复杂关系。应准确评估所有SLD患者的近期和终生饮酒情况，以便统计每周饮酒量。酒精生物学标志物（如磷脂酰乙醇）、酒精使用障碍筛查量表，以及来自朋友和亲属的信息都可以帮助区分单纯酒精相关性肝病与代谢和酒精相关性肝病。大量饮酒可导致心血管代谢危险因素，如高血压、高脂血症和高血糖，根据2023 SLD命名标准的建议，不应仅用1种代谢功能障碍标准诊断代谢功能障碍相关SLD，特别是在女性饮酒量>140 g/周和男性饮酒量>210 g/周的个体中。应定期评估代谢功能障碍和酒精使用，以做好对SLD的预后评估和管理，解决代谢和酒精相关问题。 |
| 关键词：非酒精性脂肪肝；酒精相关性肝病；酒精性肝病；酒精性肝硬化 |
An Excerpt of Metabolic Dysfunction and Alcohol-related Liver Disease (MetALD): Position Statement by An Expert Panel on Alcohol-related Liver Disease
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| Abstract: |
| This position statement explores the intricate relationship between alcohol use and metabolic dysfunction in the context of the 2023 nomenclature for steatotic liver disease (SLD). Recent and lifetime alcohol use should be accurately assessed in all patients with SLD to facilitate classification of alcohol use in grams of alcohol per week. Alcohol biomarkers (e.g., phosphatidylethanol), use of alcohol use disorders identification test, and collateral information from friends and relatives could help differentiate between alcohol-related liver disease per se and metabolic and alcohol-related liver disease. Heavy alcohol use contributes to cardiometabolic risk factors such as high blood pressure, hypertriglyceridemia, and hyperglycemia. As a result, caution should be exercised in the application of only one metabolic dysfunction criterion to diagnose metabolic dysfunction-associated SLD, as suggested in the 2023 nomenclature document, particularly in individuals exceeding weekly alcohol use thresholds of 140 g for women and 210 g for men. Additionally, metabolic dysfunction and alcohol use should be reassessed over time. This approach could ensure a more accurate prognosis assessment and effective management of SLD addressing both metabolic and alcohol-related factors. |
| Keywords: Non-Alcoholic Fatty Liver; Alcohol-Related Liver Disease; Alcoholic Liver Disease; Alcoholic Cirrhosis |
| 投稿时间：2026-01-04 |
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